When discussing health care, or hearing about it in the news, you are sure to come across the subject of “pre-existing conditions.” The Left rails against insurance companies for “discriminating” against potential clients because of their pre-existing conditions.
So what is a pre-existing condition? Let’s examine the phrase. Taking the last part first, it’s a medical condition, like diabetes, or asthma, or cancer, or any of a number of other maladies, that a patient needs to continue to treat because of its persistence. But what does the “pre-existing” part mean? That needs a little more explanation I think. What event took place that this condition existed before?
To the leftist politician, defining that part doesn’t matter. All they want you to believe is that insurance companies are unfairly withholding their service from innocent people. To them “pre-existing” only means the patient’s condition pre-existed their current search for coverage.
But this event, that makes the pre-existing modifier possible, is very important in understanding the mess the insurance industry is in. This event always has to do with someone’s job situation. It could be an employer changing providers, or it could be an employee switching jobs or losing a job altogether.
You see, the government has been meddling with the insurance industry for a while and in many ways. For this discussion though, we only need to look at the tax benefit given to employers for purchasing coverage for their employees. This is a leftover from WWII price and wage controls where employers weren’t allowed to offer bigger salaries to attract workers. Instead, America’s resourceful companies offered more benefits to employees that they wanted to hire. Eventually big tax benefits were attached to these benefits when offered by an employer, while individuals searching for insurance on their own couldn’t get the same benefits. So now it’s much cheaper to get your insurance through your employer than it is to get it on your own. This system has essentially killed the market for individually purchased insurance.
You might think this is a nice way to save a buck, but rather it has caused the situation we now have. It’s what we call “unintended consequences.” Because your insurance is attached to your job, you make employment decisions based on that insurance, instead of making employment decisions based solely on the employment situation. This is especially true if you have a pre-existing condition.
For example, let’s say you’ve had a decent job for a few years, and recently developed a medical condition (it’s not “pre-existing” yet!). You’ve had the same insurance at this job for a while and since your condition arose while under your current policy, your treatment is covered. But another company has seen your work and they are impressed enough to offer you a 15% raise along with a new title and bigger responsibilities. And your current company can’t match the offer. Without our government’s interference, this would be a no-brainer; you would take the new job, the new salary, and be excited about advancing your career. But as you see, government controls are affecting your decision. The new company’s insurance isn’t that great. You’ll have to pay a lot more for your treatments. Maybe they won’t cover it at all. What do you do? Do your own thought experiments for losing a job, or for having a child with a condition that grows up and has to leave your family’s coverage, and you’ll find similar government created predicaments.
And of course, this mess is driving up costs. People end up switching insurance companies more often than they would without government interference, especially today when we switch jobs more than people did a generation before. Every new policy creates more paperwork, and paperwork costs money. For an example of this waste, I didn’t have to look too far. I switched jobs recently. My new gig has the same insurance that the last one did, but still I had to get a new policy and I had the pleasure of filling out the same exciting paperwork. How ridiculous is that? I didn’t have to change my auto or home insurance because I took a new job.
Back to my main point though. The only reason we are familiar with the term “pre-existing condition” is because of government intervention in the economy. Incentivizing employer based insurance has created the problem and pushed the term onto the stage. If the government got out of the way, the problem, and the term, would practically disappear. And it only takes an ounce of economic imagination to see why.
Using the example from above, you would have shopped for your own insurance separately from your job (just like car insurance, life insurance, home insurance, boat insurance, or other non-insurance things like groceries), and when offered that new position at a different company you’d happily accept it, keeping your current insurance in tact. What if you lost your job and couldn’t pay your insurance? Well, insurance companies would be free to offer job-loss insurance for a higher premium. Maybe an extra $20 a month would cover you if you were out of work for a couple years (isn’t this what Aflac does?).
But what about the child that has grown too old to stay on his families insurance? After all, they’re not switching jobs? Well, I think the insurance companies would have this figured out as well. I actually think they would be banging on the delivery room door with offers for lifelong policies. Instead of being on your parent’s employer’s plan as a child, your parents might put you on your own plan that you can keep with you and pay for when you come of age. Under the current system, they’re not banging on anybody’s doors. They don’t have to. They don’t have to compete for our business.
Of course our government doesn’t understand this. They rarely take the time to understand the cause of a problem, especially when that cause is staring back at them in the mirror. Instead, they think of new laws, penalties, and subsidies (funded by ours truly) adding gasoline to the fire. Unintended consequences like this are pre-existing conditions of government intervention.