Insurance Companies Rape Women Worse

[Einhander Sn0m4n]

USA: How Our Health System Screws Over Women

USA: How Our Health System Screws Over Women

To be sure, no group is doing well under our network of private insurers, which is more holes than net.

But women fare particularly badly in terms of health, being more likely than men to leave a prescription unfilled; forgo seeing a needed specialist; and skip a medical test, treatment or follow-up.

Financially, women are worse off, too, in large part because they earn less money. Despite the fact that they skimp on their care to cut costs, three in five women are still unable to pay their medical bills.

All of which makes it surprising that men and women support health reform in almost equal numbers (38 versus 40 percent consider it a top priority, according to a recent Kaiser poll).

Odder and ickier still is the sight of Sarah Palin, Betsy McCaughey and other women leading, or sometimes blindly following, the wacko town hall movement against reform.

Many of women's problems stem from the fact that to get anything close to decent private insurance, you usually need a full-time job, which women are less likely than men to have, 52 percent versus 73 percent. (The flip side of this problem is that linking jobs to insurance leaves many women tethered to full-time jobs they'd rather not have, given their other responsibilities. In fact, 60 percent of full-time working mothers would prefer part-time work, according to a 2007 Pew poll. While some keep their full-time jobs for the income, many others stay because they have no other way to get health benefits.)

Many women who work part-time or stay at home have become a sort of medical underclass, stuck without insurance, paying dearly for it out of their own pockets or, as was Jemilla Mulvihill's experience, begging desperately, and unsuccessfully, for the opportunity to pay dearly for it out-of-pocket.

A 38-year-old yoga instructor and personal trainer, Mulvihill was uninsured when she recently discovered she was pregnant.

She had made do without coverage throughout her adult life, relying mostly on luck and over-the-counter remedies.

This time, she knew she needed something more. Even without the cost of prenatal care, a standard in-hospital delivery typically runs between $7,000 and $10,000.

If anything went wrong, the costs would be way higher. So Mulvihill resigned herself to buying private insurance, hoping to put it on a credit card and pay it off at some point in the distant future. Yet, after spending hours calling private insurance companies, she found none would take her. The reason?

Private insurers can legally reject pregnant women on the grounds that their pregnancy is a pre-existing condition.

While federal law forbids group health plans from playing this sleazy trick, on the individual market, companies face no such restriction. Given the loophole, seemingly all insurers jump through it.

Even though not getting prenatal care is a technically a violation of the law (according to family law experts, women could be prosecuted for neglect, though they rarely if ever are), private insurance plans for individuals aren't required to help them get it.

When looking for real help, many uninsured pregnant women encounter this utterly useless advice: get a policy before conceiving.

Yet planning ahead doesn't necessarily solve women's insurance problem. Many women couldn't afford whatever care they find, since companies often charge women more, in one case as much as 140 percent more, for the same health coverage, according to a 2008 study by the National Women's Law Center.

And only the lucky have the privilege of paying even these high prices, since companies can simply reject women for anything from having been subject to domestic violence to having had a C-section.

Meanwhile, the vast majority of individual plans don't even offer maternity coverage. Only 7 percent of women get insurance through the individual market, yet its unwelcoming practices clearly contribute to the fact that another 18 percent are uninsured.

So what's a pregnant woman to do if she can't afford insurance? Some women take their chances, skipping the doctor's visits and hoping for the best. (A startling 15 percent of American women receive no prenatal care in the first trimester, a fact that contributes to our appallingly high infant mortality rate).

Other women "spend down," forgoing income to qualify for Medicaid. Even then, they can wind up without prenatal care for long periods, since twenty states lack laws allowing pregnant women to receive time-sensitive coverage while waiting for approval of their Medicaid applications.

Mulvihill took this route, and is still grateful to the benefits worker who granted her a Medicaid card, despite the fact that her income was slightly above the cutoff in New York City at the time.

"I wanted to give her a hug," Mulvihill said later. "It was either have an abortion, or I'm going to have this child and the decision was in this woman's hands."

Still other women spend their money on the bogus health companies that have slithered onto the scene to exploit uninsured pregnant women.

These faux insurers should be Exhibit A in what's wrong with our current system. You can find two of them listed on PregnancyInsurance.org, a website that purports to offer solutions for uninsured pregnant women and heavily promotes two companies: Affordable Health Care Options (AHCO) and Ameriplan.

