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What new or revised public policy/law would make it easier for people to maintain a healthy weight?

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Replies

  • Theoldguy1
    Theoldguy1 Posts: 2,427 Member
    h7463 wrote: »
    lemurcat2 wrote: »
    h7463 wrote: »
    lemurcat2 wrote: »
    h7463 wrote: »
    lemurcat2 wrote: »
    lemurcat2 wrote: »
    FireOpalCO wrote: »
    CSARdiver wrote: »
    FireOpalCO wrote: »
    CSARdiver wrote: »
    There are 168 hours in a week.

    It is not your employer's responsibility to manage 2% of your time to exercise.

    Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.

    My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.

    Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?

    You can choose to outsource responsibility, but this comes at a great cost.

    I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.

    I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.

    I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.

    ?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?

    No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.

    At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.

    Please explain the bolded part above.
    How can a company count this as 'compensation', when health insurance costs can be written off as business deduction. Is your company cheating on the taxes and writing it off as expense twice..once as compensation, twice as business cost?

    What Theoldguy said. It is compensation from the perspective of the employer. That it's not counted that way to the employee (mostly) is a benefit to the employee, as they pay less in taxes.

    Also, the tax issue is totally irrelevant here -- in real terms it is compensation for the employment provided to employees (or not) and from the employee's perspective ought to be understood as part of what's being paid for the job (part of compensation), but frequently is not, which is one reason the understanding of the costs of health insurance is often flawed in the US (employees may think they get free health care or count only the premiums they pay). Some who get employer-based insurance don't understand how much is actually being paid for it (and that at least in some cases their salaries in cash would be higher if not for the insurance part).
    Employees have (by law) the right to their compensation, free and clear of any hidden or implied compensations or deductions.

    This is confused. I'm not saying they have a contract for $65K or $100K or what not and then are paid an amount less the cost of insurance. I'm saying that from the employer's standpoint what they are receiving in real terms is the $65K plus the additional cost of insurance, even if in the employer's mind the cost of insurance to the employer is not considered and if insurance costs go up they would still expect the same type of raise as in other years.

    I'm not sure what you mean by right to compensation anyway, since the amount of the compensation is not a right, it's offered by the employer and accepted (or not) by the employee. Above minimum wage (and these are salaried employees, some exempt and some non exempt), there is no right to a specific amount of compensation per year outside of whatever was agreed to be paid. There is also no right to a particular raise per year.

    What in fact happens is that most people take insurance, since ours is good, but in the rare cases where someone doesn't (perhaps the spouse has better insurance), their salary is often higher as a result, as that seems fairer. But if the employees compare salaries, I suspect it won't be seen as fair.
    Personally, I understand company-provided insurance as benefit and reward for employees who contribute through their attendance (min hours for part-time) or fulltime commitment. It should hold talent in the company, and not make people miserable by holding their well deserved pay raise hostage.

    More realistically, it's provided in fields in which payment of such is market and standard, so you need to provide it to compete. It's not a reward. And employers will of course take it into account in considering the real cost of employing an employee.

    Like I said before, I don't think employers should be the source of health insurance in an ideal world.

    Thanks for taking time to elaborate on that. I understand now what you mean.
    The thing that threw me off, is that your company is so obviously paying different salaries for the exact same work performed. Yes, the employees would definitely see this as unfair.

    As for a better world in healthcare, read about https://en.wikipedia.org/wiki/Healthcare_in_Germany .
    I think that's something to consider. It isn't free, but it definitely contributes to peace of mind, and a better quality of life.

    Interesting you selected that, as the German system is the one I often promote as a better option.

    Yes, I agree some employees don't see it as fair, and I don't like it (although I do think it's fair), but I do get why others see it as more fair, since health care is in reality part of compensation. I would far, far rather not have to deal with health care and pay people salaries/bonuses based on value. Btw, in a small firm, no one has exactly the same job as anyone else IME. What angers me about the current system is I'd rather actual salary reflect how hard working and competent someone is more accurately. And it would absent the health insurance issue at my firm, at least to some degree (there are still issues re job title, market, and seniority, of course).

    I'll say again that costs of health care in the US are distorted by the employment-based system.
    I have personal positive experience in this (first bolded part). There are a few perks in this, that are not explained in the link.
    E.g., most of the listed different health insurance organizations are specialized, and they are exclusively serving members of certain occupations/trades (and associated fields of study on student insurance policies). This gives them the freedom to pass on savings to the insured, which may reflect in a lower percentage of their salaries being deducted as premium.

