Xequecal wrote:
I don't think the time lag issue is a major factor in the viability of healthcare on the employer market vs. the individual market. On average, if something happens to you, there's less than six months until the next open enrollment period. This does not help you if you get hit by a bus, but in that case EMTALA makes sure you get the treatment you need. The average person can't afford a hospital bill for major trauma anyways so it will just get written off and charged to "the system" in pretty much exactly the same way it would have had the person actually been insured. With regard to serious chronic problems, the system essentially not having to pay for 5-6 months of that problem for "opt-outers" before it has to start paying is just not enough to change the underlying numbers much.
For many of the serious and expensive conditions, six months makes a major difference. Cancer in particular. Taken in context of the lower cost of employer health plans, yes, the limits on purchasing are a significant factor in decision making.
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This also has to be contrasted with the consequences on the employer market vs. the individual market. On the employer market, if you decide to go without healthcare, the worst possible result is you have to wait 5-6 months to start getting insurance to pay for whatever problem you developed. In an individual market that allows discrimination against pre-existing conditions, the worst possible result of going without insurance is that you are literally **** out of all non-emergency/Medicaid health care forever as no insurance company will ever touch you again.
No you're not. You go get the care and the system writes it off. People never actually go without healthcare if they ask for it. Certain providers might not touch you but there's lots of charity care available.
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Next, even if you had insurance, well, you'll get THIS problem paid for, but now you're high risk and your premiums are likely to be so high that you can't afford insurance anymore. So if you ever get another problem, sucks to be you. Also, if you develop a chronic problem for which treatment will take longer than the remaining length of your current insurance contract, you're not getting that paid for either and you'll also never be able to get insurance again afterwards. A person on the employer marketplace doesn't have to deal with any of these concerns, simply because he's on the employer marketplace. Also, while we do love to hate on fat people, the fact that the employer marketplace gives you the privilege of being able to be 400 pounds and still get cheap healthcare regardless is definitely another perk you get simply because you're getting healthcare via an employer.
If things really worked like this, individual plans wouldn't even be available for purchase. No one would buy them. You'd be smarter to just keep the money, pay what you could, and eat the bankruptcy if you had to.
As for fatasses, they may get to pay no more than anyone else, but the employers pay these costs, even in just the form of generally higher rates. This is why employee wellness programs are becoming more popular. People don't want their employers intruding into their lives, but there's a legitimate point that if you can't stop scoffing Doritoes and smoking 3 packs a day and you're losing time at work and costing money, your employer should be able to do something about it.
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