Do overweight people deserve healthcare from the province?

[1967100]

Do people who are fat and overweight deserve universal healthcare coverage? I really think they shouldn't as they always get sick and have health problems.

[B. Max]

Do people who are fat and overweight deserve universal healthcare coverage? I really think they shouldn't as they always get sick and have health problems.

Your right, they should be rounded up and marched off to the extermination camps herr 1967100.

[geoffrey]

Absolutely, but only because we have a ridiculous notion of absolute equality.

If we had private insurance, people would pay proportionatly to their fair risk to the system... I actually suppose that this could be done under public insurance.

There are a few people that are fat and are that way because of a medical condition. I don't group these people in the category as those that chose a lifestyle that contributes to their 'fatness'.

Realistically, I have no issue with someone with a BMI of >25 getting medical treatment, but they should be paying much more than my BMI of 19 does.... they pose a far greater risk to the system than I likely ever will. Why should I pay the same? I'm quite literally subsidizing an unhealthy lifestyle.

[Remiel]

If you start charging for one though, you have to start charging for them all. Your rates would increase depending on if you are overweight, a smoker, a drinker, a pothead, a drug user, a speeder, an unnecessary stress inducer, a consumer of artery clogging foods (even if you arent overweight), a thrill seeker, etc, etc, etc, etc, etc... Theoretically possible, but a paperwork nightmare.

[noahbody]

It's time the government put warnings and pictures of Rita Macneil on Big Mac boxes.

[geoffrey]

If you start charging for one though, you have to start charging for them all. Your rates would increase depending on if you are overweight, a smoker, a drinker, a pothead, a drug user, a speeder, an unnecessary stress inducer, a consumer of artery clogging foods (even if you arent overweight), a thrill seeker, etc, etc, etc, etc, etc... Theoretically possible, but a paperwork nightmare.

Not really, private insurance companies find it cost effective to screen and assess premiums based on these factors. No reason why the government can't as well.

[Adelle]

I vote yes but healthy people should get a break and unhealthy people should pay extra. Doesn't matter about the body shape but if you will tax the system in the future. Oh, and fitness clubs should be covered by the provincial HIP. Call it preventative medicine, like a vaccination for healthy living.

[Riverwind]

If we had private insurance, people would pay proportionatly to their fair risk to the system... I actually suppose that this could be done under public insurance.

You have a naive view of private health insurance. Americans get very few discounts on their insurance for 'lifestyle' reasons because private health care insurance companies only care about what is going to happen to you in the next few years - not 20 years from now. For that reason an obese coach potato in his 20s may be a lower risk than fit weekend warrior because the weekend warrior is at risk for exercise related injuries.

Futhermore, most Americans are forced to participate in group plans (via companies or medicare for the poor) which provide no incentives to change behavoir.

I agree that there should be incentives in the system designed to encourage healthy behavoir, however, private insurance is not capable of doing that in any way that could be called fair.

[cybercoma]

Do people who are fat and overweight deserve universal healthcare coverage? I really think they shouldn't as they always get sick and have health problems.

As soon as you prove people with a BMI > 25 are less healthy than people who have a BMI < 25 AND also prove that people who reduce there BMI from > 25 to < 25 become healthier.... I'll agree with you.

[rover1]

Foolish question, in my view.

[Leafless]

I vote yes but healthy people should get a break and unhealthy people should pay extra. Doesn't matter about the body shape but if you will tax the system in the future. Oh, and fitness clubs should be covered by the provincial HIP. Call it preventative medicine, like a vaccination for healthy living.

And just how to you define healthy?

Why don't you tell us about the diverse genetics that run in your family?

[fellowtraveller]

Does BMI mean Bowel Movement Index?

Really, who has more than 25 poops per day?

[Posit]

Yes it is a silly question.

Health care is an insurance plan managed by the provincial government. It is no more universal than province managed car insurance. People can be denied services and insurance for all kinds of reasons - for cosmetic or elective surgeries etc - and be limited as to the diagnostic services provided.

