Personal Responsibility for Healthcare?

[Midpack]

Quote:

Originally Posted by FIREmenow The only real way to do that is to have people pay for their own healthcare. The only way lifestyle changes will happen is if people have to pay for their own care. As my dad used to say, "...people won't change unless it hurts too much NOT to change." There would be additional pressure on healthcare COSTS in this case as well, IMHO. Maybe not enough, but some. Health insurance should be just that - insurance (not care). Getting to that model from where we are today seems mostly impossible, however.

Well said.

If there aren’t monetary incentives for individuals, the healthcare “system” will never be fair. We have to quit letting exceptions prevent all progress.

And if there aren’t pressures on the cost side, it’ll never be affordable in the USA compared to every other country in the world. But until we have campaign finance reform, that seems hopeless.

[athena53]

Quote:

Originally Posted by easysurfer As devil's advocate, how about his case? John and Jane Doe did everything right, diet, exercise when for annual health screenings. But one day they go on vacation and get into an accident from bungee jumping. Who is to say their lifestyle is more or less healthy than someone who sits around all day posting on a retirement board? . In this example, the Does didn't eat bad or not exercise but got hurt thrill seeking.

Well, life insurers will rate you higher if you regularly engage in certain risky activities such as skydiving, but I think I'd exclude actual hazardous activities from higher rating- too hard to define them all and too hard to police.

I'm thinking of SMART-type goals (sorry for lapsing into corporate jargon):

Specific
Measurable
Attainable
Relevant
Time=bound

Examples: Lose 20 lbs. in 6 months. Walk at least 10,000 steps/day at least 5 days a week during the policy period. Stop smoking. Improve cardiac function from "Poor" to "Good" as measured by step test.

[easysurfer]

Quote:

Originally Posted by athena53 Well, life insurers will rate you higher if you regularly engage in certain risky activities such as skydiving, but I think I'd exclude actual hazardous activities from higher rating- too hard to define them all and too hard to police. I'm thinking of SMART-type goals (sorry for lapsing into corporate jargon): Specific Measurable Attainable Relevant Time=bound Examples: Lose 20 lbs. in 6 months. Walk at least 10,000 steps/day at least 5 days a week during the policy period. Stop smoking. Improve cardiac function from "Poor" to "Good" as measured by step test.

I think reward and incentive for healthy behavior are good things. But cringe a bit at punishment for non-healthy.

Reading the article, I think about first class vs coach flying. Those who are fortunate enough to fly first class without a problem vs everyone else.

[Mr._Graybeard]

Part of the health problem this country has is the economy's tendency to promote unhealthy, nutritionally unbalanced products. When was the last time you saw a television commercial for kale or broccoli? McDonalds and Burger King, conversely, have a huge ad budget.

Then there's the tendency for makers of processed food to add high levels of sugar or salt to make their product more appealing. Check the sodium content in a can of soup.

People who want or need cheap, convenient dietary options may have little choice but to consume foods that, in the long run, are bad for them. And producers of those products spend big bucks to stimulate that market. It's easy to blame the consumer in this case, but some blame has to rely on the producers of unhealthy products as well.

[MRG]

Quote:

Originally Posted by Mr._Graybeard Part of the health problem this country has is the economy's tendency to promote unhealthy, nutritionally unbalanced products. When was the last time you saw a television commercial for kale or broccoli? McDonalds and Burger King, conversely, have a huge ad budget. Then there's the tendency for makers of processed food to add high levels of sugar or salt to make their product more appealing. Check the sodium content in a can of soup. People who want or need cheap, convenient dietary options may have little choice but to consume foods that, in the long run, are bad for them. And producers of those products spend big bucks to stimulate that market. It's easy to blame the consumer in this case, but some blame has to rely on the producers of unhealthy products as well.

Wow. You said a mouth full!

When I started to understand nutrition and diet the grocery store became scary!
Walking through wally world was like walking naked through hell! 🤣

Seriously where else can you go to buy so many cheap carbs for a dollar? Maybe a large feedstore?

[2HOTinPHX]

Quote:

Originally Posted by Mr._Graybeard Part of the health problem this country has is the economy's tendency to promote unhealthy, nutritionally unbalanced products. When was the last time you saw a television commercial for kale or broccoli? McDonalds and Burger King, conversely, have a huge ad budget. Then there's the tendency for makers of processed food to add high levels of sugar or salt to make their product more appealing. Check the sodium content in a can of soup. People who want or need cheap, convenient dietary options may have little choice but to consume foods that, in the long run, are bad for them. And producers of those products spend big bucks to stimulate that market. It's easy to blame the consumer in this case, but some blame has to rely on the producers of unhealthy products as well.