Unfortunately, despite the website's name and the companies' sly advertising, neither actually offers insurance to pregnant women. It turns out Pregnancyinsurance.org is run by a "life-affirming Christian ministry," which helps explain its relentlessly money-is-no-object tone when it comes to women having children they can't afford.

(Among the money-saving suggestions it offers uninsured pregnant women are signing up for Medicaid, eating well and looking into home births, which are "considerably more economical than hospital births.")

Ameriplan, a huge multilevel marketing company, capitalizes both on women's overall lack of health insurance and their need for part-time employment by setting up work-from-home businesses selling "discount medical plans."

(According to the company's website, the fact that seven in ten Americans is either uninsured or underinsured "presents the opportunity of a lifetime!") Unfortunately, women haven't had much luck either selling or using the cards.

In 2006, the Montana State Auditor sued the company, charging that it didn't actually hold up its end by contracting with local healthcare providers, leaving the Montanans who bought discount cards from the company out of luck, and their monthly fee, which ranges up to $59.95.

Ameriplan gave the state $200,000 as part of a settlement of the suit, which charged the company with conducting a pyramid scheme, in addition to engaging in insurance and securities fraud.

As for AHCO, the company is not only not an insurance company, it's a blatant fraud that exploits pregnant women, according to the Texas Office of the Attorney General, which sued AHCO in 2008, alleging that, while the company sells a "Maternity Card" that it says offers maternity services, such as doctor's visits, hospital stays, lab work, sonograms and prescriptions, "in truth and in fact the Maternity Card offers none of these services."

Healthcare reform shouldn't harm Trig Palin, as Sarah Palin has suggested it might, but it would put a knife through the hearts of the bottom-feeding companies that prey on uninsured, pregnant women.

By forbidding real insurers from denying coverage on the grounds of pre-existing conditions, as four of the five proposals now floating around the various Congressional committees would, reform should eliminate pregnant women's desperate search for coverage.

Most of those bills would also outlaw the practice of "gender rating," or charging women more for the same policies, though the Senate Finance Committee version would reportedly allow insurers to charge companies with more than fifty employees more for women.

It's still unclear how much money the government would offer to help pay for insurance premiums and out-of-pocket costs.

Since women still struggle more to cover these expenses, the size of the subsidy will determine whether they'll really be able to afford the insurance they'll be required to buy.

The biggest question of all, of course, is still whether any version of health reform will pass. In part, the answer will rest on whether women remain silent or, worse, contribute to the twisted version of events offered by groups like Concerned Women of America and (the sadly co-ed) Conservatives for Patients' Rights.

The best hope for the more than half of women who are uninsured or underinsured would be to lend their support to groups like the National Partnership for Women and Families, the National Women's Law Center and Moms Rising, who are actively fighting for reform, and against the misrepresentation of women's experience.

If they don't, women's prognosis for escaping the medical underclass, and the sleaze that comes with it, is grim.

Source: Alternet.org, 24 August 2009

Hmm, I have a sneaky suspicion that insurance companies might also charge black and gay people more for less coverage, too. Fucking disgusting, and yet another reason the entire insurance industry needs to be fucking PUNISHED!!!

[Broomstick]

It's been a long while, but remember that black men used to be chronically under employed in the US (arguably, they still are) and just as it was once legal to pay a black person less for the same work as a white person did, so, too, could less or even no health insurance be provided at a company where the while people did get insurance. That sort of discrimination is no longer legal, but blacks are disproportionally under and uninsured due to the economic realities of having shittier job situations. Black AND female is even worse, and indeed, black babies have a higher morbidity and mortality rate than white babies.

As for gays - whether open or not, I do recall there being bias against them in the 1990's when HIV was making the rounds and the grounds that gay people were at higher risk for highly expensive medical care. This escalated to the point of companies specializing in paying people with HIV to name them as beneficiaries on their life insurance so as to allow them to tap into some of the value of those policies BEFORE they died so as to pay crushing medical bills.

So, overt or not, the bias against blacks and gays also exists in the insurance industry.

[KroLazuxy_87]

My fiance is currently $5,000 in debt to a hospital, and her insurance has fought her every step of the way in trying to get her back pain properly treated. I could start a whole thread and have a discussion(rant) about it all on my own enough to fill three pages... I'm just gonna stop now before I figure out what to fume about. Keep an eye out for a post in the Venting thread, I'm gonna stew on this for a bit first...

[Serafina]

Just one quick question:

Is the number "140% more for equal coverage" right? Do woman seriously have to pay more than twice for equal coverage?
Or is it "40% more for equal coverage", which means that they have to pay 40%?
Which would still be bad discrimination, but 140% more - thats just fucked up.

