Greg Knauss's 10-year-old son's $23,800 bug bite

> We’ve got a strategy for dealing with the COBRA expiration, but it’s complicated and requires a lot of hoop jumping and is more than a little silly.

Whatever the author's strategy is, it sounds like he's quite misinformed. There are no hoops required to get HIPAA guaranteed issue coverage when COBRA runs out. All insurers are required to offer it regardless of preexisting conditions. It will cost more, but coverage is automatic with no medical information required.

The usual procedure is to simultaneously apply for underwritten coverage and guaranteed issue. If the underwritten policy is declined, the guaranteed issue takes effect. If you know you'll be declined, you can skip the medical history on the application and apply for guaranteed issue only. You have 60 days after COBRA runs out to apply.

You are also eligible if your insurance ends because the company goes out of business without making COBRA available.

Any insurance company or agent can give you more information, or search for:

California HIPAA guaranteed issue

Anesthesiologists are the worst offenders. My experience is that none of them are in network. You think you have everything covered and along comes this bill that is as big as everything else.

Woe to you if you are uninsured. I had minor heart surgery nearly two decades ago. The bill was something over $80K. The insurance company disallowed most of it, bringing it down to $20K of which I had to pay $2K. Except for the Anesthesiologist.

I think we have to start with the American Medical Association. It is in their interests to keep prices high and keep doctors in their McMansions. First follow the money, who benefits from high prices? Insurance companies, medical suppliers, and the American Medical Association gets to enforce the medical monopoly.

Life expectancy is a poor proxy for health care effectiveness. By some methodologies, once you take out things like auto accidents, the United States snaps right back into first place in those rankings. Meanwhile, in disease-by-disease rankings, the US routinely leads.

We do spend a lot for health care in the US, and we probably aren't realizing comparable value, but it is also probably not true that the actual quality of care in the US lags that of Europe.

This is why I think even if you are in favor of socialized health care, you really ought to be against the PPAFA. It's not "socialized health care", the glorious ideal you have in your head where everybody takes care of everybody and it's all smiles everywhere. It's an ungodly abomination of a thousand pages of hastily thrown together legislation with a bajillion moving parts, dozens of newly created agencies, what is basically gibberish in terms of who is paying for what driven more by what voters needed to hear than any resemblance to reality, and then after all of that, was brutally beaten by the legislative process until it could barely assemble a coalition to drag it across the finish line in a horrifically compromised state.

Trying to explain why this is a good idea and trying to explain why socialized health care is a good idea are two things that should not be done at the same time. If you think it's bizarre how many people aren't buying into the whole nothing-but-smiles theme now, wait until after a few years of experience with this turd.

The whole "Oh, the monstrous heartless conservatives just want to throw granny over the cliff so they can save a buck" is just a propaganda smokescreen put up so you don't look too much at the actual product you're pitching beyond the catchphrase level. Personally I feel some people are being pretty careless about what will actually happen to real people while they are moving abstract political footballs labelled "socialized healthcare" around without caring what's behind the abstraction. I know the abstract progress may feel good today, but the reality isn't going to stay behind the abstraction boundary.