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Do you think obese/overweight people should pay more for health insurance?
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KosmosKitten wrote: »I believe the strange part wasn't the 0 out of pocket, but the $8K total cost, which does seem so low as to be strange, but I would guess that Tricare negotiated a good deal for themselves, as they may have the power to.
They do that quite often, by what I've seen. My costs for having to fly back from Japan on emergency medical leave, be seen by a specialist and give birth in a facility far away from where my husband was stationed? $0. I didn't pay anything at all.
We weren't talking about the out of pocket, but the total costs which seemed unusually low for the procedures in question. Did you see the total costs Tricare paid and was it shockingly low for the various things paid for? Just vaguely curious about whether they are getting great deals vs some other insurers.1 -
KosmosKitten wrote: »I believe the strange part wasn't the 0 out of pocket, but the $8K total cost, which does seem so low as to be strange, but I would guess that Tricare negotiated a good deal for themselves, as they may have the power to.
They do that quite often, by what I've seen. My costs for having to fly back from Japan on emergency medical leave, be seen by a specialist and give birth in a facility far away from where my husband was stationed? $0. I didn't pay anything at all.
We weren't talking about the out of pocket, but the total costs which seemed unusually low for the procedures in question. Did you see the total costs Tricare paid and was it shockingly low for the various things paid for? Just vaguely curious about whether they are getting great deals vs some other insurers.
Yes. The costs for the ticket alone to my home state was about $3k at the time; the appointments with the specialist were $600 for the consultation and $350 per appointment. The hospital stay and all the special care we both required (my child was born with some mild complications) was about $24k. The costs that Tricare paid on their end was equivalent to maybe $3.5k total for the entire 4 month ordeal when I got the statement upon getting back to Japan and in that statement, they also listed that I owed nothing. I was shocked that they negotiated such a low fee for themselves!
I have no idea how they negotiate such good deals for themselves when not utilizing military facilities. It's a mystery.
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That's interesting, thanks!0
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Is there a benefit to charging obese people more for healthcare? What is it?0
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PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
I don't think there's any benefit to society in general, since I don't believe charging obese people more for insurance is going to motivate anyone to lose weight without the benefit of support systems like access to a registered dietician and lifestyle counselling.
For the insurance companies on the other hand, it raises profits, since more money in the pool is amortized over the same number of people.2 -
PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
Is there a benefit to charging smokers extra?
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Theoldguy1 wrote: »PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
Is there a benefit to charging smokers extra?
If you prefer punitive measures because it fulfills a moral code, then sure. But if you prefer to solve health issues, no.2 -
PopGoesTheCoyote wrote: »Theoldguy1 wrote: »PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
Is there a benefit to charging smokers extra?
If you prefer punitive measures because it fulfills a moral code, then sure. But if you prefer to solve health issues, no.
Punitive measures such as high taxes on cigarettes, higher life and health insurance rates seem to have contributed to reductions in smoking. Smoking related health issues are down.
No moral code involved, just things that seem to work.2 -
Theoldguy1 wrote: »PopGoesTheCoyote wrote: »Theoldguy1 wrote: »PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
Is there a benefit to charging smokers extra?
If you prefer punitive measures because it fulfills a moral code, then sure. But if you prefer to solve health issues, no.
Punitive measures such as high taxes on cigarettes, higher life and health insurance rates seem to have contributed to reductions in smoking. Smoking related health issues are down.
No moral code involved, just things that seem to work.
This is conflating two things together and saying they both work because one works and the other isn't as bad as the positives of the first.
Increasing the cost of cigarettes reduces the availability of cigarettes: this reduces smoking related harms by reducing the amount people smoke. This can be seen clearly in alcohol deaths in Finland, where the proportion of deaths related to alcohol is inversely proportional to the price.
Increasing the cost of health insurance reduces the availability of healthcare and causes people to die: a lack of checkups/screening for lung cancer, being dissuaded from going to the doctor until symptoms are unmanageable at home. This increases harm (and deaths) from smoking.
To reduce smoking related harm the aim should be to reduce the availability of cigarettes and increase healthcare coverage of those who smoke.
Similarly with obesity: reducing the availability and attractiveness of calorie dense foods as was done to cigarettes and tobacco (specific taxes, minimum prices, advertising bans, plain packaging etc) with increased public health engagement and BETTER healthcare for people who are obese are likely to improve the actual harms (morbidity and early mortality) of obesity.
Decreasing access to healthcare will offset increased costs to insurance companies, and maintain or improve profitability of offering insurance to obese people, but will obviously squeeze people out at the bottom end of the income scale.
