Healthcare Part II

[The Progressive]

Alabama will soon tax overweight employees of the state. So it's only starting with the state's employees and not some sweeping thing across all employers. But it's a move in a new direction. It's actually referred to as a "fat tax" by many. Here's a link.

I don't see how market-oriented proponents could argue against this because the higher premium would only apply to those with higher health risk due to high BMI, cholesterol, blood pressure, and glucose levels.

[Ser_not_appearing_yet]

I find the banning/massive taxing of fatty foods, ciggerettes and alcohol reprehensible. Its possible to enjoy these things in moderation. I hate how governments treat their people like idiots.

Just do away with these bloody taxes. If theres a health crisis then take away health benefits for self-inflicted illnesses. The vast majority of us aren't stupid, and know what we're doing.

[The White Wolf]

I find the banning/massive taxing of fatty foods, ciggerettes and alcohol reprehensible. Its possible to enjoy these things in moderation. I hate how governments treat their people like idiots.

Just do away with these bloody taxes. If theres a health crisis then take away health benefits for self-inflicted illnesses. The vast majority of us aren't stupid, and know what we're doing.

I hadn't realized that the vast majority is around 33%. I wouldn't mind seeing insurance provide discounts if you provide evidence of eating properly or exercising regularly, but I don't know many insurance companies who do.

[mcbigski]

A question for those who say private and public insurance cannot exist together without putting the private insurance out of business: putting aside for a moment the examples of multiple other countries that do exactly this, if the private world cannot compete with the public world, then why hasn't public education eliminated all private schools?

Precisely because public education has become so shitty. Private education doesn't compete on price, it competes on quality. Public education doesn't compete with it in the same way that the local community college's baseball squad doesn't compete with the New York Yankees.

To be sure, like public eduction, public health care will be health care for all of us, but not for the elite. You can bet your ass that Congress will end up with some sort of Sidwell Friends' sort of health care coverage too.

[Ormond]

Positive reinforcement and incentives will probably work better if you want to encourage people to make choices that are better for their health. And that should be the issue, not fat, or weight. It's health.

At any rate, I think the role of the government in this is to regulate the industries appropriately and to educate the public. I can easily support that soft drinks with over X amount of sugar (HFCS or otherwise) should be slapped with a warning label, much like we do with cigarettes. And I'm sad to say that the general public still are not as educated about nutritional values as they should be, imo. Still, I'd leave the money aspect off, until the government because the single-payer insurer. At that point, then the government can start offering incentives to promote healthier lifestyle choices.

I completely agree with the above.

A nationwide media blitz to make obesity as socially unacceptable as possible

And the above idea is appalling, not to mention counterproductive.

What world do you live in where you think obesity could be MORE socially unacceptable than it already is? We already live in a culture where there is a large amount of discrimination against people who are overweight and obese, where the obese have lower self-esteem and more depression, where the average child would rather lose a limb than be fat.

Having low self esteem makes it MORE likely one will be obese in the first place:

http://medicalnewsonline.net/latest-health...esity/#more-187

People are more likely to make healthy lifestyle choices when they feel good about themselves, which is associated with self-confidence and the belief that one can succeed. When people are told that being overweight means that they are lazy, irresponsible, stupid, and/or immoral, they are more likely to have a "what's the use" attitude of helplessness which makes the hard long work of losing weight much more difficult.

Another link to an article on the discrimination the obese already face and its negative consequences for their medical care:

http://xnet.kp.org/permanentejournal/sum03/stigma.html

[Ser_not_appearing_yet]

I completely agree with the above.

A nationwide media blitz to make obesity as socially unacceptable as possible

And the above idea is appalling, not to mention counterproductive.

What world do you live in where you think obesity could be MORE socially unacceptable than it already is? We already live in a culture where there is a large amount of discrimination against people who are overweight and obese, where the obese have lower self-esteem and more depression, where the average child would rather lose a limb than be fat.

Having low self esteem makes it MORE likely one will be obese in the first place:

http://medicalnewsonline.net/latest-health...esity/#more-187

People are more likely to make healthy lifestyle choices when they feel good about themselves, which is associated with self-confidence and the belief that one can succeed. When people are told that being overweight means that they are lazy, irresponsible, stupid, and/or immoral, they are more likely to have a "what's the use" attitude of helplessness which makes the hard long work of losing weight much more difficult.

Another link to an article on the discrimination the obese already face and its negative consequences for their medical care:

http://xnet.kp.org/permanentejournal/sum03/stigma.html

If you go to thailand, girls are more likely to approach you if you're overweight. They see it as a sign of wealth. :P

In all honesty though, obesity is probably more socially acceptable now than its ever been, namely because its so much more common. You hear more stories about fat people being badly treated simply because there are so many of them.

Furthermore, obesity in the vast majority of cases is self-inflicted, and so you're unlikely to find much sympathy surrounding it in a workplace. Its not like racism or sexism.

