Should some folks contribute more for gov't health care?
 

Since we're fixated in the possibility of some sort of health care reform, riddle me this: if a person engages in high-risk behavior (i.e. smoking, eating to obesity, excessive drinking, illegal drug use), should they be expected to contribute more for their health care? I'm not talking about genetic issues that may be well beyond the victim's control, but life decisions that put the individual at increased risk of health problems.

I'm wondering also about people with high-risk hobbies...

Just curious what everyone thinks.

Perhaps so, but how do you judge? I currently pay more for life insurance because I am a smoker, but I tell them that. You see, there are few repercussions of admitting to tobacco use.

This isn't what you asked, but I would be happy to pay more than I do now, simply because I make a comfortable wage and I could easily pay more. What I would be paying for is the comfort of knowing that should I have to take a lower wage job in the future, that my health care costs could go down. Or, horrors of horrors, I set off on my own and don't have any income for a few years. It is my belief that health insurance is stopping a lot of people from quitting their jobs and starting a business, and adding to a lot of small business failures.

If government were not involved in health care, there would be no need to even ask this question. If government were to get involved as a significant player, they would have a rightful argument against what kinds of risky activites people engage in. That opens the door to government restrictions on all sorts of personal behavior. That's why it's best to keep government out as much as possible.

Perhaps a better question is: assuming some sort of universal health care is enacted, what is the incentive to make healthy choices? Not that folks are making very healthy choices these days as it is...

Now that's a good question.

Here is one possibility. Preventive care becomes free. That is, you can go for a check-up with no co-pay. People will go, even though the doctor tells them to quit smoking, reduce drinking or lose weight every time. But hearing that will make them think. Well, some of them anyway.

There would be no such incentive under a "free" government administered health care system. The only incentives in such a case would come in the form of draconian laws governing what activities a person can engage in. Again, the only way to avoid this is to not get government involved to begin with.

What's the incentive now?

The g'ment is heavily, even exclusively, involved in medicare and medicaid. I can't speak to medicaid, but medicare makes no distinction beween subscribers having a "healthful" lifestyle and subscribers that don't.

Well, if one were paying out of their own pocket for medical expenses, they would have to make smarter choices than those in either private insurance or one of the current government programs. Whenever someone else is paying, the incentives for a consumer to make wise decisions are much less.


I should have been a bit clearer; I should have said "further government involvement". AFAIK, Medicare does not pay 100% of all expenses. I can't speak to Medicaid at this time since I am unfamiliar with it.

I'll say it again, the "incentives" under a government-administered health care system would take the form of laws and regulations regarding personal behavior, all in the name of the public good. There's just too much opportunity for further government intervention in all facets of life if universal government health care were to ever come into being. A government plan COULD work, but both the public and those in government would have to rid themselves of human nature. Not going to happen ever.

It's true Medicare does not provide 100% coverage. It 's also true that fact isn't relevent. The current g'ment run programs do not get invovled with personal likestyle choices. I see no reason to think that would change. But the current proposed healthcare reform does not increase the g'ment role in healthcare, does it?

When I carried my own private health insurance, there were exceptions to coverage. No coverage for flying in private planes, acts of war, and IIRC competition in a vehicle.

So you are in favor of no insurance industry at all? I'm not sure I follow.

No, he's saying increased cost makes people not smoke because health care is more expensive for smokers.
IOW, people would be as healthy as they could personally afford to be.

An interesting question. I will answer with another question: If you are covered by employer purchased insurance, do they have the right to force you to exercise? To eat healthy? To stop smoking?



What is the incentive to make healthy choices now? I would say that money is not the only incentive. I think not dying of emphysema is an incentive not to smoke. Not having a heart attack at 30 is an incentive not to let one's cholesterol out of control. Some people are not as incentivized as others.

Just tax processed food the way tobacco and alcohol are taxed. Tax added salt, added sugar. Tax high fat. Then the low fat low salt soup would cost less than high fat high salt, instead of the reverse as it is now.

I think an employer that payed for insurance would have a much better chance of enforcing a "healthy lifestyle" than the g'ment.

A healthy lifestyle is encouraged by the company that I work for.

Perhaps. The question remains however. Does your employer have the right to be the overseer of your health decisions as the primary payer? Is it good for the employer to be the enforcer? Should there be an enforcer? If yes to the last two, what is different about the employer v government?

The insurance company providing coverage could force an employer to do all that. Whether it's good or not is up to the insurance co. The difference between the employer and the g'ment is choice. We're all stuck with the g'ment. People choose their employer.

Let the rich pay for it...

People who are obese, smoke, etc tend to be on the lower end of the socioeconomic scale so they cannot pay for anything.

Put yet another surcharge on those dirty Capitalists making over $350K

Let me ask you this. Whether I engage in high risk behavior or whether I have a genetic condition, what is the difference to the bill? IOW, whether my parents have had cancer and therefore I am at higher risk for cancer or whether I smoke and might have a higher risk of cancer, what is the difference when you pay for it? Isn't the money the same either way? If you are higher risk, you are higher risk. Whether you say it is genetic and beyond your control or whether you engage in high risk behavior, the problem is still going to cost what it costs assuming the diagnosis is the same. If you get shot in the arm accidently or on purpose, what is the difference? Treatment is the same for the same wound. It hurts just as much.

Costs the same, but one is highly preventable. If it's preventable then the person making the choices to get themselves to the point of this is making all of us pay for those choices, the person with the genetic reason is not. Why should I pay for your stupid decisions? When you fall down don't give me the skinned knees. I tell my boys "pain is your teacher". If you hurt your knee while skateboarding and you did not have knee pads on- the pain teaches you to wear knee pads. When you take away the pain there is no reason to discontinue the detrimental behavior. That is the reason for pain: it tells you what you just did is bad for your body. The more pain, the worse it is for your body. Economic pain works much the same way. This is the major issue with subsidized medicine, housing, cell phones, food, etc. If you get those you also do not get the pain of not having those- which teaches you 1) Not to change what you are doing now 2)to increase what you are now doing because you are getting stuff for no work 3) Don't go to work because the money you make while working will slow the flow of your "free stuff". The left wants to give that stuff away after "buying" it with money they don't have or taking that money from someone else, the right wants you to work and earn those things for yourself.

Contribute more, you ask . . . well, is there some sort of historical precident for such a collection of revenue?

Again, what is the dollar difference? Higher risk is higher risk. IMO, higher risk, higher price. I don't care why. To ask a question on similar lines, "Why should I pay for your bad genes?". It's not my fault that your parents gave you those bad traits. I didn't make your parents give birth to you. So why should I pay for it? I am for across the board increase in pricing for higher risk whether it is your parent's fault, your fault, your kid's fault, etc, etc. Either way drains my pocket the same. Therefore, you should pay to cover your issues, be they genetic or choice.

That is why I think the govt should butt out of our private lives. I moved out of Mom & Dad's house. Now I have to contend with rent/mortgage, doing my own home maintenance, having to maintain my own cars, etc, etc. I could have stayed at home and enjoyed all that and more while socking my paycheck away or even not having to work for food and lodging. I gained my independence but the downside is I have to be responsible for it all. As they say in dog training: NILIF. Nothing In Life Is Free. I wanted my freedom but that costs.