    The second bolded section... Agreed! I had mentioned a similar thought a few posts earlier, and I got a woo for it. :D

    Declining healthcare is not that easy for everyone, though. When employers are trying to avoid the costs of their own employees, they won't just let any spouse join in. My husband had started a new job 2 years ago, and it came with stellar international healthcare. I was not allowed to participate, because I still qualified for a lousy plan with my own employer. I couldn't buy in on my own...because the provider does not operate in this state. Bummer...

    My employer has pretty decent insurance. However if the spouse has insurance available at their job and chooses to take the coverage from my employer there is a monthly spousal surcharge of around $200.
  • autumnblade75
    autumnblade75 Posts: 1,660 Member
    I've personally survived cancer 25 years ago and have seen enough bad deaths to know that I don't want any heroic measures taken to extend a so called, low quality "life."

    I've completed my health care directives, and my family knows my desires.

    So what you may judge as bravado is actually an informed choice on my part.

    Don't confuse my distrust of government as an unwillingness to help.

    I believe anything really important is too important to be left to government.

    If someone is clamoring for a government solution, I wonder why it's not important enough for them to invest their personal time, talent and treasure into the issue.
    lemurcat2 wrote: »
    lemurcat2 wrote: »
    <snip> So why not force everyone to pay for that advantage? I'm not into the idea of someone being irresponsible and not paying for that, but I'm also not into the incredibly severe cost, so I'd like something in health care more like the rest of the first world countries.

    Because I'm not into a free people being forced to subsidize irresponsible choices.

    We aren't going to refuse people who can't pay any medical attention. Emergency rooms will have to treat them. This is IMO not a bad thing, but it does mean that I think everyone should pay into the system in some sense, depending on their ability to pay. I don't think someone should be able to just choose to have no health insurance and make the rest of us pay for him. First, if he said "I'm willing to just die for lack of medical care if in a car accident" or "if I develop a medical condition through bad luck," I honestly don't believe him. I think it's bravado based on a "nothing bad will happen to me" kind of attitude. Second, I don't think a good society does let people just die from something that we could fix, because the person lacks cash (and medical bills for these kinds of things are huge) or insurance.

    So I'm willing to structure society (as in most other developed countries) so everyone has access to health care and everyone pays in. It's one of those basic ways in which living in a society requires costs and responsibilities.

    I watched my mom slowly die in the hospital over the course of a very long and unpleasant two years. That was enough to convince me that I didn't want any of that sort of "saving" either. I have not got an official directive, but this is another reminder that I should probably make a visit to a doctor to get that legal form signed. My husband knows that I'd rather he kick my impending corpse further down the ravine than allow the EMT guys to cart me to the hospital if I crash my motorcycle. As a population, we seem to have lost sight of the fact that in the end, we all die. I'd rather not prolong it.

    I'm an organ donor, even though the two people I personally knew who had transplants died shortly after. I hear they would prefer to harvest organs rather than save the donor. I've also heard stories of "teh gays" being denied lifesaving care. I am frequently mistaken for a lesbian. I sometimes joke that I maintain the haircut so that I will be denied the care - but I actually just like my hair this way. It's a happy accident if it helps me to deny myself that lifesaving care, in case I'm not conscious and able to refuse treatment.

    Bravado or no, I think if it got out that the medical profession was calling their "bluff" those who would truly prefer to receive the care would pony up the insurance premiums. Consequences of our actions, and all that.
  • autumnblade75
    autumnblade75 Posts: 1,660 Member
    I've personally survived cancer 25 years ago and have seen enough bad deaths to know that I don't want any heroic measures taken to extend a so called, low quality "life."

    I've completed my health care directives, and my family knows my desires.

    So what you may judge as bravado is actually an informed choice on my part.

    Don't confuse my distrust of government as an unwillingness to help.

    I believe anything really important is too important to be left to government.

    If someone is clamoring for a government solution, I wonder why it's not important enough for them to invest their personal time, talent and treasure into the issue.
    lemurcat2 wrote: »
    lemurcat2 wrote: »
    <snip> So why not force everyone to pay for that advantage? I'm not into the idea of someone being irresponsible and not paying for that, but I'm also not into the incredibly severe cost, so I'd like something in health care more like the rest of the first world countries.

    Because I'm not into a free people being forced to subsidize irresponsible choices.

