donderdag 8 april 2010

Niet-discrimineren op 'pre-existing conditions'-probleem

In de USA staat er in de befaamde Obamecarewet - sorry: 'Patient Protection and Affordable care Act' - is een van de gevolgen dat er niet meer gediscrimineerd mag worden door verzekeraars op 'pre-existing conditions'. Op wikipedia staat het zo:

Insurers are prohibited from discriminating against or charging higher rates for any individuals based on pre-existing medical conditions.
de gevolgen die de economen voorspellen is: mensen gaan proberen zich niet te verzekeren (en de lage boete betalen die je nu moet betalen als je je niet verzekert), tenzij als ze ziek zijn. Nu wil het toch lukken dat we effectief al zo'n voorbeeld hebben, zoals op Division of Labour wordt aangehaald.

Thousands of consumers are gaming Massachusetts’ 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses.

In 2009 alone, 936 people signed up for coverage with Blue Cross and Blue Shield of Massachusetts for three months or less and ran up claims of more than $1,000 per month while in the plan. Their medical spending while insured was more than four times the average for consumers who buy coverage on their own and retain it in a normal fashion, according to data the state’s largest private insurer provided the Globe.

The typical monthly premium for these short-term members was $400, but their average claims exceeded $2,200 per month. The previous year, the company’s data show it had even more high-spending, short-term members. Over those two years, the figures suggest the price tag ran into the millions.

Wie is er nu juist bij gebaat?

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