Taxing Poor Health (or Banning it)

[Renegade]

So is this taxing or banning just going to be for what we eat...or it could very well extend to other things.

Taken to its logical conclusion it should extend to other risk factors as well.

For all we know, it's all in the genes. Some people are more susceptible to these diseases.

Yes in many cases it is in the genes. Why shouldn't genes be a risk factor as well?

[Charles Anthony]

Taken to its logical conclusion it should extend to other risk factors as well.

What exactly is the logic? How far do you want to go?

If I take it to my logical conclusion, it should extend to enough risk factors such that it is more efficient to get rid of tax-payer funded universal health care at all. How complicated should the government's bureacracy be?

[Biblio Bibuli]

For all we know, it's all in the genes.

Yes in many cases it is in the genes.

GOOD WORK, BOYS & GIRLS!

The more baby-boomers that you manage to persuade that this bullcrap is true, the less of a burden they will be on our younger generations.

KEEP UP THE GOOD WORK!

[BubberMiley]

Over eating and being lazy are though. One will die of it.

How is that a burden on the healthcare system? If someone dies at 60 from a heart attack, they're a lot less of a burden than someone who keeps on living till they're 100. Dead people don't cost anything.

[Renegade]

What exactly is the logic? How far do you want to go?

The logic is that if you agree that any risk factor should determine the funding contribution to health coverage, then it should extend to all risk factors. I'd go as far as is practically possible.

If I take it to my logical conclusion, it should extend to enough risk factors such that it is more efficient to get rid of tax-payer funded universal health care at all. How complicated should the government's bureacracy be?

Yes I would get rid of taxpayer funded universal health care as well. I would replace it by subscriber-funded health care.

[Renegade]

For all we know, it's all in the genes.

Yes in many cases it is in the genes.

GOOD WORK, BOYS & GIRLS!

The more baby-boomers that you manage to persuade that this bullcrap is true, the less of a burden they will be on our younger generations.

KEEP UP THE GOOD WORK!

Huh? The fact that genes affect health is bullcrap?

[gc1765]

They've just discovered that lung cancer is rising among those who don't smoke at all, or not exposed to second hand smoke.

So is this taxing or banning just going to be for what we eat...or it could very well extend to other things.

For all we know, it's all in the genes. Some people are more susceptible to these diseases.

Well, we can't change our genes (and even if we could that would bring up a whole different moral debate), but we can change our diet. Taxing people for having bad genes isn't going to make their genes any better. Taxing people for eating unhealthy might have an effect.

[geoffrey]

They've just discovered that lung cancer is rising among those who don't smoke at all, or not exposed to second hand smoke.

Congrats Betsy, you just found the one environmental area that is killing people right now. The real environmental issue that governments must act on quickly. All that cancer causing stuff in the air, we are all going to die of that... not CO2 taking over the world and melting the snow on my front lawn.

[Renegade]

Well, we can't change our genes (and even if we could that would bring up a whole different moral debate), but we can change our diet. Taxing people for having bad genes isn't going to make their genes any better. Taxing people for eating unhealthy might have an effect.

1. Not all taxation is to change behaviour. Taxation may be imposed to match the relative burden put on the system.

2. Consider the case of parents with genes for a potential birth defect. Let's assume that their offspring has a significant chance for having that birth defect. If they were going to incur significant healthcare "tax" as a result of having the child, they may forgo the decision to have that child. In essence, taxing people for bad genes, has changed their behaviour.

[Charles Anthony]

1. Not all taxation is to change behaviour. Taxation may be imposed to match the relative burden put on the system.

I can not imagine how much EXTRA time, effort and money would be required to exact such a taxation system. A free market mechanism just might be able to achieve the same results more effectively: faster and cheaper with more satisfied customers.

The logic is that if you agree that any risk factor should determine the funding contribution to health coverage, then it should extend to all risk factors. I'd go as far as is practically possible.

It just sounds like you are using more tax-payers money to accomplish the bureaucracy.

Yes I would get rid of taxpayer funded universal health care as well. I would replace it by subscriber-funded health care.

If you prefer to get rid of tax-payer funded health-care, I recommend leaving it alone (letting it die out on its own) instead of propping it up along the way. Forget about it now and just let private enterprise offer us our own parallel second or third or forth or fifth tiers of service.

[Renegade]

1. Not all taxation is to change behaviour. Taxation may be imposed to match the relative burden put on the system.

I can not imagine how much EXTRA time, effort and money would be required to exact such a taxation system. A free market mechanism just might be able to achieve the same results more effectively: faster and cheaper with more satisfied customers.

I would say that you are probably right. Pricing according to risk is done in private enterprise all the time. (Life insurance, auto insurance, home insurance, etc). I'm not sure if the government can do it efficiently. Right now the barriers are not efficiency, but mindset.

