I received several “you’re heartless” comments when I suggested that healthcare should be rationed to fat people (instead of rationing it to old people).
https://kenhoma.wordpress.com/2009/08/06/instead-of-old-people-how-about-rationing-care-to-fat-people/
Well, on a variant to the theme, a number of state insurance plans penalize smokers already. In January of this year, Alabama became the first state to charge overweight employees more for their health insurance coverage, and North Carolina plans to place state employees who are overweight in a more expensive health insurance plan beginning in July 2011.
A new Rasmussen Reports national telephone survey finds that 50% support a plan that makes government workers who smoke pay more for their health insurance, and 30% favor making overweight government workers pay more for health coverage.
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Factoids
70% of Americans said they opposed a national tax on all non-diet soft drinks to combat obesity.
41% of Americans describe themselves as overweight.
49% of adults say they exercise one to three times per week, and over half say their workout lasts at least 30 minutes.
18% of Americans smoke cigarettes … 34%) don’t smoke now but used to http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/october_2009/30_say_overweight_workers_should_pay_more_for_health_insurance
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The Homa Files 
October 15, 2009 at 9:16 am |
Two arguments for government health care.
Nobody is discussing it here, but isn’t universal healthcare a moral issue? Why are we okay with children that do not see a doctor and dentist on a regular basis? Who may not be able to see the blackboard because they do not have vision benefits? Why is it ok that sickness or injury can take a person from the middle calss and leave them bankrupt? Why are we forced to save our whole lives against the posibility that our final few years will be full of medical expenses?
What could be more wasteful than a for profit insurance industry? I received a beautiful, glossy packet of insurance information this week. What a waste. Besides promotional materials and bills what do you ever receive from an inusrance company? Won’t we be making the system more efficient by simply removing the profit motive and billing inefficiency from the system?
October 15, 2009 at 11:00 am |
At the heart of all public policies issues is morals. But you can’t dismiss the moral values of others. Should the govt take from one person and provide a benefit to another when the recipient squandered their money and didn’t bother to buy insurance? Should an overweight person (due to laziness) have the same insurance premiums as someone who works diligently to take care of themselves? Smokers?
Is it morally acceptable to have thousands of govt bureaucrats employed for work that was previously done by hundreds of profit motivated insurers? Isn’t waste within a system morally troubling? Or is it acceptable because there is no profit involved?
With a fixed pool of resources, is it morally acceptable to save 1 geriatric instead of 10 babies? Is is morally questionable that the president lies about govt healthcare costing less money? Or that end of life care will remain the same as with private insurance?
Most of these debates have a strong moral component and legitimate points from all sides. But I personally find to troubling to chain the livelihood of my family to a person that makes poor decision after poor decision. Its not charity if it occurs at the point of a gun.
October 16, 2009 at 9:32 am |
Your arguments assume that people without health coverage somehow squandered their money or refused to save for a rainy day. While that is surely the case for some percentage of the poor, it is not accurate for the majority.
The biggest joke is that so many people who grew up with money don’t have any idea how lucky they are. Or how hard it is to lose their status as “wealthy” vs how difficult it is to rise from poverty to the middle class. Health costs are just another anchor around their neck.
I’m not sure I understand your paragraph about waste. A government system would be less wasteful because it would allow doctors to be healers rather than marketers and accountants. How much money leaks out of the system to people who handle billing and other services that would not be needed under government care?
What about the old? If you removed the burden of healthcare wouldn’t it be easier for people to save for retirement? How can you plan if there is no way to handicap the odds of sickness draining your savings? Doesn’t this burden the poor more heavily since they are more likely to have untreated conditions as they grow old?
Interesting that you chose to use the word “chain” in your last paragraph. While “charity should not occur at the point of the gun”, neither should it occur at the end of a whip. What about the statistics that suggest a disproportionate percentage of african-americans do not have healthcare? This is a community that was kidnapped into slavery and restricted from education and ownership for generations. High healthcare costs punish the poor unfairly – and blacks make up a disproportionate percentage of the poor.
October 16, 2009 at 11:12 am |
You can’t claim there will be this healthcare utopia where everything is fine and dandy with no negative consequences. There is waste within any large bureaucracy. But the profit motives for insurance companies mandates that they control this waste or the company will not survive. This isn’t the same for govt entities and this is the reason why govt cannot compete with private industry if the rules/regulations are the same. Medicare and Medicaid have an incredible amount of waste and this will only increase with the magnitude change in coverage.
