[ExI] [Exl] Tap tap.. Hello? Is this thing on? (Or Zombie Apocalypse!)

spike spike66 at att.net
Thu Oct 17 06:12:36 UTC 2013



From: extropy-chat-bounces at lists.extropy.org [mailto:extropy-chat-bounces at lists.extropy.org] On Behalf Of Henry Rivera
Sent: Wednesday, October 16, 2013 6:07 PM
To: extropy-chat at lists.extropy.org
Subject: Re: [ExI] [Exl] Tap tap.. Hello? Is this thing on? (Or Zombie Apocalypse!)


Spike wrote:

>>…   exempts congress from the healthcare law that they are imposing on the rest of us.  So we see the
Senate willing to send the government into default in order to impose the
healthcare law on the citizens and simultaneously exempt themselves from
that law.


>… Full time Federal employees including Congressional staff, just like Google and other organizational employees, have insurance provided through their employer. Since they thus have insurance, of course the mandate that they buy insurance doesn't apply…-Henry


Henry I see your point, and have a suggestion.  The Federal government should specifically exempt those people who actually vote on legislation from getting employer-provided health coverage.  It isn’t that many people, 535, and would likely not deter a congressman or senator from running for office.  What it would do is make them go into those exchanges and see for themselves what it is like.


To extend a previous discussion on this topic and make a few predictions, I try to imagine what all this must look like from the point of view of a health insurance company.  They must see what I mentioned before as the first wave after the exchanges opened on 1 October: the profitable track team fleeing and the dead loss zombie horde staggering inbound.  (Or would that be undead loss?)  An insurance company would be swamped with applications from people who are not insurable, and the big profit customers are nowhere to be found: they will opt out for at least two years, if not decades, until they too join the zombies.


So an insurance company would like to just lie low for a while and not issue many new policies, if any at all.  So what are the ways they could make this happen, while making it appear that they are selling policies?  I had some ideas.


Insurance companies, competitors, could temporarily work together and trade customers.  They could offer each other old-ish customers who have never made a claim in the past 5 years, then just trade them among themselves, while the zombie applications pile high.  If an insurance company formerly sold 10k policies per month, they could create the illusion of maintaining that number, while selling no new policies.  The law says they cannot turn people away because of pre-existing conditions, but it doesn’t say they cannot just fail to sell the policy because the agents are busy.  The most profitable insurance companies in the next couple years may be those who figure out how to escape from the zombies, and possibly those companies who manage to chase down and seduce the profitable track team.  But my bet is on escaping the zombies.


Regarding how they would deal with a new customer when they cannot base their coverage on pre-existing conditions, I had a thought on that.  I don’t know exactly how they will do it, but I have every reason to think that they will somehow figure out how to bribe or hack or steal or by some other mysterious means, they will get access to hospital and medical records.  They will figure out somehow or by some mysterious means who has pre-existing conditions, and they will figure out some means of fleeing.  


To get into Healthcare.gov, one is required to supply a social security number.  If an application is made online, the insurance company could just claim someone else used that social security number and therefore the application has been temporarily delayed while identity verification is being performed.  They will use the same definition of “temporarily” as HealthCare.gov, which means it could take years to confirm identity.  They can still argue they didn’t turn the customer away because of pre-existing condition, on the basis that they haven’t actually turned the customer away.  The ACA doesn’t say how quickly an insurance company must act on an application.  The insurance company will not volunteer the information that they were the someone else who used that social security number.


If the customer resorts to paper applications, this too can be easily tripped in the following way.  The insurance company fails to act long enough, the customer sends in a duplicate application.  The company accepts both applications, which are given two distinct policy numbers, payments begin on only one of them.  Customer turns out to be a zombie, sends huge medical bills to insurance company.  Insurance company switches policy numbers and claims payment was never made on the policy in question, refuses to pay.


Another variation on the theme: customer buys new policy, pays, company holds check.  A week later, medical bills start to show up.  Company shreds check, claims payment was never made, policy cancelled.


Customer shows up in person, fills out enormous application by hand.  Application lost.  No evidence can be found that the application ever existed.


I am not even in the biz, and I consider myself a moral person, but all these ideas for escaping the zombies seem pretty obvious to me.  Therefore the real insurance people who really understand risk models, will have thought of a thousand of them by now.  Insurance companies don’t like losing money any more than you and I would.  They will not insure zombies.  They don’t stay in business by writing unprofitable policies.  My guess is they will not.  My guess is they will make piles of money with the new law, more than before, way more.









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