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Old 06-04-2013, 06:51 PM   #21
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If that is the case then the calculator is asking the wrong question. The question should be - Do you use nicotine containing products?

I hope I live long enough to find out what "morbidly" obese means and how they intend to determine if it is a "medical" problem. Will they reimburse for overpayment as a new "medical" problem emerges from research? You are the doctor - what is obese and who is justified in their obesity. (What about a crippled person with low thyroid or something?)

Let's march for equal rights of all citizens to healthy diet choices and neighborhood stores that sell them. It does occur to me that people whose drug of choice is tobacco and whose diet is not nutritional but calorie laden tend to be poor than the alternative.
You bring up a good point Tadpole. I have noticed that recently the term "nicotine use" being used more instead of smoking or tobacco use. Which I find interesting because just recently the FDA said it was safe to be on nicotine replacement lozenges or gum long term instead of the 6 weeks or so originally determined. My doctor has said for a normal healthy person these products cause no harm, so I speculate the reason they mention nicotine specifically is they believe these people will eventually slide back into their old smoking/chewing habits.
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Old 06-04-2013, 07:33 PM   #22
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Funny how they outlaw underwriting, then start layering it back in. Now tobacco use, soon weight I expect, next?

I'm just surprised they did not include Alcohol as in alcohol addiction, illegal drug use, pain medication use not prescribed by a doctor...etc. I suppose i don't like the targeting of one segment of lifestyle choices. Why leave any of them out?
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Old 06-04-2013, 07:43 PM   #23
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What if a smoker checks "No"? How can an insurance company (or anyone else) check if a person is a smoker or not? (I am not a smoker, just a thought).
Obesity is probably easier to measure than smoking.
Well...there is that little thing happening like electronic medical records. It will be in your file at your general practitioner, probably a box checked and probably a report sent to the IRS and insurance companies eventually that can be cross scanned and checked.
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Old 06-04-2013, 08:01 PM   #24
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I think they're going to have to clarify a lot of this information. For example, if someone uses e-cigarettes they aren't doing themself any significant harm as opposed to a cigarette smoker. Same if you're smoking pot, assuming you are an occasional user and not a daily veg-head. Overweight people live longer than underweight people. Drinking (not to excess) is good for your heart, and it's going to be hard to prove excess. There are a lot of variables, and if the government is going to use science instead of moral judgements they are going to be changing requirements and parameters every few months as the science changes.

Also, I can't see charging smokers or heavy drinkers or obese people more for insurance when most studies show they cost less for health care over their lives than slender, non-smoking, non-drinking boring people. They die younger, faster, and cheaper. There may be some costs of treatment while they are alive, but over a life time they cost less.

I suspect there's going to be a lot of pressure to "steer" people into behavior that the government approves of as opposed to responding to the science of the day. And I also expect pretty much constant lawsuits being brought by the various groups that are being discriminated against.
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Old 06-05-2013, 06:28 AM   #25
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Charging higher rates for smokers, obese people and others with specific poor lifestyle or living habits has been practiced in the workplace for over a decade and now is not uncommon. Employers are encouraging employees to enroll in wellness programs and monitoring weight, and giving premium discounts for these things. Any group plan that gives a discount for smoking cessation, weit loss or wellness enrollment had the higher rate built into the premium.
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Old 06-05-2013, 09:01 AM   #26
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Unfortunately costs will be going up for many, many other groups too. After the news a week or so ago about Californias premiums the following came to light Rate Shock: In California, Obamacare To Increase Individual Health Insurance Premiums By 64-146% - Forbes . So in fairness, this could definately be considered sticker shock. At the end of the day someone has to pay and unfortunately it is not limited to individuals with poor lifestyles.

I just hope that at that same days end the new law, taxes, penalties, warts and all, will be a benefit to everyone.
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Old 06-05-2013, 09:05 AM   #27
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Well...there is that little thing happening like electronic medical records. It will be in your file at your general practitioner, probably a box checked and probably a report sent to the IRS and insurance companies eventually that can be cross scanned and checked.
Are you saying that smokers won't be allowed to quit anymore
And how can a general practitioner know that info anyway? Would not he/she needs an authorization to perform a test?

Bottom line: short of forcing everyone to take a test, there is no way for the insurance company to know if a person is a smoker or not.
My prediction - "official" number of smokers in US will be cut 10x next year.
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Old 06-05-2013, 09:27 AM   #28
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Also, I can't see charging smokers or heavy drinkers or obese people more for insurance when most studies show they cost less for health care over their lives than slender, non-smoking, non-drinking boring people. They die younger, faster, and cheaper. There may be some costs of treatment while they are alive, but over a life time they cost less.

Just quoting you as an example.....


The problem with this thinking is that for an insurance company... a smoker will probably cost more TODAY than a non-smoker... they are not as concerned with the total lifetime cost of the insured....

If I were an insurance company, I would want all my customers to be healthy at least until they turn 65 and are off my dime....


So, smokers, drinkers and such are unhealthy at an age when the insurance companies pay.... healthy people are unhealthy at an age when the gvmt pays....
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Old 06-05-2013, 09:29 AM   #29
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Here's the real question: Does Obamacare cover Medical Marijuana smoking in states where it is legal? If so, how do they reconcile that?

IIRC, heavy Marijuana smoking is worse for your lungs than tobacco.
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Old 06-05-2013, 09:30 AM   #30
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Are you saying that smokers won't be allowed to quit anymore
And how can a general practitioner know that info anyway? Would not he/she needs an authorization to perform a test?

Bottom line: short of forcing everyone to take a test, there is no way for the insurance company to know if a person is a smoker or not.
My prediction - "official" number of smokers in US will be cut 10x next year.