    We aren't going to refuse people who can't pay any medical attention. Emergency rooms will have to treat them. This is IMO not a bad thing, but it does mean that I think everyone should pay into the system in some sense, depending on their ability to pay. I don't think someone should be able to just choose to have no health insurance and make the rest of us pay for him. First, if he said "I'm willing to just die for lack of medical care if in a car accident" or "if I develop a medical condition through bad luck," I honestly don't believe him. I think it's bravado based on a "nothing bad will happen to me" kind of attitude. Second, I don't think a good society does let people just die from something that we could fix, because the person lacks cash (and medical bills for these kinds of things are huge) or insurance.

    So I'm willing to structure society (as in most other developed countries) so everyone has access to health care and everyone pays in. It's one of those basic ways in which living in a society requires costs and responsibilities.

    I watched my mom slowly die in the hospital over the course of a very long and unpleasant two years. That was enough to convince me that I didn't want any of that sort of "saving" either. I have not got an official directive, but this is another reminder that I should probably make a visit to a doctor to get that legal form signed. My husband knows that I'd rather he kick my impending corpse further down the ravine than allow the EMT guys to cart me to the hospital if I crash my motorcycle. As a population, we seem to have lost sight of the fact that in the end, we all die. I'd rather not prolong it.

    I'm an organ donor, even though the two people I personally knew who had transplants died shortly after. I hear they would prefer to harvest organs rather than save the donor. I've also heard stories of "teh gays" being denied lifesaving care. I am frequently mistaken for a lesbian. I sometimes joke that I maintain the haircut so that I will be denied the care - but I actually just like my hair this way. It's a happy accident if it helps me to deny myself that lifesaving care, in case I'm not conscious and able to refuse treatment.

    Bravado or no, I think if it got out that the medical profession was calling their "bluff" those who would truly prefer to receive the care would pony up the insurance premiums. Consequences of our actions, and all that.

    Not all motorcycle accidents (or other reasons for ending up in a hospital) lead to lingering unpleasant deaths if treatment is provided. Many people who show up in an emergency room, whether after an accident or for another reason, can live many more decades of healthy, productive lives if properly treated. I don't think most people would want emergency rooms to street people with compound fractures, appendicitis, etc., so they can die horribly of sepsis because they don't have medical insurance.

    You're suggesting that a dichotomy that applies in a limited set of circumstances should govern policy for a much wider universe of situations.

    I'm not suggesting anything about anyone else's medical care. I'm talking about making sure that if I'm not able to refuse care on my own, nobody decides that I would prefer saving. That is the default. I need to get those papers filed. I've already been in situations where more "care" was provided than I wanted. While I have insurance now to take care of that sort of thing, I feel a lot of responsibility for unnecessary care on my behalf driving up the cost of others' medical care. It's not free.

    I do think we should all take a little more responsibility for our own selves, which would lessen the burden on others to take care of us. And I believe that if someone would prefer not to buy insurance, they should not be forced upon pain of legal actions to buy it. And I believe that doctors are under no obligation to do a job without recompense. Emergency services are bound by law to stabilize a dying individual, but they're not required to treat any condition, even one which will repeatedly present with emergency symptoms, for free. There are no easy answers, but for my part, I'd like to opt out of this crummy game. Even if I die. In the meantime, while I'm able to consent to treatment, I'll go to the doctor if there's a bone sticking out, or I can't stop the bleeding on my own. Maybe. If I choose to.
  • Motorsheen
    Motorsheen Posts: 20,493 Member
    lemurcat2 wrote: »
    <snip> So why not force everyone to pay for that advantage? I'm not into the idea of someone being irresponsible and not paying for that, but I'm also not into the incredibly severe cost, so I'd like something in health care more like the rest of the first world countries.

    Because I'm not into a free people being forced to subsidize irresponsible choices.

    It's the modern day ant and grasshopper.

    If I'm putting 20% or so of my earnings into my 401(k) into an S&P500 index fund, and my neighbor who makes the same sort of money is buying a new sports car, motorcycles and boats frequently, why am I expected to pay for his lack of saving for retirement?

    So I make good money and drive a used, 7 year old $10k car instead of buying or leasing a new $40k car every 3 years.

    I have no problem with my neighbor buying the boats, and motorcycles and what not, because he shouldn't be forced to spend his money the way I think he should.

    But then taxpayers like me shouldn't be forced to cover him if he comes to the end of his working days and has little or nothing saved.