I totally agree with what you are saying. Go to the grocery store and look at all products that are bad for you verse the good for you products. We are so good at churning out carb and sugar products it's scary and hard to resist.
My wife is admin assistant for a guy who owns a very successful small pizza chain. They make a ton of dough outta selling that artery clogging delicious crap...yet the owner is pretty conscious about his own health...LOL....
We the human race get a big fail when it comes to taken care of our food needs..profit over people

[2HOTinPHX]

Quote:

Originally Posted by MRG Wow. You said a mouth full! When I started to understand nutrition and diet the grocery store became scary! Walking through wally world was like walking naked through hell! 🤣 Seriously where else can you go to buy so many cheap carbs for a dollar? Maybe a large feedstore?

I am scared of the grocery store too especially around the holidays...5 lb bags of candycorn...that's a vegetable right?

[Mr._Graybeard]

I suspect some people become psychologically addicted to some of the junk that gets peddled to them as "food..." I worked with a guy who guzzled at least eight Diet Cokes a day. Fortunately he brought his own 12-packs to work and didn't rely on the company soda machine, which dispensed 20-ouncers.

BTW, when did the clarion call rise up from the grass roots of consumerdom that we needed 20-ounce sodas instead of 12-ounce cans? Good thing the soft drink bottlers are looking out for us and caution that each bottle contains 2 1/2 servings...

[Luck_Club]

Quote:

Originally Posted by Mr._Graybeard I suspect some people become psychologically addicted to some of the junk that gets peddled to them as "food..." I worked with a guy who guzzled at least eight Diet Cokes a day. Fortunately he brought his own 12-packs to work and didn't rely on the company soda machine, which dispensed 20-ouncers. BTW, when did the clarion call rise up from the grass roots of consumerdom that we needed 20-ounce sodas instead of 12-ounce cans? Good thing the soft drink bottlers are looking out for us and caution that each bottle contains 2 1/2 servings...

Packaging costs drove the 20 oz movement. The same thing with the 16 oz to 32 oz glass bottles to the 2 liter plastic versions.

[joeea]

Quote:

Originally Posted by Mr._Graybeard I worked with a guy who guzzled at least eight Diet Cokes a day.

Are you in government?

I know a government guy who consumes a dozen cans of Diet Coke a day, plus a lot of KFC and McDonald's. He also eats extra desserts at pretty much every meal.

He's overweight. He doesn't work a lot of hours each day, watches a lot of TV, and doesn't exercise at all, but he does play a lot of golf.

He doesn't smoke and never drinks. So I guess he's got that going for him, which is nice.

We all may get to hear of his physical health soon (or more likely he'll keep any bad results to himself).

I wonder how much he pays for his healthcare?

[audreyh1]

The lovely illusion that your health is completely under your personal control.

There are plenty of diseases that are not due to lifestyle choices, and there are accidents as well, plenty of which aren't someone's own fault. So it's not an entirely self-controlled system.

And, as other point out, some things that are lauded as healthy are later found out to be bad for you and vice versa.

[Mr._Graybeard]

Quote:

Originally Posted by joeea Are you in government? I know a government guy who consumes a dozen cans of Diet Coke a day, plus a lot of KFC and McDonald's. He also eats extra desserts at pretty much every meal. He's overweight. He doesn't work a lot of hours each day, watches a lot of TV, and doesn't exercise at all, but he does play a lot of golf. He doesn't smoke and never drinks. So I guess he's got that going for him, which is nice. We all may get to hear of his physical health soon (or more likely he'll keep any bad results to himself). I wonder how much he pays for his healthcare?

No, I was in media, but my former co-worker is now in state government.

One night he was carted out of the newsroom on a gurney with what turned out to be a gall bladder attack. Apparently they gave him an endoscope while he was under medical care and found some polyps in his stomach. He laid off the Cokes for a while, but eventually he fell off the wagon.

[razztazz]

Quote:

Originally Posted by gayl I think keeping dr check ups should NOT cost the patient as they spot issues earlier when they are less expensive for the ultimate payer (insurance) to treat. How about a mandatory $penalty for not showing up?

You gonna make sure everybody has the money to do so? If not then people will have to it The American Way and make financial decisions in lieu of mere medical ones which would be theoretical at best since nobody can say how cholesterol or exercise or sleep patterns will affect ---an individual--.

You cannot use mass data or group aggregate output study results to diagnose and treat individuals.

This "plan" is like a wealth tax. Every year have everybody from Ralph Kramden to Ward Cleaver to George Soros inventory everything they own in this world, then tax it

[audreyh1]

Quote:

Originally Posted by Mr._Graybeard Part of the health problem this country has is the economy's tendency to promote unhealthy, nutritionally unbalanced products. When was the last time you saw a television commercial for kale or broccoli? McDonalds and Burger King, conversely, have a huge ad budget. Then there's the tendency for makers of processed food to add high levels of sugar or salt to make their product more appealing. Check the sodium content in a can of soup. People who want or need cheap, convenient dietary options may have little choice but to consume foods that, in the long run, are bad for them. And producers of those products spend big bucks to stimulate that market. It's easy to blame the consumer in this case, but some blame has to rely on the producers of unhealthy products as well.

