It's a group if they're insuring all of the employees of X enterprise. If an individual decides to quit X enterprise and start his/her own business, then he'd better not have diabetes or heart disease. If that's the case, his health care premiums will increase astronomically and his coverage will be less. That's the advantage of group insurance.
If the insurance company can pick and choose, sell to an individual rather than a group, then people at high risk will pay high premiums.
Before "Obamacare", they could simply refuse to cover "pre existing conditions." Now, they can raise the rates to unaffordable levels.
Now, should one insurer cover everyone in a particular locale, then we'd be back to group insurance again.
Yeah.. again that's the big lie. The REAL group is everyone that the company insures. That's the real group. In fact that's how insurance use to work. Face it.. insurance only works when people are paying in more than they are taking out. And that encompasses EVERYONE that company is insuring.
This whole "its group insurance is just a bunch of bull to justify their gouging. In my healthcare business.. if I were to pay for each of my employers to go out and buy a healthcare policy
my cost would be 1/3 what it is if I purchase it as a group!
I worked it out. but of course I can't.. and why? because 1. My employers don't like the idea of purchasing their healthcare on the open market.. even though I would be picking up the tab.. and 2. I lose the tax benefits (as do my employees).
Now.. why do I have to pay 2/3 more for a Group insurance? Hmmm.. well I also have an agro business.. and you know how much my healthcare costs? 1/2 of what the healthcare does per person.
Why? Well I asked the insurance companies where my corporate headquarters are. They say "well its because healthcare workers have higher utilization of healthcare then other industries"...
WHAT A LOAD OF CRAP. Healthcare workers are WAY less likely to use healthcare services on an individual basis. They don't freak out because of a cold, or a sprain or numerous other injuries, symptoms that other layman will run to the doctor for.....because we are either knowledgeable or have easy access to someone that is. And we do a lot of self treating.
What REALLY is the difference is that Healthcare workers VALUE HEALTHCARE INSURANCE.. which means that they demand their employers cover them... and the insurance companies know it AND the insurance companies know that the profits in medicine are quite good.. and the price of premium is not set by costs.. its set by demand.. and the ability to pay for it.
I tried to find the study on the internet.. but a steady done on healthcare insurance premiums and industry profitability found a positive correlation between price increases and increases in industry profitability.. when experience rating (the amount people used the healthcare insurance was stable)..
The pre existing coverage is a bit of a hooey too.. Now there is something to be said for pre existing conditions preventing someone from going without insurance.. and then blowing out their back and then deciding to get insurance to cover their surgery and then cancelling the insurance right after.
BUT.. that's a rarity that would even happen because most people in private insurance are covered by their employer. And so when you hire onto another company.. they cover those pre existing conditions (sometimes there is a delay.. but still covered)... and yet.. lordy be.. insurance companies still make whopping profits.
the real reason for pre existing conditions is to prevent competition in the private individual market. Sure.. try to price shop for better coverage when we rack up your rate 25%... because no one will cover you for that bum knee if it finally gives out.. or for your sons acne medication.. or worse he gets kicked off because you failed to disclose that he got a tube of acne cream when he was 13.