    When you talk about FORCING people to pay for others, you lose me. I thought, at least here in America, we were founded on the principle of individual freedom.

    Forcing me to participate as the government sees fit goes counter to that freedom.

    It doesn't mean I'm not willing to help. I simply want to have the freedom to choose how I help. The worst possible solution, from the perspective of preserving freedom is to allow politicians to buy votes by forcing my contributions to help in the fashion they believe will get them the most votes.


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  • sharondesfor935
    sharondesfor935 Posts: 89 Member
    lemurcat2 wrote: »

    We don't "price" foods. Price is set by the market. If celery, etc. were basically worthless (nearly free to buy), why would anyone grow them? So what would happen is a greater distortion of the market toward high cal foods. Cool!

    I'm in favor of getting rid of ag subsidies, just out of principle, but I suspect the main result would be slightly higher priced meat and dairy.

    Ah, but I'm not talking about eliminating ag subsidies at all; just the opposite. What if we subsidized crops by lowest calorie density? Take funds from Peter the cattle producer to pay Paul the lettuce producer?

    Told you I was talking crazy.
  • tbright1965
    tbright1965 Posts: 852 Member
    lemurcat2 wrote: »

    We don't "price" foods. Price is set by the market. If celery, etc. were basically worthless (nearly free to buy), why would anyone grow them? So what would happen is a greater distortion of the market toward high cal foods. Cool!

    I'm in favor of getting rid of ag subsidies, just out of principle, but I suspect the main result would be slightly higher priced meat and dairy.

    Ah, but I'm not talking about eliminating Ag subsidies at all; just the opposite. What if we subsidized crops by lowest calorie density? Take funds from Peter the cattle producer to pay Paul the lettuce producer?

    Told you I was talking crazy.

    I'm a free market guy, so I wonder why we have ag subsidies. I mean, I understand the theory, keep prices stable. But warehousing tons of government cheese really doesn't resolve the issues with over production. In fact, in encourages overproduction, at the expense of the taxpayer.

    Just another example of shielding people from the consequences of their choices. Choose to produce in excess of what the market can handle, get a check.

    I'm convinced that today, government is more concerned about power than it is actually helping.

    Subsidies to farmers growing food of questionable value.

    Subsidies to health care so people can take a pill, paid for by others, so they don't have to take charge of their choices.

    Add in a few stories (from the left and the right) about respective threats that only those of the right political persuasion can protect you from, because those of the "other" persuasion are on the side of the threat, and you have a good number of people who want the promised safety and are willing to sacrifice everyone's freedom to get it.
  • magnusthenerd
    magnusthenerd Posts: 1,207 Member
    lemurcat2 wrote: »

    We don't "price" foods. Price is set by the market. If celery, etc. were basically worthless (nearly free to buy), why would anyone grow them? So what would happen is a greater distortion of the market toward high cal foods. Cool!

    I'm in favor of getting rid of ag subsidies, just out of principle, but I suspect the main result would be slightly higher priced meat and dairy.

    Ah, but I'm not talking about eliminating ag subsidies at all; just the opposite. What if we subsidized crops by lowest calorie density? Take funds from Peter the cattle producer to pay Paul the lettuce producer?

    Told you I was talking crazy.
    Not sure it would work out because calorie dense foods aren't crops, but made from crops. I think you'd need to subsidize or tax at the level of the consumer, or have a tax on the amount of processing done to get a bit closer to altering the prices you'd want changed.
  • h7463
    h7463 Posts: 626 Member
    Theoldguy1 wrote: »
    To add to my comment above regarding fundamental changes as I can't edit it. Probably will have to have some sort of national excise tax on high calorie nutrient poor foods and also eliminate those foods from SNAP eligibility.

    SNAP has the word 'supplemental' in it.... I never understood, why items like candy, popsicles, sodas, energy drinks, and snack crackers are eligible in the first place.... I can perfectly survive without those. No 'assistance' needed on the back of the tax payers.... This would be a policy change that has my vote...
  • h7463
    h7463 Posts: 626 Member
    Carlos_421 wrote: »
    AnnPT77 wrote: »
    Yes, let's pay people more, and ask them to purchase their own health care or services on the open market (or not, based on their own self-perceived economic interests) . . . since expecting most people to plan for and fund their own retirement income has worked out so super well for everyone. :confounded:

    And the government has done better with social security?

