Health Care in the United States

Started by RubySlippers, June 12, 2006, 02:09:54 PM

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National Acrobat

QuoteTo put it in more practical terms, if you're running any sort of business, you need your employees there to do their jobs so that you can stay in business.  You *NEED* your employees...that's why you hired them in the first place, no?  Sick employees = bad production.  It's really as simple as that.  Even though my career is my own problem, it will affect me if Mary-the-Coworker doesn't take her meds, because I will eventually have to depend on her, and she may not be able to get the job done.
  You simply can't live in a community and pretend that your neighbor's problems aren't your own.  In the basest, physical sense, only air seperates one human being from another.  Our flesh is punctured easily, there are way too many things today that can shatter our bones.  Our bodies are fragile, and we're all going to need some sort of help at some point.

With that in mind, then I should be able to decide, if I run a business, to not hire people who smoke, are overweight or who drink lots of alcohol or engage in any other behavior.

If it is a societal issue, and as a businessman or co-worker, then I shouldn't engage in those behaviors, due to what strain it would put on the company's health plans, etc.

I should have the right to refuse to pay for health benefits for people who smoke, for instance. They're hurting the company.

robitusinz

#101
Quote from: National Acrobat on June 28, 2006, 01:42:11 PM
With that in mind, then I should be able to decide, if I run a business, to not hire people who smoke, are overweight or who drink lots of alcohol or engage in any other behavior.

If it is a societal issue, and as a businessman or co-worker, then I shouldn't engage in those behaviors, due to what strain it would put on the company's health plans, etc.

I should have the right to refuse to pay for health benefits for people who smoke, for instance. They're hurting the company.

Exemptions for smokers, overweight people and alcoholics are already made in many companies.  However, it's done contrary to what you may think.  Breaks are given to folks who don't smoke, who undergo regular exercise regimes, and pass physicals/blood work.  I know that while working for IBM, I received a $150 refund for being a non-smoker, and one year that I joined a gym, I got back $250 in reimbursements for doing so.  I also took physicals that I didn't pass, but I know my coworkers received certain breaks from those as well.  You can't discriminate against people, but you can certainly reward those who fall under certain criteria.  Everybody needs to have the basic opportunity, that's it.



BTW, not every health care company or policy have those options, and I'm sure that there are companies that do not pass the savings along to the employees.  I can only speak from personal experience, and using a large company as an example.  All I'm trying to show is that options do exist.

Intrinsically, insurance companies will deal with "abusers" by the simple nature of the beast...people who keep getting sick will keep having their premiums go up to a point where they simply price themselves out of coverage.  The crux of the situation lies in what is an acceptable point to effectively bar people from health care.  As it stands now, there are too many "normal" people...non-abusers, otherwise healthy people...who have cannot afford health care, and thus, if by some chance they trip and break a leg, they're royally screwed.
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RubySlippers

But lets say you run a small business and could afford $50 a month you would not offer the health care plan? After all basic or not if covers alot of the basics and a Health Savings Account would not have to be matched just allowed for putting the funds in a Money Market Account for the employee a percentage of income they want taken out. And I also must note we calculated the cost based on one days pay per month for a low wage worker so it was cost effective to offer.

And note we have to deal with people like myself that has an illness not their fault. Type I Diabetes strikes anyone I'm of my normal weight, take care of myeself and eat properly (usually even I treat myself once in a while). Yet I can't get insurance except now through my company and then I have to wait a year for full coverage of all my illnesses. Untreated I can get very ill and be a burden on society but managed I can stay fit and work. Paying taxes and doing good by society.

But lets keep this simple if a basic plan I laid out was feasible in some form could be $50 or maybe $75 a month for a single person is that reasonable to expect an employer to offer regardless of size of the business? My friend works in health care management and the numbers would be very accurate using what plans already get as deals for services and the marketplace.

We termed this a BASELINE HEALTH PLAN (BHP) that would offer the basic services for the money covering as much as possible inexpensively.


National Acrobat

I know that breaks are already given to those who practice 'safer' living, but companies are now also starting, as the media is pointing out, to deny health insurance or claims for employees who engage in behavior that would incur costs upon them. Smoking is the big one. I know I've read it in the Wall Street Journal and seen it some places on the news media, but there are now companies who are also refusing to hire those who smoke, drink a lot of alcohol, etc. and the number one reason for that is the costs that are incured for insurance for people who are at risk for what they do to themselves, not what nature or random chance does.

RubySlippers

Yes again though why punish people like me who are ill for legitimate reasons outside their control and are living right to try and stay healthy. I'm lucky my first job offers a good benefits plan even if I have to wait a year to have them cover all my needs. Many are not that lucky.

Moondazed

There's a big difference between lifestyle exemptions and actual health exemptions... when I lived in Washington they couldn't deny insurance due to pre-existing conditions, although insurance was more expensive.
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RubySlippers

In Florida they can but my employer offers Humana that has a large list of options I took the HMO with a low deductable a bit pricey but when it fully kicks in will be good. Also they will cover doctors visits and routine tests just not the drugs or medical treatment for my conditions. Until a year is up.

Zakharra

  The BHP sounds good, until you get the hospital bill. Hospitals a re expensive. A ambulance ride can cost $2-4k alone. Then there are the $6-900 a day hospital beds, medical care and any surgeries and drugs. Unless those costs are either lowered drastically or the insurance company eats the cost, then it's not workable.