Of course, in the end, this is a false saving (for the people overall) as obese people still use the healthcare systems at a disproportionate rate, just this shifts from preventative and primary care to emergency care.
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Local Farmers Markets in our area double WIC coupons and SNAP benefits. This means that families can access healthy fresh vegetables, greens, and fruit in season. There are also classes available to teach families how to maximize the value of their SNAP and WIC benefits by learning to cook from scratch and choose healthier options to feed themselves and their children. Having access to a stove and an area to cook can also make it harder to choose healthy food. At one point in our lives as a family we lived in a hotel for several months. Father with a job, heavily pregnant mother, and a three year old boy. My husband had a job that paid decently, but we were struggling to find housing in a high poverty community where many units were Section 8 and the few small houses and apartments that we could afford were in awful shape and the nearest bigger city was Wichita, Kansas more than an hour and a half away. With me due to give birth within two months, we didn't want to risk it. We ate a lot of meals out and I spent many hours entertaining our son at the local park to get us out of the tiny hotel room. Humbling experience that changed my perception of just how difficult the lives of some people are. I remember a group of kids coming up to me while I read to my son at the Park. They asked what we were doing, could they listen too, and where did I get the book? I told them about the public library just down the street and that they could check out books for free. They had never learned this. After that I bought boxes of cookies and encouraged them to join our reading session. I realized after a little girl woofed down 4 cookies that she hadn't had breakfast or lunch that I would also bring some sandwiches. It can be cheaper to get a fast food hamburger and fries that to make a healthy meal when you don't have access to a stove, grocery store, or enough money to buy better quality food.12
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PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
It's the same logic that leads to some drivers getting charged more than others for auto insurance. If the company calculates that you're likely to cost more to insure, they'll often charge you more.5 -
janejellyroll wrote: »PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
It's the same logic that leads to some drivers getting charged more than others for auto insurance. If the company calculates that you're likely to cost more to insure, they'll often charge you more.
Then they should charge women for being at risk to get pregnant, people who live in more polluted areas because they're at greater risk for cancer and other pollution-related problems, anyone who gets an autoimmune disease (AIDS, Hashimoto's, etc.), anyone who gets cancer because they got cancer and even if it gets removed, there is a risk of it returning to the lungs and the liver and more, people over 65 because they're at risk of more diseases and healthcare, parents with children because children are at risk for illness, parents whose children are disabled because that disability is going to be costly to the insurance company, people who drive instead of walk because driving is more likely to get you into an accident and walking is more likely to increase your health since you won't be as fat, and absolutely everyone who refuses to get any vaccines at all.
It's the same logic that leads to drivers getting charged more than others for auto insurance. If the company calculates that you're likely to cost more to insure, they'll often charge you more.
And to hit the "choice" aspect of this all, that being obese is a choice, smoking being a choice; having children is a choice too.
Autobahn66's post hits the real concerns better. Charging obese people more healthcare will not solve the problem of obesity. It will just add to the problem and maybe the best thing that will come out of it is a few people will get to feel sadistic vindication that fat people are getting punished.5 -
PopGoesTheCoyote wrote: »janejellyroll wrote: »PopGoesTheCoyote wrote: »Is there a benefit to charging obese people more for healthcare? What is it?
It's the same logic that leads to some drivers getting charged more than others for auto insurance. If the company calculates that you're likely to cost more to insure, they'll often charge you more.
Then they should charge women for being at risk to get pregnant, people who live in more polluted areas because they're at greater risk for cancer and other pollution-related problems, anyone who gets an autoimmune disease (AIDS, Hashimoto's, etc.), anyone who gets cancer because they got cancer and even if it gets removed, there is a risk of it returning to the lungs and the liver and more, people over 65 because they're at risk of more diseases and healthcare, parents with children because children are at risk for illness, parents whose children are disabled because that disability is going to be costly to the insurance company, people who drive instead of walk because driving is more likely to get you into an accident and walking is more likely to increase your health since you won't be as fat, and absolutely everyone who refuses to get any vaccines at all.
It's the same logic that leads to drivers getting charged more than others for auto insurance. If the company calculates that you're likely to cost more to insure, they'll often charge you more.
And to hit the "choice" aspect of this all, that being obese is a choice, smoking being a choice; having children is a choice too.
Autobahn66's post hits the real concerns better. Charging obese people more healthcare will not solve the problem of obesity. It will just add to the problem and maybe the best thing that will come out of it is a few people will get to feel sadistic vindication that fat people are getting punished.
I guess I don't see the decision to reproduce as a "risk" as much as I see it as a "necessary condition for the species to continue existing" and the people who choose to reproduce will then usually pay more for insurance (unless someone else is adopting the children).