[Riverwind]

I would say that you are probably right. Pricing according to risk is done in private enterprise all the time. (Life insurance, auto insurance, home insurance, etc). I'm not sure if the government can do it efficiently. Right now the barriers are not efficiency, but mindset.

The insurance companies are make money by simply refusing to sell insurance to people they decide are high risk. This means that many people are simply denied access to essential services - this is simply not acceptable solution for the overwhelming majority of people. You cannot argue that people are free to go to another insurance company because insurance companies tend to use exactly the same algorithms so once you are denied with one company you will be denied with all companies.

Private insurance for essential services is one of those situations where the free market looks great on paper but is useless in practice.

[Renegade]

I can not imagine how much EXTRA time, effort and money would be required to exact such a taxation system. A free market mechanism just might be able to achieve the same results more effectively: faster and cheaper with more satisfied customers.

I've thought about the implementation further. Suppose that once a year medical checkups were MANDATORY in order to obtain continued healthcare coverage. We all can agree that yearly checkups are a good practice anyway, and have a benefit as a preventative or proactive approach to medical care.

The results of the yearly assessment, if uniform, can be fed into as system to assess risk and thereby price medical coverage.

Of course this can be done privately as well.

It just sounds like you are using more tax-payers money to accomplish the bureaucracy.

Of course there will be bureaucracy, just as there is in any institution private or public. I've never said that it shoudl be taxpayer funded. I've said that it shoudl be suscriber funded both for coverage and bureaucratic costs.

If you prefer to get rid of tax-payer funded health-care, I recommend leaving it alone (letting it die out on its own) instead of propping it up along the way. Forget about it now and just let private enterprise offer us our own parallel second or third or forth or fifth tiers of service.

Unfortunately I don't think it will die on its own in a suitably short period of time. Having it linger on for another 50 years does me no good. It looks like it is here to stay for a while, so practically my approach would be to adapt it to adopt many of the features of a free enterprise system.

[Renegade]

I would say that you are probably right. Pricing according to risk is done in private enterprise all the time. (Life insurance, auto insurance, home insurance, etc). I'm not sure if the government can do it efficiently. Right now the barriers are not efficiency, but mindset.

The insurance companies are make money by simply refusing to sell insurance to people they decide are high risk. This means that many people are simply denied access to essential services - this is simply not acceptable solution for the overwhelming majority of people. You cannot argue that people are free to go to another insurance company because insurance companies tend to use exactly the same algorithms so once you are denied with one company you will be denied with all companies.

I agree, some people will be denied coverage based upon risk. I think it will be a small minority. IMV, I don't have an issue if health coverage of those high-risk individuals were either left to charitable institutions or the government provided an insurance of last resort.

Private insurance for essential services is one of those situations where the free market looks great on paper but is useless in practice.

I would say that auto and property insurance are essential services, yet they seem to work as well in practice as in theory.

[Riverwind]

I agree, some people will be denied coverage based upon risk. I think it will be a small minority. For me, I don't have an issue if health coverage of those high-risk individuals were either left to charitable institutions or the government provided an insurance of last resort

I don't consider the entire population of people over 65 to be a 'small minority'. The US has a publicly funded medicare program for seniors because the vast majority of them cannot purchase adequate coverage.

I would say that auto and property insurance are essential services, yet they seem to work as well in practice as in theory.

Auto insurance only works reasonably well in provinces with a gov't run insurer. Provinces with private auto insurance systems have many more problems with access. Property insurance works well only because very few people need to claim - even then the property insurance industry has arbitrary rules that force the most entrepreneurial people in society to go without basic insurance on their homes.

[Charles Anthony]

I would say that auto and property insurance are essential services, yet they seem to work as well in practice as in theory.

They are only "essential" for people who would go bankrupt if they were sued.

If I was a rich zillionaire without car insurance, you could sue me in a car crash and get whatever you deserved. Unfortunately, most drivers are not worth the damage they can inflict.

You cannot argue that people are free to go to another insurance company because insurance companies tend to use exactly the same algorithms so once you are denied with one company you will be denied with all companies.

I agree. I think the essential question is do we want universal health-care?

If you want to provide universal health-care, do so but, at the very least, also permit multi-tiered health-care to co-exist.

[Riverwind]

If you want to provide universal health-care, do so but, at the very least, also permit multi-tiered health-care to co-exist.

No argument from me on that point. I think the best systems are ones that combine free markets with gov't regulation and/or gov't funded core services.

[Renegade]

I don't consider the entire population of people over 65 to be a 'small minority'. The US has a publicly funded medicare program for seniors because the vast majority of them cannot purchase adequate coverage.

The US has has a publicly funded medicare program for all seniors because seniors are a powerful political lobby. Most seniors can plan for the purchase of adequate medical coverage if it is their expectation that they have to do so. If they expect that the public will fund their healthcare, they will not set aside money to do so.