[Week]

I find the banning/massive taxing of fatty foods, ciggerettes and alcohol reprehensible. Its possible to enjoy these things in moderation. I hate how governments treat their people like idiots.

Internalizing externalities. The public costs from increased health care costs from each of these (general unhealth from fatty foods, cancers/emphysema (including 2nd hand which did in my Grandmother) from cigarettes, and liver cancer/drunk driving) are not recouped in the straight price of each item. They are all, in their own way, a drain on society and partaking in them should for people to pay forward what they eventually take out for their poor decisions.

Just do away with these bloody taxes. If theres a health crisis then take away health benefits for self-inflicted illnesses.

So then all smokers will simply be unable to pay for their health care...max out their credit cards and/or default on their health care costs which means the public/hospitals need to pick up the tab. Great fucking idea!

The vast majority of us aren't stupid, and know what we're doing.

Actually, most are and most don't. Even if we do, that doesn't mean we do it.

Source

Percent of noninstitutionalized adults age 20 years and over who are overweight or obese: 67% (2005-2006)

Source

It is clear that medical knowledge about the negative impact of being overweight has percolated into the minds of the average American, almost all of whom agree that being obese is harmful to one's health. In fact, the message has come through so clearly that at this point Americans are just as likely to say that being obese is very harmful as to say the same about smoking -- long the target of both governmental and private industry public education campaigns.

People know obesity is bad and it doesn't matter. People are fat and continuing to get fatter. It isn't easy for a lot of people to live a healthy lifestyle and most who have an unhealthy lifestyle don't know how to change it.

Furthermore, obesity in the vast majority of cases is self-inflicted, and so you're unlikely to find much sympathy surrounding it in a workplace. Its not like racism or sexism.

From the above poll:

Being Obese: Unsympathetic- 21% Sympathetic- 74%

Smoking: Unsympathetic- 37% Sympathetic- 58%

[Ormond]

If you go to thailand, girls are more likely to approach you if you're overweight. They see it as a sign of wealth. :P

In all honesty though, obesity is probably more socially acceptable now than its ever been, namely because its so much more common. You hear more stories about fat people being badly treated simply because there are so many of them.

The fact that you put "probably" in your sentence above shows this is just your theory. The actual research on this shows it is not the case. In spite of obesity being more prevalent, it is NOT now more socially acceptable in the USA than it has been before.

http://drweigh.com/blog/tag/discrimination/

[Ser_not_appearing_yet]

Well yeah, we smokers have it worse than the fatties, obviously. Not only do we drain health resources through our own disgusting past-times, but we poison other people's air as well. We are, naturally, despised. :smoking:

So then all smokers will simply be unable to pay for their health care...max out their credit cards and/or default on their health care costs which means the public/hospitals need to pick up the tab. Great fucking idea!

A fairly frequent smoker/drinker speaking here... and its our own problem. I've accepted the idea that i smoke and drink, and am fully prepared to pay for any resulting health costs out of my own pocket. I wouldn't feel right using tax-money in that circumstance.

[Week]

Well yeah, we smokers have it worse than the fatties, obviously. Not only do we drain health resources through our own disgusting past-times, but we poison other people's air as well. We are, naturally, despised. :smoking:

Your jovial discussion of this is pretty disgusting to me. My Grandfather smoked for nearly all of his life and died at 70, his wife (who never smoked) developed emphysema with significant scarring in her lungs and died just a few years later. She never made the poor choice to smoke, yet it cut her life short also. This is not a rare anecdotal story either.

A fairly frequent smoker/drinker speaking here... and its our own problem. I've accepted the idea that i smoke and drink, and am fully prepared to pay for any resulting health costs out of my own pocket. I wouldn't feel right using tax-money in that circumstance.

No, as I've said above and before, it is not your own problem. It affects the health of everyone around you and raises the price of everyone's health care. You pay into health care the same as me, but you'll more than likely end up costing more and potentially contribute to other people's health care cost more. Not to mention that any smokers that go to the emergency room without health care due to their habit are on the public dollar. So, while you may think you are very noble for your stance and willingness to pay..you cannot speak for all of your smoking brethren nor can you prevent the effects of second hand smoke (unless you quit).

[Aemon Stark]

A fairly frequent smoker/drinker speaking here... and its our own problem. I've accepted the idea that i smoke and drink, and am fully prepared to pay for any resulting health costs out of my own pocket. I wouldn't feel right using tax-money in that circumstance.

Ridiculous attitude - you would "pay" for any resulting health consequences in a far more profound way than anything monetary.

ETA: It's true that not everyone who smokes will get lung cancer, but it's a sufficiently awful way to go that the personal cost is high enough without having to be pay for your own lung resections, brush biopsies, and palliative care.