I'm not necessarily an advocate for charging the obese more, I'm just pointing out I can certainly understand the business reasons an insurance company might want to do so. On a population level, excess weight is an absolute contribution to health care costs and it's something that can be tracked on a level that is impossible for things like "do they sometimes choose to walk instead of drive?"
Being obese IS a choice on a level that just isn't true for things like being over 65 or living in an area with pollution.6 -
kristingjertsen wrote: »Local Farmers Markets in our area double WIC coupons and SNAP benefits. This means that families can access healthy fresh vegetables, greens, and fruit in season. There are also classes available to teach families how to maximize the value of their SNAP and WIC benefits by learning to cook from scratch and choose healthier options to feed themselves and their children. Having access to a stove and an area to cook can also make it harder to choose healthy food. At one point in our lives as a family we lived in a hotel for several months. Father with a job, heavily pregnant mother, and a three year old boy. My husband had a job that paid decently, but we were struggling to find housing in a high poverty community where many units were Section 8 and the few small houses and apartments that we could afford were in awful shape and the nearest bigger city was Wichita, Kansas more than an hour and a half away. With me due to give birth within two months, we didn't want to risk it. We ate a lot of meals out and I spent many hours entertaining our son at the local park to get us out of the tiny hotel room. Humbling experience that changed my perception of just how difficult the lives of some people are. I remember a group of kids coming up to me while I read to my son at the Park. They asked what we were doing, could they listen too, and where did I get the book? I told them about the public library just down the street and that they could check out books for free. They had never learned this. After that I bought boxes of cookies and encouraged them to join our reading session. I realized after a little girl woofed down 4 cookies that she hadn't had breakfast or lunch that I would also bring some sandwiches. It can be cheaper to get a fast food hamburger and fries that to make a healthy meal when you don't have access to a stove, grocery store, or enough money to buy better quality food.
THIS
Exactly this.
Been there. Done that. (by which I mean very similar)
I do want to add also: Yes. Farmer’s Markets are usually wonderful with SNAP and such.
The problem is that Farmers Markets tend to be in ritzy areas. And only open during very limited hours. So, if you’re working? Or have limited transportation? Tough nuggets. No SNAP farmers market bonus for you.1 -
MargaretYakoda wrote: »kristingjertsen wrote: »Local Farmers Markets in our area double WIC coupons and SNAP benefits. This means that families can access healthy fresh vegetables, greens, and fruit in season. There are also classes available to teach families how to maximize the value of their SNAP and WIC benefits by learning to cook from scratch and choose healthier options to feed themselves and their children. Having access to a stove and an area to cook can also make it harder to choose healthy food. At one point in our lives as a family we lived in a hotel for several months. Father with a job, heavily pregnant mother, and a three year old boy. My husband had a job that paid decently, but we were struggling to find housing in a high poverty community where many units were Section 8 and the few small houses and apartments that we could afford were in awful shape and the nearest bigger city was Wichita, Kansas more than an hour and a half away. With me due to give birth within two months, we didn't want to risk it. We ate a lot of meals out and I spent many hours entertaining our son at the local park to get us out of the tiny hotel room. Humbling experience that changed my perception of just how difficult the lives of some people are. I remember a group of kids coming up to me while I read to my son at the Park. They asked what we were doing, could they listen too, and where did I get the book? I told them about the public library just down the street and that they could check out books for free. They had never learned this. After that I bought boxes of cookies and encouraged them to join our reading session. I realized after a little girl woofed down 4 cookies that she hadn't had breakfast or lunch that I would also bring some sandwiches. It can be cheaper to get a fast food hamburger and fries that to make a healthy meal when you don't have access to a stove, grocery store, or enough money to buy better quality food.
THIS
Exactly this.
Been there. Done that. (by which I mean very similar)
I do want to add also: Yes. Farmer’s Markets are usually wonderful with SNAP and such.
The problem is that Farmers Markets tend to be in ritzy areas. And only open during very limited hours. So, if you’re working? Or have limited transportation? Tough nuggets. No SNAP farmers market bonus for you.
I feel like this is very community-reliant. For example, I live in a city that is fortunate enough to have several different farmer's markets, including many that are extremely accessable via public transportation and not in high income areas. There are also options that are available outside the stereotypical farmer's market hours.