Do you have any cite to your assertion that the majority cannot purchase adequate coverage?

Auto insurance only works reasonably well in provinces with a gov't run insurer. Provinces with private auto insurance systems have many more problems with access. Property insurance works well only because very few people need to claim - even then the property insurance industry has arbitrary rules that force the most entrepreneurial people in society to go without basic insurance on their homes.

I live in a province where automobile insurance is not provided by the government, despite this virtually everyone who drives can purchase insurance. It is only a very small majority, who because of their record, are rightly denied coverage.

----------------

Your defence of a non-risk based system is based upon the premise that the majority of people would find it unacceptable that some people are denied coverage. People have been conditioned as to what is acceptable by the last 40 years of "free" medical coverage. As technology advances makes healthcare more and more expensive, I think people will question their acceptance of having to subsidize the health costs of heavy users of the system. This situation will come to a head as more boomers retire, and a ever larger percentage of the community requres healthcare subsidization. In the end, the government will be forced to ration healthcare, and allow private-risk based providers to supplement coverage. I would prefer if they simply went the risk-based route themselves.

[Riverwind]

Do you have any cite to your assertion that the majority cannot purchase adequate coverage?

There are 40 million americans with no healthcare coverage at all. That fact alone demonstrates why a purely market based healthcare system is a failure. I have no numbers regarding the percentage of seniors that would not be eligible for insurance in a private system, however, my experience with insurance companies leads me to believe that a huge percentage of seniors would be ineligible.

I live in a province where automobile insurance is not provided by the government, despite this virtually everyone who drives can purchase insurance. It is only a very small majority, who because of their record, are rightly denied coverage.

Coverage can be denied by increasing premiums so high that a person cannot afford them. I don't really have a problem with a system where people who actually had expensive accidents paying more. I have a big problem with systems where people are changed punative rates even though they have had no accidents because they belong to some arbitrary 'high risk' group.

In the end, the government will be forced to ration healthcare, and allow private-risk based providers to supplement coverage. I would prefer if they simply went the risk-based route themselves.

I agree that we will need to ration care and that people will have look to private market to supplement care. However, there is a huge difference between a system where the gov't provides basic insurance and a system where the gov't provides nothing.

[Renegade]

There are 40 million americans with no healthcare coverage at all. That fact alone demonstrates why a purely market based healthcare system is a failure.

I don't point to the US system as a model. There are numerious inefficiencies in their system and no real cost containment. Much of the failure of their system is due to the high cost of coverage and the administrative overhead. If cost were constrained and the administrative and malpractice burden were reduced, overall costs would be much more affordable, despite the fact that health care premiums were risk based.

I have a big problem with systems where people are changed punative rates even though they have had no accidents because they belong to some arbitrary 'high risk' group.

Sorry to disappoint you, but this happens in many public insurance systems as well. Witness that males under 25 are charged extremely high rates just because of the cagegory they belong to. Personally I don't have a problem with it.

I agree that we will need to ration care and that people will have look to private market to supplement care. However, there is a huge difference between a system where the gov't provides basic insurance and a system where the gov't provides nothing.

I guess it is somewhat a question of where we draw the line on what is basic coverage. In my view, that line is pretty low. You may disagree.

[cybercoma]

Sorry to disappoint you, but this happens in many public insurance systems as well. Witness that males under 25 are charged extremely high rates just because of the cagegory they belong to. Personally I don't have a problem with it.

Off topic, but you probably don't have a problem with it because you're not a male under 25. But the rates they are charged (often times in excess of $300 or $400/month for insurance) is ridiculous and should prevent them from driving. Here's the problem, if they DON'T drive and are not insured when they eventually do apply for insurance it's still much higher than they should be paying because they went uninsured for so long.

The other stupid thing about car insurance is this. I get into an accident, $1000 of damage is done to my vehicle. I can't afford to pay it so I make a claim. I pay a $500 deductible, then the insurance company pays the other $500 for the repairs. In the meantime I've been paying insurance for years. After about 5 months of paying $100/month insurance, they've made their money back. On the 6th month, my insurance renewal comes in and they're going to charge me an additional $250/month on top of what I've already been paying.

I don't see how this is justifiable. Even if you are a theoretical "increased risk," they're still making an insane amount of money out of the deal.