While the government can't discriminate against obese people, some doctors choose to refuse to treat patients that do not accept their advice or treatment. However, being overweight is not necessarily a health factor, anymore than working in smog-ingested Toronto is. If you move to ban anyone, then target those that live in the cities and pollute the environment, by driving SUVs, smoking or farting excessively outdoors.

[Slavik44]

In your poll you have asked if people with a BMI over 25 deserve healthcare, the inherrent problem with using a BMI is you would also be excluding athletic individuals from health care services. You might be able to base it on BF% but that, often, is highly dependant on the method used and the person who tested you.

So we are left with no universal way to truely test for fat people.

Likewise who else do we screen out? All unhealthy individuals? Maybe people in wheelchairs? What about people with medical conditions? These are risk factors, do we start assessing premiums to these people as well?

[Catchme]

Oh yes, lets decline sports enthusiasts while were are at it, and all people with type 2 diabetes, and those skinny people who store fat inside, good grief I tell ya!

[bush_cheney2004]

....Futhermore, most Americans are forced to participate in group plans (via companies or medicare for the poor) which provide no incentives to change behavoir.

I agree that there should be incentives in the system designed to encourage healthy behavoir, however, private insurance is not capable of doing that in any way that could be called fair.

This is not necessarily so....several lifestyle management programs are purchased by American employers to help manage behavior driven risk and group insurance rates. For instance, a third party "Wellness" vendor will conduct voluntary health and lifestyle assessments to build a profile that is managed by mail, and if necessary, telephone calls. This is dovetailed with employee incentives, pharm medications, anti-smoking programs, blood pressure monitoring, etc.

http://www.staywellhealthmanagement.com/

Wellness vendors have been successful because prevention is very cost effective.

[Riverwind]

This is not necessarily so....several lifestyle management programs are purchased by American employers to help manage behavior driven risk and group insurance rates.

You are actually supporting my point. These programs encourage healthy lifestyles through prevention and education. These programs do not charge individual employees more based on their 'risk profile'.

[ScottSA]

Realistically, I have no issue with someone with a BMI of >25 getting medical treatment, but they should be paying much more than my BMI of 19 does.... they pose a far greater risk to the system than I likely ever will. Why should I pay the same? I'm quite literally subsidizing an unhealthy lifestyle.

Far too simplistic. My BMI is 28.5, yet my bodyfat percentage is low. That's just because I go to the gym a lot. I'm 6' and 210 lbs, and carry a lot of weight that's not fat. I daresay I'm not at a startling risk of any medical condition.

I agree that there ought to be a difference in medical costs due to lifestyle and consequent health risk, and I think healthy folk ought to somehow suffer financial hardship less than obese useless slugs, but that's really hard to do in the presence of universal healthcare. Seems to me that the solution lies in a combination of user sticks and nonuser carrots. I sure don't have the solution, but I know one MP tried to introduce a private member's bill for something as simple as making gym memberships a tax credit, and I see no downside to that at all (especially since I have a part interest in a gym). I don't see how to apply the stick in any sort of reasonable way, but the carrot aspect...to reward folks for good health...is a great idea.

[bush_cheney2004]

You are actually supporting my point. These programs encourage healthy lifestyles through prevention and education. These programs do not charge individual employees more based on their 'risk profile'.

Yes they do (underwriters "charge more") because employee premiums and/or lost incentives are impacted by participation and compliance. Group rates are impacted by the compliance rate for the entire risk pool, which is passed on by the employer.

[leonardcohen]

It's time the government put warnings and pictures of Rita Macneil on Big Mac boxes.

I almost killed myself laughing over that :}

[Fat Freddie]

Oh yes, lets decline sports enthusiasts while were are at it, and all people with type 2 diabetes, and those skinny people who store fat inside, good grief I tell ya!

