Re: Health Care Cost Driver: Wednesday Depressies.
posted at 9/5/2013 2:00 PM EDT
In response to MattyScornD's comment:
In response to FortySixAndTwo's comment:
In response to MattyScornD's comment:
In theory, I might agree with you.
However, in practice, it doesn't work because some conditions - including obesity, diabetes, etc. - tend to be concentrated in poorer communities which have less coverage and lower quality health care as a whole.
It may 'tend' to but there are millions of middle class and even rich people who are obese and therfore have aliments due to obesity.
Reform has been structured to incentivize healthy behavior and penalize unhealthy behavior. This is a sea change in the way that policies are underwritten and premiums adjusted.
Is this true for group employer insurance? How if, for a group there is one set of rates do they penalize for unhealthy behaviors? And how do insurers know of said unhealthy behaviors? How will an insurer know that someone started smoking? Or that someone stopped working out?
Education about health is one thing. (ketchup is a vegetable? HFCP is corn?) But several recent studies have shown that people don't understand how health insurance works. To borrow a phrase, they have not understood how "they have a skin in the game".
How health insurance works is not rocket science. If people don't know it's because they don't want to know. It's like those people who signed on for 5 yr interest only adjustable mortgages. They clearly didn't take the time to understand what would happen when the 5 years ended and the interest rate jumped up. People are fri99in lazy
This has already started. As I've said before for example, smokers are and will be surcharged just like bad drivers are. Positive gains in health and lifestyle choices will be rewarded.
Again, how is this done on group employer health insurance? How could an insurer know so and so smokes?
Likewise, doctors and hospitals that fail to diagnose and treat their patients properly will suffer hits to their reputations and bottom lines. All stages of the health care system will be made accountable or reap what they sow.
This isn't anything new. If your doctor or hospital misdiagnosed you in the past wouldn't you have switched your doctor/hospital? I know I would have.
Yes, but middle class and rich people can pay for better insurance, ergo treatment. Poor people cannot, so they don't get treated, and they get sicker more often in greater numbers.
Well sure they can and probably do pay for "better" insurance. But better insurance doesn't mean there will be treatment. Again, there is a vast amount of obese people who are middle class and rich (the one who can afford better coverage). Point being that all the coverage in the world doesn't mean someone will actually use it. Even if they do use it, as in going to doctors for annual checkup. It doesn't mean they'll listen to doctors advice. If that were true there'd be very, very few people who are obese.
For group insurance, it's simple; they just penalize the whole group. Everyone signs a health statement in order to get insurance. Lying on that statement is a fireable offense...at least at every company I've worked for. Again, in theory, I agree that some people can 'game the system' by lying about smoking. But in practice, people are terrified of losing their jobs.
I've worked for four different companies and have never had to fill out a health statement that asked if I smoked.
It's a bit elitist to assume that everyone has the same educational opportunities, reads the same magazines, watches the same shows, follows the news, etc. The truth is that food is largely cultural and people usually do what they've always done until forced to change.
It's elitist to assume everyone has eyes and can see the same magazines I see at checkout counter? It's elitist to assume people have the ability to read the tv guide and see there are shows like The Doctors, Dr. Oz, Biggest Loser, Extreme Weight Loss, most of which these shows are on the major networks that come with basic cable? Hell, Oprah used to do MANY shows on health. She was watched by MILLIONS. Sorry I made such an elitist assumption. Who knew watching ABC, NBC, or CBS was so elitist.
And I submit, too, that many overeating issues are psychological in nature, whether caused by stress, abuse, or plain mental illness. This does not make them victims, per se, but psych issues also need to be treated in order to be overcome. And while I agree about the therapeutic benefits of exercise, for many it's just not that easy.
Sorry, but I'm not one who tolerates excuses. I don't use them in my own life and won't tolerate them from anyone else. Overeating is an excuse. We all have the abilty to make changes. You just have to WANT to make the change.
I understand your objections, and some of your concerns are valid, but what's the alternative? The status quo is clearly not working. Something's gotta give....
Not sure how we get people to stop being so lazy. In fact, I don't think we ever will. We become lazier and lazier as time goes on. Each generation is lazier than the last. I fear it's only going to get worse. Remember when you were a kid? Bet you played out side everyday. During summers I bet you had breakfast then went out and played till lunch. Had lunch then went right back outside to play some more till dinner. Then after dinner outside again till streetlights came on. Sound familiar? That doesn't happen now, or at least if it does it's the exception to the rule. Kids play on computer or video games unless it's a scheduled soccer game or baseball game. Then right back inside. It's sad.
I see it in the kids I coach. Been coaching for about 12 years. The kids who are in shape are the exception. Majority of kids range from flabby no muscle tone to obese. We have kids who can barely do 5 REAL pushups. Meaning straight body, chest to floor pushups. We have kids with 20-25% bodyfat. We pretty much have to force these kids to lift weights. My high school team never had to be told to lift. It's what you did. Play a sport, you lifted weights.