The changing market of health insurance

I recently found this article about health insurance and thought it was relevant to the assigned reading for this week.  The article briefly describes the story of Jerry Garner, a man who underwent a kidney transplant and who ended up uninsured.  After mistakenly ignoring a survey sent by his previous insurer, Garner lost his insurance.  Without health insurance, the $2000/month costs of his immunosuppressant drugs had to be paid out of pocket.  As could be expected, this steep bill was a huge burden for the Garner family.   Even though the family was often forced to choose between the mortgage and the drugs, they didn’t completely forgo the medications needed to keep Mr. Garner alive.  This emphasizes the idea that there is not a limit on price when it comes to life and death decisions.  Garner did not have insurance, but he was willing to pay $2000 that he did not have in order to receive the medication.

Fortunately, Garner was eventually able to find and qualify for a pre-existing condition insurance plan.

We have always known that insurance companies do not want to insure people with pre-existing conditions because of the risk they pose to the companies profits.  People suffering from conditions such as diabetes or people who have had organ transplants cannot shop around for insurance companies because no one will take them on.  Instead, they are forced to pay out of pocket for their medical expenses, or forgo the treatments altogether (and as we have learned, people are usually willing to pay anything for their medical care even if they cannot afford it).

Until recently, health insurance has been virtually impossible for those with pre-existing conditions (unless they entered a state high risk pool).  The new health care law has now required pre-existing insurance plans, which have much lower premiums than the state high risk pools.  The new plans offer standard coverage, extended coverage, or a plan with a high deductible and health savings account.  Though there are eligibility restrictions (you must be uninsured for at least 6 months, cannot be on Cobra, must have proof you are uninsured, etc), this is a good temporary option for people who would otherwise not have access to health insurance and is evidence that the health market is changing.

 

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1 Comment

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One response to “The changing market of health insurance

  1. Leila Houshmand

    I too agree that the new Affordable Care Act reaching out to pre-existing conditions is a huge milestone. The number of stories that I have read about people losing insurance because of miniscule things or the number of things that insurance companies count as a ‘pre-existing condition’ is absurd. In this case, the fact that the man was dropped from insurance because he did not fill out a survey is crazy to me. In this case, it looks like insurance companies are just looking for reasons not to provide care to their members, which is the principle of why insurance is purchased. I think if this had happened in many other markets it would have been questioned, but the political pull of insurance companies have allowed their practices to go on unquestioned. Hopefully, the Affordable care act and health insurance for those with pre-existing conditions is a step in the right direction.

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