Good night
Fina

[Broomstick]

"More than twice as much for the same coverage" is accurate, yes. In fact, three time the rate for a man of the same age and state of health is not uncommon.

Yes, it is fucked up.

[Jaepheth]

I'm not sure I see why the insurance companies need to be punished.

Insurance is, has been, and always will be about the numbers. It's a simple fact that males do not ever require prenatal care, do not suffer problems associated with menopause, etc. Also, men statistically die sooner than women and so are less likely to require extended medical care toward the end.
As for blacks and gays being charged more, I would think that the insurance companies are acting on studies that indicate that those groups are at higher risk for medical problems. (For example, gay men are typically asked not to donate blood due to the increased risks)

The question is, do you want a user-pay system, where those more likely to require health care must pay more for it? Or is it more desirable to charge everyone the average price and thus overcharge those who happen to be healthy (or rather, members of a statistically healthy or inexpensively cared for group).

Now don't get me wrong; I'm in favor of universal health care (I don't think there should be profit motivation in healthcare), but I think it's a bit unfair to say the insurance companies are evil and deserving of punishment without evidence that their mortality tables are politically motivated.

[Korvan]

Seems that from the insurance companies point of view, ovaries are a preexisting condition.

[Serafina]

[quote="Jaepheth"]I'm not sure I see why the insurance companies need to be punished.

Insurance is, has been, and always will be about the numbers. It's a simple fact that males do not ever require prenatal care, do not suffer problems associated with menopause, etc. Also, men statistically die sooner than women and so are less likely to require extended medical care toward the end.
As for blacks and gays being charged more, I would think that the insurance companies are acting on studies that indicate that those groups are at higher risk for medical problems. (For example, gay men are typically asked not to donate blood due to the increased risks)
/quote]

It may bee justifiable from a economic point of view - although i doubt that women cost the companies three times as much as men.

But it is not justifiable from a social point of view. All these three things are not a question of lifestyle - it's simply not your fault if you are black, gay or a woman.
Insurance companies should only be able to charge more if it clearly your fault that you will cost them more - be it an unhealthy lifestyle, or simply bad driving.

It seems reasonable to make an exception for age - after all, anyone gets older, and while it isn't your fault, it affects everyone.

I thougt US-americans would understand the concept of "equal chances for everyone", but again, they seem to be totally ignorant of socialist concepts that increase chances.

[The Grim Squeaker]

But it is not justifiable from a social point of view.

That should only apply if you were using a government funded healthcare system, as opposed to a private system focused on charging people according to costs (and not fairness).

All these three things are not a question of lifestyle - it's simply not your fault if you are black, gay or a woman.

True, but it's not someones fault if they're born deaf, blind and dumb, or with a variety of permanent expensive illnesses. Under a government system, the taxpayers would pay for it, but in a system that aims for charging as little as possible (from each according to his premium), said person is fucked, since he really does "cost" the company a lot more than a normal healthy person.

Insurance companies should only be able to charge more if it clearly your fault that you will cost them more - be it an unhealthy lifestyle, or simply bad driving.

That would be an excellent improvement for Gubermental health schemes. For private, non subsidized companies, you can't force them to charge less than their costs for an individual.

[Serafina]

<snip>

Which is exactly why a profit-oriented health care system is morally wrong, and a govermental controlled system (be it by strict laws for companies or a govermantal run system) is morally superior.

[The Grim Squeaker]

<snip>

Which is exactly why a profit-oriented health care system is morally wrong, and a govermental controlled system (be it by strict laws for companies or a govermantal run system) is morally superior.

Morals are great, though it has little to do with efficiency or what works. It's morally wrong that you have a massively superior quality of life to 80% of the world's population just due to where you were born for example .

(Disclaimer: Before people jump on me, I support national health care, I live in a national health care system [Israel], and I only support private health care options if run in conjuction with a nationwide health system (like the one in Singapore for example, or scandalously expensive private options here [which I don't use]).

[Simon_Jester]

It may be justifiable from a economic point of view - although i doubt that women cost the companies three times as much as men.

But it is not justifiable from a social point of view. All these three things are not a question of lifestyle - it's simply not your fault if you are black, gay or a woman.
Insurance companies should only be able to charge more if it clearly your fault that you will cost them more - be it an unhealthy lifestyle, or simply bad driving.

It seems reasonable to make an exception for age - after all, anyone gets older, and while it isn't your fault, it affects everyone.

