Do you think obese/overweight people should pay more for health insurance?

I'm a vet, and the VA care is crap. Herded through like cattle, doctor's who aren't afraid of getting sued, government employee's that sit on their *kitten* and do very little...always with the 'not my job excuse' and no fear of being fired due to the bureaucracy involved.

I had a paralyzed friend that got a cut on his leg, VA didn't treat it properly, turned into blood poisoning, and he died from it. Tried to get my VA ID card, and asked another guy when I got there how long he'd been waiting to get his done. He looked at his watch and said, "Going on 3 hours now." I got up and left. Would have filled out a report outlining the crappy service, but didn't want to wait 3 hours to get someone to hand me a piece of paper. So me and all the dead people aren't filling out their surveys to complain about the poor quality of care...so sure, the reports look just fine.

Bry_Lander wrote: »

mburgess458 wrote: »

Bry_Lander wrote: »

jdlobb wrote: »

Bry_Lander wrote: »

jdlobb wrote: »

Bry_Lander wrote: »

NoxDineen wrote: »

Nobody should pay for health insurance. Not directly anyway. Single payer system.

Then brace yourself for single-payer quality.

gladly

There is a lot more to life expectancy than health care, lifestyle habits are far more relevant. Have you ever traveled throughout Western Europe and taken a look at the physical composition and habits of most of the people? A lot of bike riding, a lot of sensible portions, and not a lot of waddling.

and you explain Canada...how?

Also, as someone who used to live in the UK, their fitness and behavior isn't appreciably different than ours.

If I were to grant you that socialized healthcare is the sole reason for the increased longevity for the sake of argument - Canada and the UK get an additional 2 years of life. That isn’t a very compelling case for the government to completely take it over.

It is also much cheaper... and everyone has access to healthcare. The only benefit you can point to for the U.S. system is that some people make a ton of money from it. It isn't cheaper, it isn't better, and it doesn't work at all for millions of Americans. We are fine with "the government completely taking it over" for veterans and the elderly (Medicare) and some poor/disabled people (Medicaid).

We should either decide between:
1. We're okay with poor people dying due to not having access to healthcare and stick with a for-profit model or
2. Go more towards a single payer/Medicare for all system.

What we have now is no healthcare to many poor people until they are close enough to death that they can go to an ER.

Veterans are absolutely not "fine" with government healthcare administered by the VA, it has been a disaster and done a disservice to millions of vets - if that is a model for single-payer healthcare, we are in deep trouble if this ever gets implemented.

I'm sorry you've had bad experiences with the VA. I think the quality of care depends on the facility. There are a few, high-profile notorious VA hospitals giving the rest a bad name. You never hear the positive stories. My husband has received amazing, super attentive and timely care at the Loma Linda VA. They saved his life - literally. We're very grateful for the excellent service that goes above and beyond. We wouldn't even want private care after our experiences there. (In fact, I wish I could go there...)

I'm a veteran, technically classified as disabled, and find the VA system unusable. While follow-up care is available to me for service related issues the process and time involved make it nearly impossible to hold a full time job and use the services.

The medical care provided while in the military was absolutely top notch. I went through three traumatic injuries and the care I received was state of the art and all involved were among the best and highly motivated. I think this is key to understanding the difference between the military and the VA. There is no motivation to do better within the VA. This is the inherent problem with all single sourced systems.

jdlobb wrote: »

Bry_Lander wrote: »

mburgess458 wrote: »

Bry_Lander wrote: »

jdlobb wrote: »

Bry_Lander wrote: »

jdlobb wrote: »

Bry_Lander wrote: »

NoxDineen wrote: »

Nobody should pay for health insurance. Not directly anyway. Single payer system.

Then brace yourself for single-payer quality.

gladly

There is a lot more to life expectancy than health care, lifestyle habits are far more relevant. Have you ever traveled throughout Western Europe and taken a look at the physical composition and habits of most of the people? A lot of bike riding, a lot of sensible portions, and not a lot of waddling.

and you explain Canada...how?

Also, as someone who used to live in the UK, their fitness and behavior isn't appreciably different than ours.

If I were to grant you that socialized healthcare is the sole reason for the increased longevity for the sake of argument - Canada and the UK get an additional 2 years of life. That isn’t a very compelling case for the government to completely take it over.

It is also much cheaper... and everyone has access to healthcare. The only benefit you can point to for the U.S. system is that some people make a ton of money from it. It isn't cheaper, it isn't better, and it doesn't work at all for millions of Americans. We are fine with "the government completely taking it over" for veterans and the elderly (Medicare) and some poor/disabled people (Medicaid).

We should either decide between:
1. We're okay with poor people dying due to not having access to healthcare and stick with a for-profit model or
2. Go more towards a single payer/Medicare for all system.