Yep - you've really got a point there. The USDA helps too.

Eating healthy is more expensive, more time consuming, and requires some skill to make it palatable, compared to buying cheap fast food or quickie mostly prepared meals or going for the lowest cost foods and subsisting on beans rice and tortillas with a little chorizo and cheese thrown in.

[jimbee]

Well, this thread sure went south quickly.

[athena53]

Quote:

Originally Posted by audreyh1 The lovely illusion that your health is completely under your personal control. There are plenty of diseases that are not due to lifestyle choices, and there are accidents as well, plenty of which aren't someone's own fault. So it's not an entirely self-controlled system.

I would never claim that and I made that clear in my earlier post. Stuff happens and it's partly luck and/or the grace of God, depending on your beliefs, that I'm almost 65, have no noticeable aches and pains, and my only prescription is to alleviate a symptom of menopause. I would not, however, discount the fact that I weigh less than I did in HS, I go to the gym daily and dinner tonight is stir-fried veggies and bulghur in a tomato sauce spiced with cumin.

[KenZ71]

Maybe health & life insurance costs and benefits should be combined? If the same company had your info and was trying to keep you healthy and had a big incentive to keep you around they would truly try hard.

Another off the wall thought... some of the internet billionaires ( Bezos, Musk, Zuckerberg, etc ) have floated the idea of universal basic income to replace lost jobs due to automation. Maybe that should be with a heavy dose of healthcare.

[Luck_Club]

So the healthcare debate is an interesting one. I'm of the mindset that financial incentives drive human behavior.

Currently the financial incentives are geared towards cheap crap food, that is cheaper to the consumer, but a higher cost (health care) to society. If you want to eat healthy, the outside perimeter of the grocery store, it is expensive! Apples are $1 a piece, a head of lettuce is $2.50! Go to the protein & you get more expensive the healthier you get.

My DF is a case in point. He is by all measures extremely frugal and a great cost to the healthcare system. I calculated his BMI at over 50 He takes 5-7 pills a day for his type II, stent and other ailments. He never forgets his medicine, and takes it religiously. However, when I brought in a nutritionist, he didn't listen and wouldn't do a single thing she asked. So even though he will go through the painstaking process of switching prescriptions to get a $20 reward for switching a prescription,he stubbornly refuses to change his lifestyle. The medicine and doctors visits along with health insurance offer no financial incentive to change his behavior, so he continues down the same path.

Multiply that out times 10's of millions, and you see where the problem lies.

[audreyh1]

Quote:

Originally Posted by athena53 I would never claim that and I made that clear in my earlier post. Stuff happens and it's partly luck and/or the grace of God, depending on your beliefs, that I'm almost 65, have no noticeable aches and pains, and my only prescription is to alleviate a symptom of menopause. I would not, however, discount the fact that I weigh less than I did in HS, I go to the gym daily and dinner tonight is stir-fried veggies and bulghur in a tomato sauce spiced with cumin.

All that and you can still suddenly be diagnosed with pancreatic cancer and find out you pretty much only have a year left as happened to my lovely, otherwise robustly healthy and very health-conscious mother at age 62, or the super fit neighbor down the street who could out-zumba everybody in her late 60s, but developed brain cancer and did not survive.

Being healthy helps and is great, but it may still not mean you escape a serious health problem or fatal disease.

[socca]

The Affordable Gym Act (AGA) - 2022

Highlights:
• beginning in tax year 2023, all Americans older than 18 are required to be a member of a gym providing minimum essential services
• Americans with less-than-median modified adjusted gross income (MAGI) will receive subsidies to help pay their gym membership dues (this includes high-net-worth and very-high-net-worth people who cleverly reduce their MAGI with the expressed purpose of receiving subsidies)
• the costs associated with upgrading gym facilities and services to comply with the AGA will be passed on to consumers in the form of higher membership dues. For example, under the AGA all gyms are required to have an on-site Olympic-sized swimming pool, which could be challenging for gyms located on the top floor of a skyscraper. The lucky folks receiving massive gym membership subsidies will be largely spared the effects of these higher dues.
• to enforce compliance, each year gyms will report to the IRS the months in which their members were enrolled in good standing. All Americans will receive a Form 1095-GYM from their gym to be filed with their annual tax return as proof of compliance with the AGA.
• failure to enroll in a qualified gym in any given year will result in a 'shared responsibility' tax surcharge
• there is no requirement to actually set foot in a qualified gym - membership alone is sufficient to satisfy the AGA

Coming soon to a government near you!