The following is intended solely to clarify what your position is:

It often isn't your fault that you caught some kind of particularly nasty disease. Should someone who got AIDS from a blood transfusion have to pay more for health insurance? I suspect your answer is "no," and I agree that the answer ought to be "no." But what if they get AIDS from, say, injecting themselves with illegal drugs? It's definitely your fault that you stabbed yourself with a dirty needle. Do you believe or not believe that such a person should have to pay more?

I thougt US-americans would understand the concept of "equal chances for everyone", but again, they seem to be totally ignorant of socialist concepts that increase chances.

Right. Sure. Sneers aside, the fact that someone says 'I don't see why the insurance companies need to be punished for this... women may cost the insurance companies more' proves less than you imply it does. At most, it proves you're talking to someone who doesn't see the insurance companies as some sort of cartoon villains who will jack up insurance rates on women for the sheer love of doing so, whether it makes sense or not. It does not prove that they are ignorant of the concept of equal access.

A lot of people understand concepts without applying them fanatically in every situation, and I'm surprised you didn't realize that people like that can exist in such a vast group as "US-americans." There are about three hundred million of us. Surely you don't believe that a country with bad policies must be made up exclusively of people who are absolutely ignorant, and to be sneered at for their ignorance?

[Serafina]

It may be justifiable from a economic point of view - although i doubt that women cost the companies three times as much as men.

But it is not justifiable from a social point of view. All these three things are not a question of lifestyle - it's simply not your fault if you are black, gay or a woman.
Insurance companies should only be able to charge more if it clearly your fault that you will cost them more - be it an unhealthy lifestyle, or simply bad driving.

It seems reasonable to make an exception for age - after all, anyone gets older, and while it isn't your fault, it affects everyone.

The following is intended solely to clarify what your position is:

It often isn't your fault that you caught some kind of particularly nasty disease. Should someone who got AIDS from a blood transfusion have to pay more for health insurance? I suspect your answer is "no," and I agree that the answer ought to be "no." But what if they get AIDS from, say, injecting themselves with illegal drugs? It's definitely your fault that you stabbed yourself with a dirty needle. Do you believe or not believe that such a person should have to pay more?

"False dilemma"-fallacy.
You see, you can have both. We HAVE both in Germany - if you are injuring yourself by your own fault (accidents do not count, obviously), then you will get only limited or no coverage.

The insurance companies have to show that you did inujure voluntarily or by criminal neglicience - if that is the case, you may be denied coverage.

For most serious injuries and diseases, you get coverage anyway, but if it is not life-threathening or crippling, you will be denied coverage.

Right. Sure. Sneers aside, the fact that someone says 'I don't see why the insurance companies need to be punished for this... women may cost the insurance companies more' proves less than you imply it does. At most, it proves you're talking to someone who doesn't see the insurance companies as some sort of cartoon villains who will jack up insurance rates on women for the sheer love of doing so, whether it makes sense or not. It does not prove that they are ignorant of the concept of equal access.

A lot of people understand concepts without applying them fanatically in every situation, and I'm surprised you didn't realize that people like that can exist in such a vast group as "US-americans." There are about three hundred million of us. Surely you don't believe that a country with bad policies must be made up exclusively of people who are absolutely ignorant, and to be sneered at for their ignorance?

Granted, i generalized here.

However, i was talking aobut the "general public" and politicans. "The american dream" is that everyone can get rich.
To me, the everyone part of it makes equal chances a necessity. Thus, i expected that americans are nearly fanatical about "equal chances".
I merely commented on the fact that they are not, which surprised me and seems highly inlogical.

[Simon_Jester]

...
It often isn't your fault that you caught some kind of particularly nasty disease. Should someone who got AIDS from a blood transfusion have to pay more for health insurance? I suspect your answer is "no," and I agree that the answer ought to be "no." But what if they get AIDS from, say, injecting themselves with illegal drugs? It's definitely your fault that you stabbed yourself with a dirty needle. Do you believe or not believe that such a person should have to pay more?

"False dilemma"-fallacy.

How is this a false dilemma, and how am I committing a fallacy by asking the question? I wasn't claiming that you have to charge the person who got AIDS by stabbing themself with a rusty needle full of drugs the same as you do the person who got it from a blood transfusion. I was asking if you thought so, one way or the other.

In a profit-oriented plan, they both pay the same (high) price. In a rigorously egalitarian system, they both pay the same price (as everyone else). In a compromise system, one of them pays more than the other because one of them was at fault and the other wasn't. Fine by me.

But from what I knew about your opinions, I couldn't predict in advance whether that would be acceptable to you.

