Listen to some Republicans tout the advantages of high-risk insurance pools and you would think they have found the perfect replacement option for Obamacare.

It’s going to work just like auto insurance, I heard one congressman explain during a TV interview. The marketplace provides one set of insurance policies for people who are high risk and another set of insurance policies for the rest of the country.

What advocates of such a system fail to mention is that car owners in the high risk pools got there because of poor driving records.

OPINION


People considered “high risk” by the health insurance industry may have been born with a genetic disease, or suffered a serious injury at home, or may be victims of arbitrary insurance rules.

For example, many years ago I wrote a column about a firefighter who had suffered a heart attack at home and died in front of his three young children.

His widow decided to have her children see a therapist as a precautionary measure and paid for the treatment out of her own pocket. When her husband’s employer-based health insurance lapsed, she sought to purchase a family insurance policy on her own.

The insurance questionnaire asked if any member of her family had been treated for mental illness and she mentioned the therapy her children received. None of them had ever been diagnosed with a mental problem. The treatment was simply precautionary and she stated as much.

Nevertheless, the health insurance company notified her that the family would be considered high-risk for suicide because the children had been to a psychologist. As a result, premiums for health insurance would be so high the woman couldn’t afford them.

All because she had done the right thing as a mother.

I contacted the insurance company and it confirmed everything the widow had told me. Her family was considered high risk because of the mental health care the children had received.

This was before Obamacare. But it was a great example of why national health insurance was needed. Millions of Americans were losing their health insurance due to the loss of a job or change of employment and when they sought insurance in the private marketplace the costs were prohibitive due to “pre-existing conditions.”

Republicans, who never liked the concept of national health care, attacked Obamacare and Trump was elected promising to repeal it.

But there are an estimated 23 million Americans enrolled in Obamacare and Republicans realize that simply dumping them would create a tidal wave of stories like the one I related.

Yet, despite years of complaining about Obamacare, they have no real alternative plan to replace it. There are repeated claims that if only the free market were allowed to operate across state line without government interference all health insurance problems would vanish.

But the marketplace is profit driven. Insurance companies make billions of dollars by insuring healthy people and avoiding customers that could cost them money. The health insurance industry discovered long ago it could make even more money by simply refusing to pay for medical care when it became expensive, even when the conditions and treatments were covered by the insurance companies’ policies.

Some people say they don’t want the government making life and death decisions when it comes to their care, or telling them what doctors they can see. But doctors and hospitals often don’t make health care decisions now. Those decisions get made by insurance companies all the time.
High risk pools are a lousy option for people who are chronically ill. But it’s how insurance companies make money off of them. And that money does absolutely nothing to improve medical treatment.

It’s all about profit, while putting the rest of us at risk.

Email: philkadner@gmail.com

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