What we have now is no healthcare to many poor people until they are close enough to death that they can go to an ER.

Veterans are absolutely not "fine" with government healthcare administered by the VA, it has been a disaster and done a disservice to millions of vets - if that is a model for single-payer healthcare, we are in deep trouble if this ever gets implemented.

I'm a vet, who gets care at the VA, and this is absolutely untrue. The conservative media blows up every little problem with VA healthcare and pretends like the VA is some uniquely bad system.

It's not.

Every survey shows that veterans are, on average, highly satisfied with the care they get at the VA, and it consistently rates higher than private hospitals.

There are numerous studies out there that compare quality of care, patient satisfaction, and health outcomes between private hospitals and VA and they consistently find the VA to be as good or better than private hospitals.

I've had issues with VA doctors in the past, and I've had issues with private doctors. But as someone who's been regularly going to the VA for care, even though I have good private insurance, I have had a great experience.

The ONLY problem I have ever had is in getting an initial appointment with a primary care doc when I move to a new city and have to chance clinics. This takes too long, and is a serious problem. HOWEVER, after getting that initial appointment I consistently get fast appointments with specialists, tests, and follow up appointments with the primary care doc. I have experienced the exact same level of service in 4 different cities (Baltimore, New York, Fort Worth, and Dallas).

I'm not alone. My grandfather has been going to the VA for all his healthcare needs for over 40 years, he refuses to go anywhere else. Every time they move they make sure they're close to a VA facility. I've seen him get visibly enraged watching republicans and those *kitten* stains at "Concerned Veterans" talk *kitten* about the VA on television.

Regrettably, VA quality varies wildly from region to region and state to state. In some regions/states, VA care is superior to private care. In others, VA care is slightly more dangerous than standing in traffic.

MKEgal wrote: »

Anyone whose voluntary actions causes them to cost a health insurance company more should be charged more for their insurance, and maybe care. ...

Too much weight is caused by eating more than you burn.
Whether that's because I'm depressed, or on steroids, or just really like Oreos doesn't matter - the cause is eating too much, the result is being overweight.

This belief is what causes a lot of problems for those who are overweight, and it has as its underlying premise something that, IMHO, ignores the entire reality of limited choice.

The more negative the consequence of a choice, the more limits there are ON that choice, until it gets to a point where we wouldn't consider it a choice at all. Like, choosing which path to take for your morning jog has little negative consequences, right?. Choosing to, oh, marry the villain who is holding your brother hostage and will kill him if your refuse? Not much choice there.

If someone complained about the scenery on their jog, we'd probably say, 'why are you complaining? You chose it.'
But if someone complained about their marriage to the villain, we would not usually say, 'why are you complaining? You chose to marry him.' We'd be more likely to say, so sorry, we know you had no choice but to do what you did.

The same thing applies to being overweight, in many cases.

There are medications that cause people to gain weight EVEN IF they do not change their previously fine eating habits. There are medications that create such cravings for certain foods (carbs is one I can think of off hand) that a person can either eat, or feel like they are starving, constantly, every single day. There are injuries and conditions that make it extremely painful to move, which not only make it hard to exercise, but make it hard to COOK, so your only choice is to get all premade food, and good luck getting healthy choices for that with enough calories.

Not to mention that for some people, they spend most of their worrying, and often money, on the people they care for rather than themselves (I can think of a lot of single parents for this one). If you only have enough money to buy SOME healthy food, who are you gonna give it to, yourself or your kids?

There are a lot more examples, but treating overweight folks as though all skinny people and all overweight people have had the exact same experiences and the exact same stressors and skills and opportunities affecting their ability to stay in shape, is ignoring the reality of human existence.

Treating overweight folks as though YOU would do better if you were in THEIR place - which I know this poster of this didn't say, but is rather implied by many of the posts on this issue so far - is both ignorant and rather arrogant as well, I think.

You literally don't know what it's like for someone else, nor do you know what led to their being overweight. And if you have not HAD any mental illnesses, or taken meds, or been an addict, or lived in poverty...you have no freaking idea how that impacts a person.

I am not saying that everyone who is overweight did nothing wrong, or had no choice. But the point is, none of us know, looking at someone. We don't know why someone lost a limb, why they are wearing black clothing, why got a perm, OR why they are overweight.

We don't ACT as though we know why someone lost a limb or are wearing black or got a perm, though. So why do so many of us treat people who are overweight as though we 'know' why they are overweight?

In England it is the NHS and I believe that those who have medical problems relating to obesity should have to make a higher NI payment because they are at greater risk and type 2 diabetes, for example, is a lifelong medication costing far more than the individual is likely paying in.

jdlobb wrote: »

hold on. I'm one of the ones here advocating for higher premiums for the obese. This isn't a "you" vs "they" argument. I AM they. I AM obese. My parents ARE obese. Most of my family IS obese.