Granted, i generalized here.

However, i was talking aobut the "general public" and politicans. "The american dream" is that everyone can get rich.
To me, the everyone part of it makes equal chances a necessity. Thus, i expected that americans are nearly fanatical about "equal chances".
I merely commented on the fact that they are not, which surprised me and seems highly inlogical.

OK, that makes sense.

But if you're going to insult me, I request that you stick to insults which are true, or at least plausibly true. "All Americans do not understand [simple concept]" is not plausibly true, for statistical reasons.

[Serafina]

<snip>

Well, i like our current (german) system.

You pay the same most times, even if you have preexisting conditions - unless they are clearly your fault (by criminal neglicience or voluntary stuff).
Some examples:
-you get cheap breast surgery (or something similar, you pay that yourself) and something goes wrong - you most likely have to pay the following treatments on your own (unless you sue the doctor).
-you are not taking your prescribed medication - you are responsible if you get worse, and some of the costs will be paid by yourself
-you are not wearing your dental braces - if this affects the treatment, you may be responsible for some of the costs.
-you have an accident on your motorbike - whether its your fault or not, expenses will be paid for you
-You sleep with someone who has a STD - expenses will be paid (since its pretty unlikely that the insurance company can proove that you wanted to have that STD)

A special case: If you are transsexual but are taking hormones on your own (without the assistance of any doctor/psychatrist) then it may happen that you have to pay the (substantial) expenses on your own, since the companies will claim that the hormones caused the transexuality.
Thats about the most unjust ruling i know about - which shows that it mostly IS just, with the expection of a few borderline cases.


Be assured that i never wanted to insult you or any US-americans, and if i did, i apologize.
I wanted to point out that some behaviour seems to be contradictional, but it was NOT meant as an insult.

[Surlethe]

I think it's a bit unfair to say the insurance companies are evil and deserving of punishment without evidence that their mortality tables are politically motivated.

Your points on the statistical methods used by insurance companies are certainly sound, but why would you withhold the label "evil" until certain motivations are demonstrated?

[Einhander Sn0m4n]

I think it's a bit unfair to say the insurance companies are evil and deserving of punishment without evidence that their mortality tables are politically motivated.

Your points on the statistical methods used by insurance companies are certainly sound, but why would you withhold the label "evil" until certain motivations are demonstrated?

Greed is evil, after all. Even equal-opportunity greed, which the OP's link says this is certainly not.

Seems that from the insurance companies point of view, ovaries are a preexisting condition.

And the truth is very much self-evident that "Preexisting Condition" is Insurancese for "No, I will not help you, now could you please fuck off and die painfully in the street already?"

[Darth Wong]

I think it's a bit unfair to say the insurance companies are evil and deserving of punishment without evidence that their mortality tables are politically motivated.

Your points on the statistical methods used by insurance companies are certainly sound, but why would you withhold the label "evil" until certain motivations are demonstrated?

Because corporations are amoral, not evil. They act predictably within the rules of the game they play. Any CEO who tried to play the game differently would be promptly ousted by the board of directors for reducing the profitability of the organization. Any board of directors which did not behave this way would face a shareholder revolt.

It's the entire financial system as it is currently constituted which could be said to be "evil", not the corporations in it. They are amoral (which is not much better, but there's a difference).

[KroLazuxy_87]

Money certainly makes the world go 'round.

Me seemingly arguing with myself:

I've seen stated a couple times above that women cost health insurance companies more because of care related to pregnancy. Shouldn't some of that cost be shifted to men though? Women can't get pregnant on their own, and often times(though not often enough) the woman will be caring for the child with her husband.

The woman is raising the child with a spouse and they share an income, so leaving the cost on the woman is okay since the husband's income will help.

However, all too often a women is raising a child on her own, and doesn't have a spouse to aid in the costs.

Then raise child support payments!

Too many dead beat dads don't pay them anyway...

Then she shouldn't have been sleeping around!

The system let her down though by not properly teaching sex-ed in school or providing condoms.

Jesus was punishing her for _BOOM_ >My head explodes<

[RRoan]

Here's hoping we get universal health care before my parent's insurance stops covering me in a couple years...

[The Kernel]

Because corporations are amoral, not evil. They act predictably within the rules of the game they play. Any CEO who tried to play the game differently would be promptly ousted by the board of directors for reducing the profitability of the organization. Any board of directors which did not behave this way would face a shareholder revolt.

