Saturday, December 1, 2007

Fix American Healthcare? Fix Americans

Step One: Admit that we're fat and lazy.

Health care costs in America won't normalize until Americans start taking responsibility for their own actions. Many liberals think government should be a safety net for those that don't. It's called Universal Health Care. The bottom line: The US government, and ultimately our economy, can't bear the brunt of this thinking much longer.

There are many reasons why health care costs in the US are skyrocketing and they aren't all tied to the practices of insurance companies and health care providers. Much of it can be attributed to poor decision-making on the part of our population.

While numbers have slowly declined, 23% of Men and 18% of Women in America Smoke; 29% of Americans below the poverty level are smokers. Meanwhile our own Federal Government is subsidizing the tobacco industry to the tune of 16-48 million dollars.

There was a story recently in the news of an immigrant to New Zealand that was denied entry due to his BMI (Body Mass Index) as he would be a burden to the government-provided health care system.

The government's reasoning is simple: it will take only immigrants of an "acceptable standard of health", ie those "unlikely to impose significant costs or demands on New Zealand's health or special education services"

If the US enacted a Universal Health Care system and did the same we'd hear: "What ever happened to "Give us your poor, your tired, your huddled masses longing to be free..."

Whatever happened to personal responsibility? We live in a Microwave society. We want it now and we want it fast. Whatever it is. Damn the consequences for the future. We are entitled.

Our health care system is in crisis because we are a society of fat, lazy people.

By 2015, 75% of Adults Will Be Overweight; 41% Will Be Obese
66% of U.S. adults were overweight or obese in 2003-2004

More people say they're active, but the scale doesn't back their claims

A national telephone survey found the percentage of women who report regular physical activity rose to about 47 percent in 2005, up from 43 percent in 2001. The percentage of men reporting regular exertion rose to about 50 percent, from 48 percent.

The small but significant increases are considered good news, but also seem a little perplexing: U.S. obesity rates are not declining, and there are indicators that some weight-related conditions such as heart disease are getting worse in some adults.

If I smash up my car, and it's my fault, I pay more for my insurance versus someone that has a clean record. I would expect the same of my health insurance. Why would those that choose to eat reasonably and exercise pay more for those that don't? Why would those that don't smoke pay for those that do? Isn't that common sense?

You want to eat 4000 calories a day and sit in front of the TV with a smoke in your maw all night long? I don't care. Just don't ask me to pay for it.

We have a Gas Guzzler tax why not a Beer Belly tax? Ass Tax!

Does anyone else see the irony of a 300lb Michael Moore making a film promoting a Universal Health Care system?

In the current system, most of us access health insurance through our employer. The employer pays a rate based on the aggregate demographics of their employees. If you are the only employee that has a normal build (read not obese) and doesn't smoke, you still pay more through your employer to compensate for your coworkers.

Step Two: Eliminate the current third party payor (mostly employers) system and allow people to shop for their health insurance on their own; and on their own merit. Increase competition among insurance and healthcare providers. Make them compete on service levels and covered treatments and conditions.

Obviously there would have to be considerations for pre-existing conditions that are not caused by lifestyle choices, and a short-term transitional benefit for the unemployed, etc., but the bottom line is we all need to be held accountable for our lifestyle choices and our government no longer has the resources to save us from ourselves.

So the next time you hear Hillary or any other liberal pleading for Universal Health Care, ask them how they feel about individual premiums for the program being adjusted up or down based on one's personal health status. While you're at it, ask them why they call it "Universal" and not "Socialized".


jkruse said...

...allow people to shop for their health insurance on their own; and on their own merit.


Obviously there would have to be considerations for pre-existing conditions that are not caused by lifestyle choices

don't really go together.

What kind of considerations do you propose? It's not going to be 'free market to the rescue.' Anything else is just socialized medicine, right? (I've got no problem calling it what it is.)

jroosh said...

There is no such thing as a totally free market in America any more. I don't believe markets can solve all of our problems either.

Obviously the health care industry is heavily regulated and will continue to be.

There is currently a state health insurance program for those that can't access insurance through work or are otherwise uninsurable.

That program would have to continue.

Also, it can be difficult for someone to get health insurance if they have been without it for a while, even if they are healthy. Its called adverse risk.

There would probably have to be a provision for those individuals as well so they can get insurance for a while and then be able to move on to their own program thereafter, once they have a history of being insured.

I hope you didn't miss the point of my post. It was more about our poor lifestyle choices as a society and the burden they are creating for out healthcare system.

Whether it becomes socialized or not, our collective health is as much an issue as how the system is run and paid for.

Bike Bubba said...

You know, I'd love to see the barriers to taking simpler major medical coverage reduced. I had it for a while while unemployed, and it was about 60% cheaper than comprehensive insurance. Unfortunately, since the latter is "tax-free" and the former is not, there is a huge disincentive to choose coverage that creates an incentive to stay in shape.

Step two is to prorate coverage based on habits--you're 50 lbs overweight and refuse to lose, you pay more than the guy who keeps in shape.

You'd be pretty surprised what markets can do when government gets out of the way.

jkruse said...