This is about math and risk. Not about profits. I don't give a *kitten* about health insurer profits.

But increasing premiums for the morbidly obese would lower premiums for people with a healthy weight. This would also encourage people to lose weight, thus lowering health care expenses across the economy.

There are plenty of people in the health care industry making a FORTUNE on obesity, and the fact that insurance has to eat it when it comes to people making poor life choices.

So no, this isn't YOU vs THEY. This is reality vs mindless idealism.

I know you want to try and frame this as "fat people did nothing wrong," but that's naive. The percentage of overweight people whose weight is due to things outside their immediate control, is minuscule in comparison to the number of people who have just had a lifetime of *kitten* choices around diet and exercise.

People like me, who got fat because they made bad decisions, shouldn't get to free ride on the backs of people who made good decisions and gain sympathy or "benefit of the doubt" on the backs of people who have legitimate issues that caused their weight problems.

Sorry, you're right on the you vs them issue- I get on my high horse sometimes. Mostly you got hit with some of my frustration after having this conversation with someone where it was very much a 'all the fat people in the world are lazy' and then coming on this posting. Myself, I have super skinny people in my family, I have obese people in my family. For both, some of them are the way they are due to their own choices, and some are not.

However, I truly do not think increasing premiums will in any way help anyone but the insurance company. Sure, they COULD lower premiums if some people with higher risks paid more, and healthy folks paid less. The real question is: would they? And I think idealism mostly comes in thinking that they would.

The entire history of our insurance companies would contradict that. Because being obese used to be a pre-existing condition. People DID have to pay higher premiums. And it in no way made for lower premiums for anyone else. Premiums were high, coverage was pretty pathetic in many cases, and going BACK to that is not likely to go any better than it did in the past.

Literally, why would they? The insurance companies, in my experience, very rarely 'eat it' with anything. They make sure WE eat it. If they have to pay legitimate costs because of a horrible accident, or costs because someone made poor life choices, it does not seem to matter to them. Best I can tell, they will make sure that as much of that cost is paid by the people buying insurance, If they can get away with paying no money at all to a patient, without too much negative press, in my experience they absolutely will.

I used to have to work with medical insurance companies, and frankly, well...if you've ever seen that scene in the children's cartoon, The Incredibles, with the insurance company and their amoral little boss whose whole purpose was to make the shareholders money? That has honest to god been my own experience with them. I'm sure there ARE good people working in many of these companies, and maybe even good companies too, but some of the crap I have seen with them has to be seen to be believed, seriously.

I never, in any way, expect insurance companies to do anything that will cost them money, and I always expect them to do everything that will make them more. And the only factor that I've seen that keeps them in check is that bad press will cost them a bit of money. So it is literally in THEIR best interest to peddle the idea that WE will pay more money if anyone with ANY increased health risks gets health insurance as easily as healthy folks, and more importantly, that is is entirely out of the insurance company's control that we all pay more money.





As for 'fat people did nothing.' I don't believe that. I just believe that WE don't know what the situation is for someone else. And I honestly don't know that the majority of people ARE actually doing it due to bad choices, or if it's the other way around. I have no idealistic view on this subject, honestly. I just know there can be many reasons for obesity.

But here in the USA, while we have a lot of hype that the majority are obese due to their own choices, I don't think we actually have good statistics on the subject. I haven't seen any, anyway. Have you? (And I mean that sincerely, if you've seen studies, I'd love to see them).

We have a big cultural view of 'you can do anything if you try hard enough.' So admitting that sometimes you can't, that sometimes you will be ugly, or sick, or overweight, or poor, no matter what you do, doesn't play into that national outlook. Which means that if you're overweight, the assumption more often is that a person is solely at fault, with the only factor being poor choices in diet and exercise.

But just assuming that doesn't make it true (doesn't make it false either. Again, just saying we don't know, is all). I guess, in the end, I see it from the other angle. You said, "People like me, who got fat because they made bad decisions, shouldn't get to free ride on the backs of people who made good decisions and gain sympathy or "benefit of the doubt" on the backs of people who have legitimate issues that caused their weight problems."

I guess I would say, people who have legitimate issues causing their weight problems shouldn't be penalized because we want to punish people who made bad decisions. Because, going by the history, insurance companies will NOT make any distinction between the two. They'll just charge people more for being obese, period.

People who say that it's unfair that the healthy pay for the sick have no basic understanding of how insurance (and a decent society) works. Trust me, at some point, no one reaches the age of sixty without SOME sort of pre-existing condition.