I know this isn't the case everywhere and there is a lot of work to be done, but this is a good example of something that can be impacted on a community level if there is a grassroots desire to do it.2 -
janejellyroll wrote: »MargaretYakoda wrote: »kristingjertsen wrote: »Local Farmers Markets in our area double WIC coupons and SNAP benefits. This means that families can access healthy fresh vegetables, greens, and fruit in season. There are also classes available to teach families how to maximize the value of their SNAP and WIC benefits by learning to cook from scratch and choose healthier options to feed themselves and their children. Having access to a stove and an area to cook can also make it harder to choose healthy food. At one point in our lives as a family we lived in a hotel for several months. Father with a job, heavily pregnant mother, and a three year old boy. My husband had a job that paid decently, but we were struggling to find housing in a high poverty community where many units were Section 8 and the few small houses and apartments that we could afford were in awful shape and the nearest bigger city was Wichita, Kansas more than an hour and a half away. With me due to give birth within two months, we didn't want to risk it. We ate a lot of meals out and I spent many hours entertaining our son at the local park to get us out of the tiny hotel room. Humbling experience that changed my perception of just how difficult the lives of some people are. I remember a group of kids coming up to me while I read to my son at the Park. They asked what we were doing, could they listen too, and where did I get the book? I told them about the public library just down the street and that they could check out books for free. They had never learned this. After that I bought boxes of cookies and encouraged them to join our reading session. I realized after a little girl woofed down 4 cookies that she hadn't had breakfast or lunch that I would also bring some sandwiches. It can be cheaper to get a fast food hamburger and fries that to make a healthy meal when you don't have access to a stove, grocery store, or enough money to buy better quality food.
THIS
Exactly this.
Been there. Done that. (by which I mean very similar)
I do want to add also: Yes. Farmer’s Markets are usually wonderful with SNAP and such.
The problem is that Farmers Markets tend to be in ritzy areas. And only open during very limited hours. So, if you’re working? Or have limited transportation? Tough nuggets. No SNAP farmers market bonus for you.
I feel like this is very community-reliant. For example, I live in a city that is fortunate enough to have several different farmer's markets, including many that are extremely accessable via public transportation and not in high income areas. There are also options that are available outside the stereotypical farmer's market hours.
I know this isn't the case everywhere and there is a lot of work to be done, but this is a good example of something that can be impacted on a community level if there is a grassroots desire to do it.
Agreed.
We’re rural. So the Farmers Market is in the county seat, and one kind of central small town twenty miles up the road. Saturday in one spot, Sunday in the other.
I do know most of the local farmers donate what they can to the food bank.
But if you’re way out in the sticks? Or you work on weekends in this heavily tourist dependent town? (most tourist associated jobs mean working weekends) Again. Tough nuggets.
And there is a LOT of grassroots support for assisting those who are struggling. But it’s not enough. I’m not sure if it will ever be enough.0 -
janejellyroll wrote: »MargaretYakoda wrote: »kristingjertsen wrote: »Local Farmers Markets in our area double WIC coupons and SNAP benefits. This means that families can access healthy fresh vegetables, greens, and fruit in season. There are also classes available to teach families how to maximize the value of their SNAP and WIC benefits by learning to cook from scratch and choose healthier options to feed themselves and their children. Having access to a stove and an area to cook can also make it harder to choose healthy food. At one point in our lives as a family we lived in a hotel for several months. Father with a job, heavily pregnant mother, and a three year old boy. My husband had a job that paid decently, but we were struggling to find housing in a high poverty community where many units were Section 8 and the few small houses and apartments that we could afford were in awful shape and the nearest bigger city was Wichita, Kansas more than an hour and a half away. With me due to give birth within two months, we didn't want to risk it. We ate a lot of meals out and I spent many hours entertaining our son at the local park to get us out of the tiny hotel room. Humbling experience that changed my perception of just how difficult the lives of some people are. I remember a group of kids coming up to me while I read to my son at the Park. They asked what we were doing, could they listen too, and where did I get the book? I told them about the public library just down the street and that they could check out books for free. They had never learned this. After that I bought boxes of cookies and encouraged them to join our reading session. I realized after a little girl woofed down 4 cookies that she hadn't had breakfast or lunch that I would also bring some sandwiches. It can be cheaper to get a fast food hamburger and fries that to make a healthy meal when you don't have access to a stove, grocery store, or enough money to buy better quality food.
THIS
Exactly this.
Been there. Done that. (by which I mean very similar)
I do want to add also: Yes. Farmer’s Markets are usually wonderful with SNAP and such.
The problem is that Farmers Markets tend to be in ritzy areas. And only open during very limited hours. So, if you’re working? Or have limited transportation? Tough nuggets. No SNAP farmers market bonus for you.
I feel like this is very community-reliant. For example, I live in a city that is fortunate enough to have several different farmer's markets, including many that are extremely accessable via public transportation and not in high income areas. There are also options that are available outside the stereotypical farmer's market hours.