I appreciate the idea of creating an incentive to stay in shape, but what happens when you're on your limited coverage insurance and you get cancer? Unfortunately, most of the catastrophic medical problems that will afflict people our age have nothing to do with our physical condition. It generally takes decades of bad living to manifest itself into chronic health problems. (The exception, of course, is if you get smoked by a city bus while you're staying in shape on your bicycle.)

If that insurance is 60% cheaper than comprehensive, I can't imagine it's going to help that much when you get billed for $150k of surgery, chemo, and radiation.

As far as what happens when government gets out of the way - strapping young physical specimens like myself get coverage with no problem. Somebody who's unlucky enough to be stricken with a chronic illness is on his or her own. Lose your insurance and get hit by a car? Good luck finding an emergency room that will talk to you. I know the Bush team has built a very compelling case that government literally can't do anything right, but in the right hands it really can do good.

Off topic - got your tickets for Orlando yet? I've already committed to visiting family out of state that day, so we won't be going to the Champs Bowl. Maybe next year.

Bike Bubba said...

No tickets for Orlando--price out airfare, lodging, and tickets for seven, and you've got an idea how much of an MSU fan I'd have to be (sorry, I'm not) to attend. I might watch, not sure.

And actually, things like cancer are the beauty of major medical--it does cover the big stuff, just not the routine stuff.

To put things in perspective, the Cooper Institute (Ken Cooper of "Aerobics" fame) estimates that something like 55% of medical expenses are for issues related to diet, exercise, and smoking. Even a lot of cancers, for what it's worth.

Consider next that 40% of the cost of "managed care" is not the care, but the management.

Now consider what an avid cyclist might be able to negotiate in terms of healthcare; 50% off due to good physical condition, and another 40% off due to a high deductible plan. You end up with an overall 70% reduction in cost, or something like $7k in your pocket back each year.

jkruse said...

First, any plan that discourages routine physical exams is foolish. Primary, preventive medicine is extremely cost effective - it's the complement to your aerobics guy's health spas.

Second - let's say you find a company that gives you a 70% reduction in your rates. They can't do that and simultaneously cover somebody who needs dialysis or AIDS drugs. Who pays for that person's care? Like it or not, insurance is a game of shared risk. Paying for more than you're getting? I say you count your blessings.

Bike Bubba said...

Why should those who take care of their bodies foot the bill for those who do not?

Let's be serious here; any sane insurance policy has clauses that increase, or decrease, the cost due to risk factors. If you doubt this, get a speeding ticket, or tell your life insurance company you just took up skydiving.

Why should medical insurance be any different? Why should those with good habits subsidize those with vile habits?

Those who would share risk need to make sure it doesn't cross the line into moral hazard, I dare suggest.

jkruse said...

Fine - you and I will pay very little for our health insurance.

Obese people will have to pay 100% more than you or I. As we know, a large number of very poor people (who probably can't afford insurance at the current rate) are obese. People who work 2 or 3 minimum wage jobs don't have much time left over for exercise, and 99 cent big macs are cheaper than a bag of fresh vegetables from the local farmer's market. If they had access to insurance before, they sure don't now. I guess they'll just die at home.

And I still don't know who is going to pay for diabetes treatments.

Bike Bubba said...

Now exactly what is your point? So today we have people who are too poor to afford comprehensive insurance, and if we make changes, they'll be unable to afford insurance.

Looks like an A=B proposition at worst, Kruse, and that ignores the reality that as there are incentives for good health, people will take steps to get that, including buying the $1.29 heads of lettuce at Rainbow instead of the $3 Big Mac.

(it's the McChicken and the double cheeseburger that go for 99 cents...)

jkruse said...

Two points.

I'm in favor of moderate incentives for healthy lifestyles, but if some rates go down dramatically, that will result in many more people having no coverage.

Second, obesity is a more complex problem than laziness and gluttony. (Smoking, on the other hand, represents a massive cost to society and is a much more straightforward issue.)

Bike Bubba said...

The trouble is that you're wrong on both counts. Presenting the real bill won't eliminate insurance; it will modify behavior. Or do you think that the stockholders of UHC will tolerate a 50% drop in the # of users of their product?

Sorry, the market is smarter than you think it is. People can figure out a way to nudge the obese and smokers into healthier habits without causing a catastrophe.

In the same way, obesity is really simple; calories in, calories out, like the dieticians and doctors have been telling us for nearly a century. Yes it would help if we ended maize, dairy and sugar subsidies, but reality is that my family's food budget is about the same as would be provided under food stamps.

So I know quite well how well a family can eat on modest means. Sorry, but the claims of the left simply don't wash here.

jkruse said...

Or do you think that the stockholders of UHC will tolerate a 50% drop in the # of users of their product?

I don't understand what you mean by "presenting the real bill," but the stockholders would love for UHC to drop lots of its unhealthy users. The practice is called cherry picking. It's illegal for a reason.

Bike Bubba said...

You present the real bill by increasing rates for those who are obese or smoke, and you decrease them for those who do not, just like your car insurance rates depend on your driving record, and your life insurance rates depend on your risk of early death.

And no, it's not generally speaking illegal, nor should it be.

Again, if something like 55% of medical expenses are eminently preventable, why on earth should we put fat smokers in the same bin with nonsmoking people in good shape?