Personal Responsibility for Healthcare?

[Midpack]

Quote:

Originally Posted by audreyh1 The stability simply indicates that as overweight individuals moved into obese, then those were replaced by normal healthy weight individuals moving into overweight. It doesn’t matter if the overweight category itself has remained fairly stable, some of those must be what used to be healthy weight individuals because so many have moved on to become obese and extreme obese. Looks like in the men you had around 50% overweight and obese in the 60s. Now it looks like you have around 75% overweight, obese, and extreme obese. So in the 60s around 50% of men used to be normal/healthy weight or underweight and now only 25% are.

Got it, thanks.

[tinlizzy]

Quote:

Originally Posted by flintnational - Finally, WIC (the old food stamp program) may be the worst. We allow some of the most vulnerable in our society to use their precious resources to buy soda, candy and fruit loops. WIC only excludes the purchase of hot food, liquor and tobacco. Soda is just fine. So, now imagine a "lifestyle" program from the same system that brought you the above. Soda and fruit loops might be the required "healthy" diet. Sorry for the rant and long post.

WIC is not the old food stamp program. It's for parents with children under 5 i believe, the income guidlines are higher than food stamps, and foods that can be purchased are limited and very restrcted. https://www.fns.usda.gov/wic/wic-foo...eligible-foods

The food stamp program is now called SNAP = that's what you're thinking of.

[redduck]

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Originally Posted by FIREmenow ...They are not strapped to a chair and forced to eat it.

That's their loss. I sure do miss those college days.

[FIREmenow]

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Originally Posted by redduck That's their loss. I sure do miss those college days.

[6miths]

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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."

Often things that sound logical don't work. People don't actually make lifestyle choices based on something that is years and more likely decades in the future. Generally OECD countries with 'free' (and of course it isn't, it is a pooled risk model) healthcare have better lifestyle indices than the one that has a pay as you go model.

[ShokWaveRider]

Quote:

Originally Posted by 6miths Often things that sound logical don't work. People don't actually make lifestyle choices based on something that is years and more likely decades in the future. Generally OECD countries with 'free' (and of course it isn't, it is a pooled risk model) healthcare have better lifestyle indices than the one that has a pay as you go model.

+ A Lot. It has been proven many times over.

We all have to pay to get the pool workable. Emphasis on ALL. Everyone, The simplest way is to have a single payer system where everyone contributes based on their income level. Just like income tax a graduated scale. BUT no one should be able to "wiggle" out of it.

[Midpack]

Quote:

Originally Posted by 6miths Often things that sound logical don't work. People don't actually make lifestyle choices based on something that is years and more likely decades in the future. Generally OECD countries with 'free' (and of course it isn't, it is a pooled risk model) healthcare have better lifestyle indices than the one that has a pay as you go model.

There’s a lot more involved in lifestyle choices than just cost of healthcare. It’s hard to believe those who consistently make very poor choices don’t do so in part because they’re paying little to nothing directly out of pocket for health care. The answer is probably somewhere in between, but I agree it has to include everyone, no opting out...

Quote:

Originally Posted by ShokWaveRider We all have to pay to get the pool workable. Emphasis on ALL. Everyone, The simplest way is to have a single payer system where everyone contributes based on their income level. Just like income tax a graduated scale. BUT no one should be able to "wiggle" out of it.

[Huston55]

This thread has, predictably, run down the path of comparison of health care systems & what drives the cost of ours in the USA. At the risk of repeating myself (see earlier post in this thread), “we know why this is.”

Here’s a good IMO (you may find the speaking a bit too ‘energetic’ ) video that explains it pretty well. Just as an aside, bet you’re surprised that the USA spends more tax $$$ per capita than all those “social democracies” in Europe; not even counting all the private $$$ spent in the USA.

Enjoy.

https://m.youtube.com/watch?annotati...&v=qSjGouBmo0M

[MRG]

Quote:

Originally Posted by 6miths Often things that sound logical don't work. People don't actually make lifestyle choices based on something that is years and more likely decades in the future. Generally OECD countries with 'free' (and of course it isn't, it is a pooled risk model) healthcare have better lifestyle indices than the one that has a pay as you go model.

From my experience that's correct. I made some great health improvements, quitting tobacco, changing diet, and exercise. They always came as a dramatic event.

A kind nuersurgon explained why quitting tobacco was so important in my case(degenerative disc). I'd had a really rough few months of pain. I quit that day.

My prior PCP took the opportunity to explain why he thought my weight and lack of exercise contributed to tachycardia. I had asked what I could do about it, it was driving me batty! He knew I was ready for the same conversation we'd had a few times before. Six months later it was gone, along with 50 pounds, and many other ailments.

[Pilot2013]

Looks like Kentucky will require some "minor" health improvement activities in order to maintain Dental and Vision care through Medicaid. Could be a bellwether for this type of "incentive" requirement.

I won't comment on the 80 hr work requirement for able bodied persons of working age at this time....

[FIREmenow]

Quote:

Originally Posted by 6miths Often things that sound logical don't work. People don't actually make lifestyle choices based on something that is years and more likely decades in the future. Generally OECD countries with 'free' (and of course it isn't, it is a pooled risk model) healthcare have better lifestyle indices than the one that has a pay as you go model.

*I* think you're being short-sighted for what I was referring to. You're thinking of an immediate decision. Yes, I think what you say would happen in the near term.

Once the idea has been around, and ingrained into family upbringing and education over a couple of generations, things would likely change over. The pain of the interim is the problem that would not survive any decision or policy.