[Ser_not_appearing_yet]

Your jovial discussion of this is pretty disgusting to me. My Grandfather smoked for nearly all of his life and died at 70, his wife (who never smoked) developed emphysema with significant scarring in her lungs and died just a few years later. She never made the poor choice to smoke, yet it cut her life short also. This is not a rare anecdotal story either.

I'm not sure what relevance this has. You posted a poll where people were more sympathetic to the overweight than smokers. I said (essentially) that this was obvious. I'm sorry your grandparents died from smoking related illnesses. For your information, i would never smoke near someone who objects to it, so calm down.

No, as I've said above and before, it is not your own problem. It affects the health of everyone around you and raises the price of everyone's health care. You pay into health care the same as me, but you'll more than likely end up costing more and potentially contribute to other people's health care cost more. Not to mention that any smokers that go to the emergency room without health care due to their habit are on the public dollar. So, while you may think you are very noble for your stance and willingness to pay..you cannot speak for all of your smoking brethren nor can you prevent the effects of second hand smoke (unless you quit).

I understand that your grandmother died as a result of possible passive smoking complications, but you are exaggerating how much damage smoking does to other people. So long as smoking is banned indoors, there should be no problems, and as you should've guessed I'm arguing against the taxation rather than the segregation.

I accept i don't speak for other smokers, but i feel they should take responsibility for their actions. No-one forces you to smoke.

Ridiculous attitude - you would "pay" for any resulting health consequences in a far more profound way than anything monetary.

Yes, and I've accepted those consequences as well.

[Week]

Yes, and I've accepted those consequences as well.

As you've already said, you cannot speak for any other smokers, neither their acceptance of public debt nor their ability to pay. Therefore, it makes sense for it to be taxed to shit so that there are fewerfreeriders in our system.

Also, once smokers are on Medicare, they will be all on the public dime regardless of personal responsibility.

[Ser_not_appearing_yet]

Honestly, if you're going to tax it that much simply due to the 'health costs' then you may as well ban it altogethor (which would do a much better job of stopping people smoking and saving health costs). A lot of it seems like the government taking on the role of your local dealer. It all seems rather hypocritical.

[Aemon Stark]

Some other issues at play. Notably, the level of cigarette taxation does affect smoking rates. Raise the rate and you reduce the smoking, so it's certainly effective as a public health intervention. The flipside is that smoking rates are related to affluence - poorer people are more likely to smoke, so we can see clearly why raising the price reduces tobacco use. Finally, nicotine is highly addictive, and it is not a simple matter of willpower once the habit is formed.

[Ser_not_appearing_yet]

Some other issues at play. Notably, the level of cigarette taxation does affect smoking rates. Raise the rate and you reduce the smoking, so it's certainly effective as a public health intervention. The flipside is that smoking rates are related to affluence - poorer people are more likely to smoke, so we can see clearly why raising the price reduces tobacco use. Finally, nicotine is highly addictive, and it is not a simple matter of willpower once the habit is formed.

Nicotine is highly addictive, just as addictive as heroin or cocaine in fact. This is partly why i don't buy the raising of taxes as a prevention technique. Rather, its similar to a drug dealer who steadily raises his prices, extorting as much free money as possible from his clients, who have no choice but to find the money somehow. It might stop people starting smoking, but once someones hooked it doesn't matter how poor they are, they will find money to pay for smokes.

I think this taxation being used as an excuse for prevention is a partly a smokescreen (excuse the pun) for bonus government spending money.

[Krafus]

From The Guardian; Hundreds of millions spent by the healthcare industry to fight the health reform.

If this article was the very first thing I learned about the US healthcare debate, I'd consider supporting the reform purely on the basis that if the healthcare industry opposes it so fiercely, then it must be a good thing for Joe Q. Public.

[Shryke]

Don't know if this has been mentioned yet, but:

http://www.politico.com/livepulse/1009/Har...ll.html?showall

HELP Committee Chairman Tom Harkin said in a conference call today that Republicans will not have a seat at the table when Senate Majority Leader Harry Reid merges the HELP and Finance bills into a single piece of legislation.

Not unexpected if you've been paying attention. Basically, when the ACTUAL bill gets made, the Republicans will not be a part of it.

Also:

http://www.lvrj.com/news/breaking_news/Rei...n-63155937.html

U.S. Sen. Harry Reid, D-Nev., said today there will be a "public option" in whatever health insurance reform bill comes out of Congress.

[Shryke]

He's full of shit I'd say.

The Obama Administration seems to be handling the whole thing pretty ok. Not perfectly, but it's still on track.

Don't trust the media on this especially.

[Hereward]

I think this taxation being used as an excuse for prevention is a partly a smokescreen (excuse the pun) for bonus government spending money.

If this were true, why would the government be spending so much money on anti-smoking campaigns, nicotine replacement therapy, stop smoking counselling, etc? And, indeed, why would they not set tax rates at the point where income is maximised, rather than at a level that is driving a small but significant percentage of people to stop every year, driving down the tax take?