Usually true, but not a universal rule. Take the example of Costco and let me quote an interview with its CEO Jim Sinegal:

Q: You recently announced that August same-store sales were up 9%, yet Wall Street analysts were unhappy because you hadn't met their expectations.

A: You know, that has nothing to do with reality. Analysts put their own numbers on things, and we can't help them there. We think that 9% in the state of this economy is pretty good.

Q: Some of those analysts have argued that Costco's generosity to its workers hurts the company and its shareholders.

A: You have to recognize -- and I don't mean this in an acrimonious sense -- that the people in that business are trying to make money between now and next Thursday. We're trying to build a company that's going to be here 50 and 60 years from now. We owe that to the communities where we do business. We owe that to our employees, that they can count on us for security. We have 140,000 employees and their families; that's a significant number of people who count on us. We owe it to our suppliers. Think about the people who produce products for us -- you could probably multiply our family of employees by three or four times. And we owe it to our customers to continue to offer good prices. Our presence in a community makes pricing better throughout that community because when you have a tough competitor in the marketplace, prices come down.

Sinegal is notorious because he has managed to maintain high growth at Costco while thumbing his nose at Wall Street by paying employees a living wage and giving them premium benefits, yet still competing with the likes of WalMart.

[Tiriol]

Usually true, but not a universal rule. Take the example of Costco and let me quote an interview with its CEO Jim Sinegal:

Q: You recently announced that August same-store sales were up 9%, yet Wall Street analysts were unhappy because you hadn't met their expectations.

A: You know, that has nothing to do with reality. Analysts put their own numbers on things, and we can't help them there. We think that 9% in the state of this economy is pretty good.

Q: Some of those analysts have argued that Costco's generosity to its workers hurts the company and its shareholders.

A: You have to recognize -- and I don't mean this in an acrimonious sense -- that the people in that business are trying to make money between now and next Thursday. We're trying to build a company that's going to be here 50 and 60 years from now. We owe that to the communities where we do business. We owe that to our employees, that they can count on us for security. We have 140,000 employees and their families; that's a significant number of people who count on us. We owe it to our suppliers. Think about the people who produce products for us -- you could probably multiply our family of employees by three or four times. And we owe it to our customers to continue to offer good prices. Our presence in a community makes pricing better throughout that community because when you have a tough competitor in the marketplace, prices come down.

Sinegal is notorious because he has managed to maintain high growth at Costco while thumbing his nose at Wall Street by paying employees a living wage and giving them premium benefits, yet still competing with the likes of WalMart.

It appears that what we have here is a genuine case of someone who understands the meaning of company's responsibility for the society and acts accordingly. And considering that the company is doing rather well it seems to work just fine. An excellent example to strive for.

[Questor]

Sinegal is notorious because he has managed to maintain high growth at Costco while thumbing his nose at Wall Street by paying employees a living wage and giving them premium benefits, yet still competing with the likes of WalMart.

Costco also works with the special ed programs in our area. And because they pay a living wage and give decent benefits, a lot of the kids who are developmentally disabled, but still able to function on their own can get a job and benefits.

[Jaepheth]

In my mind, "evil" conveys a sense of malice, and I simply don't see malice in the insurance companies' actions (in this scenario). So I'd agree with Mike in calling them amoral as opposed to evil.

I'd propose the following thought experiment.

1. Let's say there's an insurance company willing to charge everyone the same, average price for health care.
2. Many members (white middle and upper class males) will goto a user-pay company because they will pay less there.
3. Our fictional company must now raise its rates because with the loss of the low cost customers, their average cost has gone up. If they do not do this, they will begin losing money and go bankrupt.
4. Now that the average has gone up, a lot more people find themselves paying more than they would at a user-pay company. They now leave.
5. GOTO 3; etc, etc, until only the highest cost customers remain at our fictional company at which point they are essentially paying the same price that they would at a user-pay company.

So we see that in a free-market scenario, the user-pay system represents a sort of Nash equilibrium.
I see two viable solutions to this:
1. Subsidize the fictional company and allow them to operate at a loss and therefore not need to raise rates.
or
2. Mandate the average-premiums system so that it's the only game in town. This prevents our fictional company from having to compete with user-pay systems and the only subsidies needed would be for the poor who cannot afford the average premium.

I believe the second solution is better because it would mostly be self-sufficient.


As for pre-existing conditions. Remember, an insurance company's business is risk, not paying medical bills. As soon as it's known that a condition exists, then there ceases to be any uncertainty about a person needing treatment, at which point it's literally none of their business. You might as well go to a grocery store and ask to see their used cars.