I know a woman who runs all the time. She looks great for a person who spends a great deal of time healing up from knee surgeries and having treatments for her breast cancer. She also has herpes and loves to sleep with strange boys in the nighclubs. She has far more health issues than the guy across the street from me who is carry sixy pounds more than he should. I think the medical system should have a user fee attached to everyone who uses it like my union dental plan has for those of us that use it. I think people would be less likely to clog the ER with scraped knees and colds if it meant a long wait and a $35 user fee.

[Wilber]

Back in the sixties this country decided that universal health care was a fundamental part of our society. Universal means everyone.

[geoffrey]

Far too simplistic. My BMI is 28.5, yet my bodyfat percentage is low. That's just because I go to the gym a lot. I'm 6' and 210 lbs, and carry a lot of weight that's not fat. I daresay I'm not at a startling risk of any medical condition.

BMI isn't the best indicator, and this the problem with setting up a objective method of determining someone's health... at a reasonable cost anyways. I'm only an inch shorter than you but a good 70 pounds lighter... my activity is xc ski (plus alpine) in the winters and cycling in the summers. Both likely health as a horse, but completely different dynamics. My aerobic capacity is likely many times yours, but your muscle mass (good at burning calories while just doing nothing) is undisputably many times mine. Both of us are much less likely than the average to have a heart attack or type 2 diabeties or a bazillion other costly problems.

And I selfishly think we should both be rewarded for our completely different but equally benefical steps to reducing our burden on the health care system.

Obviously people can't be trusted to provide accurate reports of their physical activity or eatting, but we can certainly provide incentives from a tax basis (which is our insurance premiums) in Canada to those that lower their risk to the system. Having fitness equipment GST exempt would be step one in my opinion... fitness equipment isn't a luxury item, it's a living essiential like food. Your going to die early if you don't have it.

[Slavik44]

Far too simplistic. My BMI is 28.5, yet my bodyfat percentage is low. That's just because I go to the gym a lot. I'm 6' and 210 lbs, and carry a lot of weight that's not fat. I daresay I'm not at a startling risk of any medical condition.

BMI isn't the best indicator, and this the problem with setting up a objective method of determining someone's health... at a reasonable cost anyways. I'm only an inch shorter than you but a good 70 pounds lighter... my activity is xc ski (plus alpine) in the winters and cycling in the summers. Both likely health as a horse, but completely different dynamics. My aerobic capacity is likely many times yours, but your muscle mass (good at burning calories while just doing nothing) is undisputably many times mine. Both of us are much less likely than the average to have a heart attack or type 2 diabeties or a bazillion other costly problems.

And I selfishly think we should both be rewarded for our completely different but equally benefical steps to reducing our burden on the health care system.

Obviously people can't be trusted to provide accurate reports of their physical activity or eatting, but we can certainly provide incentives from a tax basis (which is our insurance premiums) in Canada to those that lower their risk to the system. Having fitness equipment GST exempt would be step one in my opinion... fitness equipment isn't a luxury item, it's a living essiential like food. Your going to die early if you don't have it.

I think there is a fairly large difference between tax breaks on health related items and activities (which I would support) and forcing people to pay premiums based on their BMI or even other measures of Bodyfat percentage.

I know that if using the 25 BMI measure I would be forced to pay a premium. I am a bit of a gym rat, I have bulked up to as high as 225 and am currently cut down to around 175. Both numbers put me over a BMI of 25, one of them in state of almost morbid obesity, which is not and has never been the case. At all times I have attempted to get atleast 1-2 days a week of cardio in, on top of 4-5 days of weightlifting.

This helps to highlight the problem of classifying obesity and fatness for such strict purposes. It is easy to do subjectively but an entirely different thing objectively, the same is true for measures of body fat percentage...

Using Calipers is highly dependant on the person who tests you and their skill, you could literally get ten people to test you and get ten different results. Beyond that the results have a moderate margin of error.