I know this isn't the case everywhere and there is a lot of work to be done, but this is a good example of something that can be impacted on a community level if there is a grassroots desire to do it.
I wish that had been the case when I lived in MS. I lived by the ocean, but only the "ritzy" city one city over really had a farmer's market and it offered no benefits to WIC or SNAP participants, but also, there was no bus transportation that ran to it from our larger city. There were farms in our area, but again, if you had no car, you weren't going to drive to them. Most of the convenient places to walk to had little or no fresh produce and you really needed a car to drive to any of the larger grocery stores that carried better/healthier options.
We did have roadside stands, though. Usually selling tomatoes, potatoes, watermelons, sometimes pumpkins and cucumbers. Oh, and boiled peanuts. And once in a great blue moon, I'd see a guy selling flats of strawberries.
For being one of the largest cities in the state, the public transit sucked. And there are a lot of places in the southern U.S. like that.
I imagine where I live now is probably going to be quite a bit different, but I'm still figuring that one out. 2 -
They already do in France, my half sister is morbidly obese and she has to pay a premium for health care. But in France it's a whole different culture, they don't care about offending overweight people.7
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They already do in France, my half sister is morbidly obese and she has to pay a premium for health care. But in France it's a whole different culture, they don't care about offending overweight people.
If you think people in the US care about offending overweight people…. I have a bridge in Brooklyn I can sell cheap….7 -
MargaretYakoda wrote: »janejellyroll wrote: »MargaretYakoda wrote: »kristingjertsen wrote: »Local Farmers Markets in our area double WIC coupons and SNAP benefits. This means that families can access healthy fresh vegetables, greens, and fruit in season. There are also classes available to teach families how to maximize the value of their SNAP and WIC benefits by learning to cook from scratch and choose healthier options to feed themselves and their children. Having access to a stove and an area to cook can also make it harder to choose healthy food. At one point in our lives as a family we lived in a hotel for several months. Father with a job, heavily pregnant mother, and a three year old boy. My husband had a job that paid decently, but we were struggling to find housing in a high poverty community where many units were Section 8 and the few small houses and apartments that we could afford were in awful shape and the nearest bigger city was Wichita, Kansas more than an hour and a half away. With me due to give birth within two months, we didn't want to risk it. We ate a lot of meals out and I spent many hours entertaining our son at the local park to get us out of the tiny hotel room. Humbling experience that changed my perception of just how difficult the lives of some people are. I remember a group of kids coming up to me while I read to my son at the Park. They asked what we were doing, could they listen too, and where did I get the book? I told them about the public library just down the street and that they could check out books for free. They had never learned this. After that I bought boxes of cookies and encouraged them to join our reading session. I realized after a little girl woofed down 4 cookies that she hadn't had breakfast or lunch that I would also bring some sandwiches. It can be cheaper to get a fast food hamburger and fries that to make a healthy meal when you don't have access to a stove, grocery store, or enough money to buy better quality food.
THIS
Exactly this.
Been there. Done that. (by which I mean very similar)
I do want to add also: Yes. Farmer’s Markets are usually wonderful with SNAP and such.
The problem is that Farmers Markets tend to be in ritzy areas. And only open during very limited hours. So, if you’re working? Or have limited transportation? Tough nuggets. No SNAP farmers market bonus for you.
I feel like this is very community-reliant. For example, I live in a city that is fortunate enough to have several different farmer's markets, including many that are extremely accessable via public transportation and not in high income areas. There are also options that are available outside the stereotypical farmer's market hours.
I know this isn't the case everywhere and there is a lot of work to be done, but this is a good example of something that can be impacted on a community level if there is a grassroots desire to do it.
Agreed.
We’re rural. So the Farmers Market is in the county seat, and one kind of central small town twenty miles up the road. Saturday in one spot, Sunday in the other.
I do know most of the local farmers donate what they can to the food bank.
But if you’re way out in the sticks? Or you work on weekends in this heavily tourist dependent town? (most tourist associated jobs mean working weekends) Again. Tough nuggets.
And there is a LOT of grassroots support for assisting those who are struggling. But it’s not enough. I’m not sure if it will ever be enough.
I visited the farmers market recently with my mother and was shocked. Our farmers market is horrifyingly expensive, compared to the grocery. And food there is not necessary local or grown by farmers - it’s common for booths to ship in food from big growers and sell it at stalls. But the main thing is the expense, a pint of berries more than twice the price of the ones at the store, ditto peaches, squash, corn, crowder peas. Ended up spending $80 on a small plastic bag of one meal and a few snacks. I’m wondering if people who suggest to shop at Farmers markets live somewhere where the situation is different.3
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