JMHO

[Bir48die]

Quote:

Originally Posted by ShokWaveRider + A Lot. It has been proven many times over. We all have to pay to get the pool workable. Emphasis on ALL. Everyone, The simplest way is to have a single payer system where everyone contributes based on their income level. Just like income tax a graduated scale. BUT no one should be able to "wiggle" out of it.

I disagree that income based payer system is the way to go. We as a society continue to move toward over taxing those who are successful in all areas including states that are trying to cover their overspending. I am a fan of single payer health care (as a solution to ACA). A family who's parents are successful and they are all physically fit will pay a higher premium than a family who is a bigger burden on the system? I don't agree with this. I also don't agree that you tax those by their ailments.

I am a fan of having those on subsidized health care take a more active part in improving their health.

[easysurfer]

I'm content to say that I don't know the solution. Like that old Joni Mitchell song "Both Sides Now", seen from both sides and really don't know the answer at all.

In personal terms, I grew up in a large enough family where some are better well off than others. At least from what I've seen in my situation, it does seem that those more well off are expected to foot the bill of responsibility. But also for some that aren't so well of, they aren't "faking" their need. They really do need assistance.

Just my 2 cents .

[Danmar]

Quote:

Originally Posted by Midpack +1. Nothing wrong with repeating it, there are always new members, but we’ve had this discussion for many years. We’re the only developed country in the world that can’t figure it out despite almost 60 examples all over the world, and we actually pay way more (indirectly so many don’t realize it) than every other country in the world with poorer outcomes than most. All goes back to campaign finance (more than partisan politics IMO)... Unfortunately what Churchill observed is still true -’You can always count on Americans to do the right thing – after they’ve tried everything else.’

Agree. I generally dont participate in these health care threads. The general outline of a solution is so obvious yet round and round you go. Americans must get so frustrated with this issue. I hope you figure it out eventually. Doubt it will be in my lifetime.

[flintnational]

Quote:

Originally Posted by tinlizzy WIC is not the old food stamp program. It's for parents with children under 5 i believe, the income guidlines are higher than food stamps, and foods that can be purchased are limited and very restrcted. https://www.fns.usda.gov/wic/wic-foo...eligible-foods The food stamp program is now called SNAP = that's what you're thinking of.

Thanks. I confused the two.

[redduck]

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Originally Posted by JDPascale Meanwhile Dunkin' Donuts wants to open 9,000 new stores.... We will never win this battle of the bulge too much delicious junk food every where you look...

Not to single you out JD (but this post of yours was one of the shortest).

In this thread there are many references to junk food, sugary drinks and other unhealthy types of foods which over a period time can cause numerous and serious health problems leading to higher insurance premiums. No argument there. But, liquor is barely mentioned and certainly not elaborated upon. And, when mentioned, there have been no follow-up responses (as far as I recall). I imagine that alcohol illnesses raise health insurance rates as much as poor eating choices--maybe more if we were to include alcohol-related accidents. Why the downplay of alcohol in this thread?

[USGrant1962]

Quote:

Originally Posted by redduck Not to single you out JD (but this post of yours was one of the shortest). In this thread there are many references to junk food, sugary drinks and other unhealthy types of foods which over a period time can cause numerous and serious health problems leading to higher insurance premiums. No argument there. But, liquor is barely mentioned and certainly not elaborated upon. And, when mentioned, there have been no follow-up responses (as far as I recall). I imagine that alcohol illnesses raise health insurance rates as much as poor eating choices--maybe more if we were to include alcohol-related accidents. Why the downplay of alcohol in this thread?

Off the top of my head I would think it is because obesity has gone up significantly while alcohol consumption has gone down significantly since the 1970s. So it is doubtful that alcohol consumption is responsible for the increase in health care costs.

[redduck]

Made me look: I'm sure this is not the last word on drinking increase/decrease, but...
(the below has been cut and pasted by redduck)

This is from an Aug. 12, 2017 Forbes article:

" The increases were seen from the years 2001-2002 to 2012-2013 in a number of demographics

Almost all kinds of drinking across all demographics rose between the two time points, and some rose sharply.

• Alcohol use rose from 65% to 73% of the adult population, which is about an 11% increase. The increase was much higher for minorities, women, seniors, and people with less education and income.
• High-risk drinking rose from about 10% to 13% of the population, or an almost 30% increase. In minorities, women, and older people, the numbers were considerably higher.

• People who were identified as having alcohol use disorder (AUD) increased from 9% to 13% of the population, an increase of almost 50%. For women, the increase in AUD was 84%, for Hispanic and African-American individuals it was 52% and 94%, respectively. And for older people, the increase was a whopping 105%.

In other words, people are drinking more alcohol than before, and more people are drinking alcohol than before."


note: highlights not by redduck

[USGrant1962]

Yes, alcohol use has been trending up from a low point in the 90s, but is nowhere near what it was in the 70s and 80s when obesity and medical costs started skyrocketing.

See https://www.statista.com/statistics/...ges-in-the-us/

[harllee]

What about people who live healthy lives, exercise and eat well, etc but have poor health anyway through not fault of their own? Not all diseases are caused by something a person does or does not do. My husband is a very healthy weight, exercises and eats well but has a disease that requires very expensive medication. Before the ACA he could not get "real" insurance and had difficulty obtaining his medication. He is now on Medicare and can get his medication for a more reasonable cost. His life and health would have been greatly improved if the U.S. had universal health care or medicare for all.