Your comment about removing healthcare costs and enabling folks to save for retirement is completely inaccurate. The elderly consume the lion’s share of healthcare spending and the young are the ones paying a disproportionately high amount. All the congressional bills illustrate this point. You seem to be assuming that this healthcare bill is free and therefore everyone can save for retirement since they no longer have to pay for insurance.
I’ll also say that I’ve been poor and around predominately poor people most of my life. Poverty in the US is one of those conditions that is primarily based upon a series of poor decisions. This goes for whites, blacks and in my local community, Native Americans. I’ve yet to see a poor person remain poor that worked hard, made sound financial decisions and worked to improve themselves. Unfortuntely it may take decades to improve your lot, but you don’t reach middle class by spending all your money, apathetically working at your job and staring at the TV. So while it may make folks feel good that they are ‘helping’ some poor chap down the street, I have a big problem working hard, trying to do the right things and have the govt forcefully take from me to provide for some folks that only perform the bare minimum to survive. Its not charity if it occurs at the point of a gun. Good intentions don’t always have good results.
If you want to make healthcare more affordable to the poor, grant them more freedom to purchase insurance across state lines, pay for only catastrophic insurance if they so choose and make the policies portable so don’t worry about insurance if they lose their jobs. For truelly catastrophic illnesses (cancers, etc) have a govt safety net if folks max out their insurance coverage (eg $1 million lifetime max). But to shoehorn every American into a one-size fits all coverage model will be catastrophic for everyone.
October 17, 2009 at 11:52 am |
“Poverty in the US is one of those conditions that is primarily based upon a series of poor decisions. This goes for whites, blacks and in my local community, Native Americans.”
I’m just going to let that sit there exactly how you wrote it. Unfortunately there are many americans that think this way. We have a generation of people who were born with a silver spoon in their mouth, but believe they earned it.
1) Upward mobility in the United States is a thing of the past
2) Blacks must be 3-times lazier than whites since their historical unemployment rate is triple the level for whites. Except during our salad days of slavery – when everybody had a job. Is your argument that slavery and institutional racism had no effect or that they never happenned?
3) You are assuming that the private healthcare companies must be efficient to survive. Nonsense. Healthcare is like cable TV – you get whatever your building subscribes to. There has never been true competition because the healthcare company does not need to sell itself to the masses. Just some guy in HR who gets to choose what the rest of the company will use.
4) You agree with me that healthcare is the largest expense for the elderly, but you come to the conclusion that taking away the expense of heathcare will not help the elderly plan for retirement. Huh? If somebody saves enough to feed and shelter themself in retirement, why are we subjecting him to a health crap shoot? Under your system we all must save as if we will facea a catastrophic health event. If it does not happen, I guess we have moe to give our kids. If it does happen, hope it is late in your retirement or face poverty in your golden years.
4) You didn’t touch my comment about dental or vision. How can a kid learn if he can’t see? How can anybody get a job without a reasonable set of teeth in their mouth. You think I’m joking? Would you hire somebody with a rotted set of teeth or huge gaps? What if we are leaving behind future business leaders? What if Bill Gates had been born into abject poverty? You think our corporations were run better 50 years ago when all of the minority and woman talent was being wasted? Many middle calss workers with healthcare are like sharecroppers. You think these people will start business and risk capital? When there is the potential for a “health bomb” to blow up their lives and their families? When I tell people about starting my business the #1 comment from people is that I’m lucky that I can take this risk since I don’t have kids. This means that other potential small business owners – the people republicans so deify – are being held back by our system.
5) You sound like you have a few bucks in your pocket. That may explain why you think catastrophic coverage is a good choice for the poor. I recently spent ~ $550 to visit a doctor, get H1N1 tests, and medicine. I use catastrphic because I can easily pay the $550 out of pocket, but do not want to be wiped out by a serious illness. Now imagine a family of 4 in the same situation. If only 3 of the four get sick, they would be looking at $1,600 in expense. And let’s hope the main bread winner is the person who does not get sick, because otherwise the family may not earn any money for that week (or two based on my sickness). High paying jobs tend to come with insurance, but low paying jobs do not, In that world, how can the poor afford decent coverage? But the rich – who tend to make policy – do not seem to understand this. Partially because the coverage they receive is largely untaxed. I would argue that most people have no idea how much healthcare they use per year, because their company/insurer are the only ones to see the full bill. This is like a company buying their CEO a home. or providing an office after the CEO has been fired. You’ve been paying this guy a fortune for years! Why can’t he pay for his own secretary?
You can call it socialism or whatever you want, but the moral choice is clear to me. If I were Obama I would simply wait another year. Wait for more people to become unemployed. Wait until more people understand what life is like without healthcare.