I would bet that there is some language that would allow an insurance company to not pay claims if they can prove you are a smoker... so if you come down with lung cancer and they can see that you were a smoker from the x-rays etc.... well, too bad for you....
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Old 06-05-2013, 10:23 AM   #31
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Unfortunately costs will be going up for many, many other groups too. After the news a week or so ago about Californias premiums the following came to light Rate Shock: In California, Obamacare To Increase Individual Health Insurance Premiums By 64-146% - Forbes . So in fairness, this could definately be considered sticker shock. At the end of the day someone has to pay and unfortunately it is not limited to individuals with poor lifestyles.

I just hope that at that same days end the new law, taxes, penalties, warts and all, will be a benefit to everyone.
This Forbes piece by Avik Roy has been cited more than many other as proof of dramatic price increases resulting from implementation of the PPACA. It is the base for the WSJ article linked earlier in this thread. There are a fair number of rebuttals. The problem is we could draw some meaningful conclusions from it but instead find mostly hyperbole and excessive posturing.

The fact is that most of the policies to be sold on the California exchange will have premiums similar to those already in force for the 90% of Californians that have insurance today through group policies. Because group policies tend to cost less as the group size increases, there was an expectation that the individual policy premiums would be a bit higher. Instead, they are slightly lower.

Comparing those prices to quotes from an online insurance broker is inconclusive, because those policies are all subject to underwriting and all of us can be denied coverage at that price. An individual holding a policy at that price will certainly see a sizable increase in premium at the exchange. That case, however, cannot be projected to the public at large, because over 90% of the population either pays the current exchange rate or has no insurance.

The media seems obsessed it portraying this as either wildly successful or failing dismally. What matters now is implementation and how we are affected. A much more relevant question is what happens to the policyholder with an underwritten policy with low premiums. What is the premium cost of the national care policy on the California exchange? What factors are keeping the premiums levels low in California and how do they affect us?
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Old 06-05-2013, 10:26 AM   #32
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I would bet that there is some language that would allow an insurance company to not pay claims if they can prove you are a smoker... so if you come down with lung cancer and they can see that you were a smoker from the x-rays etc.... well, too bad for you....
But does the question on the application says: "Were you a smoker?" or "Are you a smoker?" ?
If the question is "are you a smoker?" then stop smoking a few weeks before that X-ray is all it should take.
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Old 06-05-2013, 10:33 AM   #33
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But does the question on the application says: "Were you a smoker?" or "Are you a smoker?" ?
If the question is "are you a smoker?" then stop smoking a few weeks before that X-ray is all it should take.
Or just don't smoke (or inhale?) while answering that question on the application.

What is the meaning of the word 'are'?

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Old 06-05-2013, 01:02 PM   #34
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But does the question on the application says: "Were you a smoker?" or "Are you a smoker?" ?
If the question is "are you a smoker?" then stop smoking a few weeks before that X-ray is all it should take.
Actually, just look at your hand... if there is a cigarette in it you are a smoker... As my father used to say.. "I quit smoking forty times a day...."
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Old 06-05-2013, 02:56 PM   #35
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Are you saying that smokers won't be allowed to quit anymore
And how can a general practitioner know that info anyway? Would not he/she needs an authorization to perform a test?

Bottom line: short of forcing everyone to take a test, there is no way for the insurance company to know if a person is a smoker or not.
My prediction - "official" number of smokers in US will be cut 10x next year.
No, not saying that. Just assuming that when your general practitioner asks they get an answer that is somewhat honest. I suppose I'm thinking most go to the general practitioner often enough to have a relationship and for the general practitioner to know their health.
Besides, even my practitioner in this rural area is now computerized, asks questions and checks the boxes. Assuming most others are as well...
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Old 06-05-2013, 03:03 PM   #36
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Or just don't smoke (or inhale?) while answering that question on the application.

What is the meaning of the word 'are'?

-ERD50
Had to laugh at this one ERD50.!
Answer would be : "Today I'm not" so the applicant is momentarily being truthful!
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Old 06-05-2013, 04:50 PM   #37
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But does the question on the application says: "Were you a smoker?" or "Are you a smoker?" ?
If the question is "are you a smoker?" then stop smoking a few weeks before that X-ray is all it should take.
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Or just don't smoke (or inhale?) while answering that question on the application.

What is the meaning of the word 'are'?

-ERD50

Well, since you asked....

The application that I had to answer at my last mega asked 'have you smoked at any time in the last 12 months'.... (or something similar)....


This created a big stink from some guys as they would smoke a cigar maybe two or three times a year... but did not want to pay the premium increase....
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Old 06-05-2013, 05:43 PM   #38
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<snip>
If the question is "are you a smoker?" then stop smoking a few weeks before that X-ray is all it should take.
No personal experience with this, but my understanding is the "stopping" part can be quite difficult for some.
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Old 06-06-2013, 07:37 PM   #39
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Funny how smokers are the one group the government allows to be discriminated against.

I wonder when a BMI surcharge will kick in.
Well, when someone else is subsidizing your healthcare costs, they usually reserve the right to tell you to live in a manner that reduces their cost.
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Old 06-06-2013, 09:59 PM   #40
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Well, when someone else is subsidizing your healthcare costs, they usually reserve the right to tell you to live in a manner that reduces their cost.
In this PPACA setup, the biggest subsidies flow from healthy people (who are charged relatively more than the value of what they are expected to receive) to sick people and from higher income people (who receive no subsidies) to those who have lower incomes. It might be that the healthy and those with high incomes, as the "billpayers", will feel they should get an extra vote in telling people how to live, but I doubt very much they'll get this.

And, drivers of cars subsidize the increased healthcare costs of motorcycle riders.
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