    I'm not sure the government did anything directly wrong with social security. The indirect policies for political reasons did hurt - the change in income distribution towards the top where it wasn't taxed for SS is what I think is the biggest failure. An uncapped tax could alter solvency, but addressing income and wealth inequality would be better.

    Flash back to the 1980s, and start reading who built up the fund, and who borrowed and lost it...
  • amy19355
    amy19355 Posts: 805 Member
    I am convinced that the root cause of all problems in this world are READING problems.
  • CSARdiver
    CSARdiver Posts: 6,257 Member
    lemurcat2 wrote: »
    Most medicare care is not "prolonging life without longterm life or life without pain" sort of care. Much of it can secure a full recovery. Therefore, I would note that the immediate movement to that subset of care is a strawman. Most of the latter has 0 to do with expanding subsidized care/gov't care and is an existing issue (perhaps) with Medicare.

    Young guy without insurance gets in a car accident or gets shot or develops cancer all of which may be 100% curable but incredibly expensive to do so is not identical to "I don't want to live for weeks on a respirator." And sorry, but I don't believe young guy who bought crappy health insurance or none because he didn't read the policy or didn't think he needed it is copacetic with not getting the emergency or other care he cannot afford. Nor am I cool with him needlessly dying, but I think he should have contributed to the overall costs.

    The majority of medical costs are spent on two large pools - end of life and emergency care. Much of this is changing rapidly with our evolution in thinking of death and our utilization of hospice. Emergency care has yet to see it's renaissance, but the financial reality make this inevitable.

    There are a minimal number of medical interventions that result in full recovery. Most are merely risk mitigators and due to genetic variation impact <50% of the population. What is fully under individual control is behavior (bearing in mind the nature of the site we are debating this). Your health is largely determined by behavior. Genetics plays a small part in this, but this is a very small percentage of the population.

    It's an interesting legal/moral debate. One the one hand if the young man in this scenario died or suffered injury a savvy lawyer would sue a party for negligence and receive millions in awards. However, the value of effort invested to save the same man's life is expected to occur with minimal compensation.

    If the goal is to reduce cost then logically we would remove all unneeded processes. Insurance and government would be the greatest expenses involved....that is, unless reducing cost is not the goal.

  • ashleygroizard
    ashleygroizard Posts: 181 Member
    I think we have enough laws already.

    People just need to take some personal responsibility. Anyone who's made it past fourth grade should be able to figure this out.

    Eat less. Take a walk. Ta Da.

    Is that all it is to weight loss eat less and take a walk?
  • ashleygroizard
    ashleygroizard Posts: 181 Member
    Or prevent obesity?

    From a maintenance perspective, I wish calorie disclosure would go further. I would like to see mandatory calorie counts for all restaurants and shops selling food items, regardless of number of locations. Not to the extent of sending food to a lab for measurement, but at least calculating calories for all the ingredients and dividing by their serving size.

    I would like to see doctors tell there patients all about weight loss when overweight and helping there patients before they get to obesity. Everyone usually goes to the doctor. And I think if doctors help there patients get to a healthy weight and stay at a healthy weight there would be less people getting obese and overweight. I think the food companies sell to much junk food and should be working on making nice foods that are healthy with less calories and foods that fill people up. My doctor suggested to try and lose some weight and since he said that I’ve gone from 104kgs to 77kgs. Best thing my doctor said to me because now I’m trying to lose weight and get healthy and get in good shape. I’m grateful to my doctor for helping me. Now I’m learning about weight loss walking and eating less and drinking more water and cut out most junk food and try to stick to drinking water sugar free energy drinks and coffee and bike riding and not interested in getting my license back because I’m happy walking most places and walking to public transport to go thirty minutes or more out of town by bus and train. I really think doctors should help there patients so the world can be happier and healthier and fitter.
  • ashleygroizard
    ashleygroizard Posts: 181 Member
    AnnPT77 wrote: »
    I think we have enough laws already.

    People just need to take some personal responsibility. Anyone who's made it past fourth grade should be able to figure this out.

    Eat less. Take a walk. Ta Da.

    Is that all it is to weight loss eat less and take a walk?

    If you eat enough less, and take a long enough walk, yes. ;)

    Your right because I have been eating less and walking 270minutes to 630 minutes a week or sometimes more and I’ve lost heaps of weight. It does take time but it works. Weight loss can be very slow but I’m learning patience and trying to stick to my habits