Hydrostatic testing, although theoreticaly very accurate is greatly dependant on oxygen levels in your body, and how well you can force yourself to go with out oxygen.

There is also an X-ray form of measurement, perhaps more reliable but also bloody expensive.

No matter what, the money spent trying to test 30 million Canadians would be astronomical. It would also not be a one time thing, it would have to be done atleast on a yearly basis. So thats like a gun registry a year...not good. somehow it sounds less likely to save money and more likely to create yet another government cash dump.

What about court costs? Are You telling me people wouldn't fight decisions. What if you set the standard at 15% and someone measures 17%...they could rightfully claim to be possibley within the guidlines, because no test can be that accurate. What if they measure 18.1%, 18.5%, what about 19%...not only are we dealing with a bloody expensive undertaking, that we don't yet have the infrastructure for, but we are opening a can of worms because it is absolutely impossible to objectively and universally quantify a fat person.

Subjectively it is a piece of cake, Objectively it is impossible. It would be an comedy of errors and charges that would leave no one laughing and everyone groaning.

I do not see such a solution as being at all feasible or cost effective.

I agree however, that there is some potential in tax breaks to health related items and activities. However, that might not be a solution so much as a reward. Every January people shell out huge amounts of money to get in shape, and by febuary there are sitting on their ass eating potatoe chips and watching T.V, complaining that they couldn't loose weight.

I think that not only should we provide tax breaks, but I think it is time we considered expanding Physical Education to include a nutrition component. We have a multi-billion dollar industry that stands as a testament to peoples nutritional ignorance. I think if we want to reform and improve healthcare pro-active preventative measures should be looked into and it should include not only providing people with a cheap answer but also the knowledge to make good decisions.

Unfortunately punishing people for being fat is not objectively feasible, it would be expensive, time consuming, create more government bueracracy (I think the government is in need of a healthy diet almost as much as Canadians), it is simply a can of worms...really big and fat worms.

[geoffrey]

I agree however, that there is some potential in tax breaks to health related items and activities. However, that might not be a solution so much as a reward. Every January people shell out huge amounts of money to get in shape, and by febuary there are sitting on their ass eating potatoe chips and watching T.V, complaining that they couldn't loose weight.

I agree with all of your above statements, it's difficult, if not impossible, to find an appropriate standard. But we already see private companies doing this to a large extend, you pay more if your a smoker, you pay more if you have a history of high cholesterol, ect. ect..

Is TV a cause of obesity? Should it be taxed like cigarettes? Perhaps not. The problem with TV is that you can watch at much as you want without paying more. I'm not comfortable with the social engineering that would be behind a move to limit TV watching. On very inclement days I watch TV while riding on the indoor trainer. Just another case of trouble with specific solutions.

I think that not only should we provide tax breaks, but I think it is time we considered expanding Physical Education to include a nutrition component. We have a multi-billion dollar industry that stands as a testament to peoples nutritional ignorance. I think if we want to reform and improve healthcare pro-active preventative measures should be looked into and it should include not only providing people with a cheap answer but also the knowledge to make good decisions.

Or tax junk food like we tax tobacco and alcohol. I don't see why we haven't yet. A $10 bag of chips is going to stop people from eatting things that are unhealthy no matter how you spin it. Tobacco I think is killing far less people in Canada now than obesity through things like preventable heart disease and diabeties.

Unfortunately punishing people for being fat is not objectively feasible, it would be expensive, time consuming, create more government bueracracy (I think the government is in need of a healthy diet almost as much as Canadians), it is simply a can of worms...really big and fat worms.

Not punishing them is equally expensive in the long run in my opinion. Some stats show more than half of Canadian kids now have a weight problem of some type. I certainly don't want to pay that health care bill 50 years from now. If any of them live past 40. A heart attack takes someone out of the workforce for anywhere between 1 and 6 months generally... that's a huge cost to society... on top of the medicial costs.