[watching&waiting]

There are so many reasons why some people are unhealthier then others, that this is just plain stupid to think we can base healthcare with lifestyles. Many over wieght and even obese people have no health problems at all. I remember when I was in for my second kidney operation, that the guy next to me was a marthon runner and he died there of congestive heart failure. I was on my second kidney operation due to Genetic causes. I was 148 pounds, 5' 11"and 28 years old. I was also told that my arthritis was going to be a thing that I needed to address as if I did not address it I would be in a wheelchair by the time I was 48 years old. I did address it as best as I could and I am now 55 years olds and still walking. While yes I am in constant pain I take pain killers for this. That is why I now live on a disability pension that I bought when I was 18 years old. I would have to say I have been a big user of healtcare over the years, and I wonder just at how anyone can even try to think that my health could have changed anything. If there were no government plans I would have proably died by now. Instead I will live on with reasonable quality of life, for many years yet. Now I am the third son out of a family of four. All my brothers and sisters have excallent health, as did my parents. My genetic disorder that gives me gout, arthritis and kidney problems, would preclude me from ever being able to by private insurance, and as I said I have only been able to have policies that I bought way back as a teenager, before I found out about what lay ahead.

Now, by the way this thread topic is going, I guess it is my fault that I am a big user of healthcare, and I should have sought private insurance earlier etc. Much of what I have read here makes me really want to go off at many of you, but I will not. As I know that regardless of the opions expressed here, there is no way any government will support these views. The true people who are unhealthily obese, do not live long lives. Hell even those who are healthy but push the envelopes you see die long before they are 50. Just look in any paper at the obituaries. It is sad that many of those you are talking about being a drain on the system, are there in the papers obituary columns. Yes they really put a drain on the system.

Today we can usually make a big difference in the lengths that we can treat and keep people alive. Should we put some controls on it. Say once you use up a certain amount of credits, we take you off the lists and let you die? That is what you are all talking about here, and it disturbs me to no end. People who let themselves go due to their choice in lifestyle, are more then likely those who uyou see dying before they are 50. The majority of people with Heart attacks still die. We do not save that many even with today medicine. So that group you all seem to be holding in contempt, are dying everyday for the choices they made, and you want to further attack them? I would give anything to be able to wake up and not suffer any pain. Go play sports like I used to. But you see because I had an underlying condition that I did not know about, all those thing I did when youger like lift car motors out with out a hoist, play tackle foot ball and fighting in the Legion Boxing Club, all these things gave me places that later in life would give me osteoand ruhmatoid arthrites, and yes they do not stop you then, but you grow older and pay many times over for those things you did, that you thought were healthy. Now My question for all of you is just how would you tell me from any other person you are trying to point at in this threads topic?

[Renegade]

but you probably don't have a problem with it because you're not a male under 25.

No, not now I'm not but I once was, and yes, I too paid those high rates then. Doesn't change my view.

The other stupid thing about car insurance is this. I get into an accident, $1000 of damage is done to my vehicle. I can't afford to pay it so I make a claim. I pay a $500 deductible, then the insurance company pays the other $500 for the repairs. In the meantime I've been paying insurance for years. After about 5 months of paying $100/month insurance, they've made their money back. On the 6th month, my insurance renewal comes in and they're going to charge me an additional $250/month on top of what I've already been paying.

I don't see how this is justifiable. Even if you are a theoretical "increased risk," they're still making an insane amount of money out of the deal.

I would happily address this, unfortunately this thread is not the place for it.

[Biblio Bibuli]

People who let themselves go due to their choice in lifestyle, are more then likely those who you see dying before they are 50.

"It's all in your genes!" .... or ... "When it's your time to go, it's your time to go!" ... some say, carelessly.

A friend of mine is afraid of flying and once we were flying together and when turbulance hit she really worried. And so I tried, carelessly, to ease her mind by telling her not to worry, that she'll go only when it's her time to go.

"There are 300 people on this plane you asshole, what if it's one of THEIR times to go?", she replied.

[geoffrey]

Off topic, but you probably don't have a problem with it because you're not a male under 25. But the rates they are charged (often times in excess of $300 or $400/month for insurance) is ridiculous and should prevent them from driving. Here's the problem, if they DON'T drive and are not insured when they eventually do apply for insurance it's still much higher than they should be paying because they went uninsured for so long.

The other stupid thing about car insurance is this. I get into an accident, $1000 of damage is done to my vehicle. I can't afford to pay it so I make a claim. I pay a $500 deductible, then the insurance company pays the other $500 for the repairs. In the meantime I've been paying insurance for years. After about 5 months of paying $100/month insurance, they've made their money back. On the 6th month, my insurance renewal comes in and they're going to charge me an additional $250/month on top of what I've already been paying.

I don't see how this is justifiable. Even if you are a theoretical "increased risk," they're still making an insane amount of money out of the deal.

That's how insurance works. My rates are extremely low and I'm a male under 25 with a sports car. The moral of the story, don't get in at-your-fault accidents. Don't get speeding tickets.

And your insurance will be reasonable. I pay just a little more than my dad who drives a similar car and he's approaching retirement. Both of us zero accidents or speeding tickets (speeding convictions anyways ). It's not age discrimination, it's discrimination based on habits and definitive risk profiles. The same can apply to health.