RubySlippers

That's why it focuses of preventative care low cost primary care doctors visits, low cost on drugs relatively speaking and a focus on day outpatiant care. And in my area a friend stayed at the hospital 5 days and it cost $6000 with the ambulance. My point is to keep the care WITH the person not the company for continuous care. But you wanted responsibility and the plan does focus on that if people don't work to avoid a serious problem then they are going to use up their benefit fast.

Zakharra

 Get tort reform and that may keep primary care doctors in the business. One problem is the number of doctors that are abandoning their practices. It's too expensive and frustrating, with all of the lawsuits and such by patients and their families and lawyers.

And keep this out of the hands of the government. If the government gets involved that it will not work.

robitusinz

Quote from: National Acrobat on June 28, 2006, 06:19:18 PM
I know that breaks are already given to those who practice 'safer' living, but companies are now also starting, as the media is pointing out, to deny health insurance or claims for employees who engage in behavior that would incur costs upon them. Smoking is the big one. I know I've read it in the Wall Street Journal and seen it some places on the news media, but there are now companies who are also refusing to hire those who smoke, drink a lot of alcohol, etc. and the number one reason for that is the costs that are incured for insurance for people who are at risk for what they do to themselves, not what nature or random chance does.

I'm not really sure how I stand on not offering jobs to people who follow unhealthy lifestyles.  I beleive that people should do whatever they please as long as they're not bothering anyone else, but there's no denying that those who follow bad habits put a burden on medical systems.  I personally do not know the magnitude of the impact that a smoker has on a company's insurance policy.

On a fascist note, I wish they would just outlaw smoking, period.  That's just something that has no benefit.  Luckily, it looks like smoking's going to be phased out within a few generations.  I don't know the actual statistics, but I personally know very very few smokers around my age, compared to the vast amount of smokers I know from my mother's generation.
I'm just a vanilla guy with a chocolate brain.

RubySlippers

Well a local sheriffs office bans smokers from applying for jobs and they must be tabacco product free for 6 months before they apply. My view is a habit is different than a legitimate medical problem that is protected Federally in many cases.

robitusinz

Quote from: RubySlippers on June 29, 2006, 11:10:12 AM
Well a local sheriffs office bans smokers from applying for jobs and they must be tabacco product free for 6 months before they apply. My view is a habit is different than a legitimate medical problem that is protected Federally in many cases.

It's all a problem of perception.  When people think of programs to benefit "all Americans", the people they think about are the ghetto queens with their 8 kids from 7 different daddies, or the smoker who puffs his way to cancer, or the druggie with the puffy veins.  They don't think about the average, normal, Dick-and-Janes who are the actual beneficiaries of these programs.

Changing society for the greater good never works because while people may go out of pocket to help out someone like you, Ruby, afflicted faultlessly, the sad reality is that they won't spare a dime for John, the crackhead down the street who sucks dick for cocaine.  Yet, it's John who's in their minds constantly, not you.
I'm just a vanilla guy with a chocolate brain.

National Acrobat

If you are going to have a policy or program to benefit everyone, that means everyone.

However, I think there need to be penalties and consequences for those who partake of such a system but knowingly do things that will harm themselves, thereby putting an undue extra burden on the rest of us.

I have no problems with private companies doing what they wish with benefits. If you smoke, you are at higher risk for a huge number of health problems, all of which can compound each other, driving the cost for your care even higher.

RubySlippers

I have a good example here a man overweight big time and he was in the hospital with a quadruple bypass (or more) and the county was paying his bills. Now we are talking what $100,000 plus drugs and therapy and the like. He was released from two primary care doctors for not cooperating with the progtram- basic do what the doctors prescribed for treatment.

Now this man I saw in the hospital and he had a large pizza with extra toopings cheese and meat I think brought in and ate it. Smoked cigars. Drank beers and alcoholic drinks. Refused to basically do his treatment program. The last doctor refused him and he was dropped from the program.

Now I pay taxes and am happy to help the indigent but this was outrageous. I do what I'm expected to stay healthy not easy but even I can afford a small treat now and then in my diet if careful. But one must do what must be done to better take care of oneself and in this mans case follow the treatment program. Especially since all his costs were being covered.

So one must seperate the legitimate poor and lower income care from people that can't be treated and its their own fault.

robitusinz

Quote from: RubySlippers on June 29, 2006, 02:57:45 PM
I have a good example here a man overweight big time and he was in the hospital with a quadruple bypass (or more) and the county was paying his bills. Now we are talking what $100,000 plus drugs and therapy and the like. He was released from two primary care doctors for not cooperating with the progtram- basic do what the doctors prescribed for treatment.

Now this man I saw in the hospital and he had a large pizza with extra toopings cheese and meat I think brought in and ate it. Smoked cigars. Drank beers and alcoholic drinks. Refused to basically do his treatment program. The last doctor refused him and he was dropped from the program.

Now I pay taxes and am happy to help the indigent but this was outrageous. I do what I'm expected to stay healthy not easy but even I can afford a small treat now and then in my diet if careful. But one must do what must be done to better take care of oneself and in this mans case follow the treatment program. Especially since all his costs were being covered.

So one must seperate the legitimate poor and lower income care from people that can't be treated and its their own fault.

Eh...ok, first of all, the guy you described is a fucking slob.  Aside from what I'm going to say after this, the guy shows an utter contempt for the treatment he's getting, a complete lack of consideration for those around him, and a total lack of respect for his nurses and doctors.

Now, that being said, obesity isn't much different from other diseases.  I'm dealing with it right now.  I'm 350 pounds on a 5'10" frame.  I'm telling you right now that I do not WANT to eat unhealthy food.  I just can't help myself.  And I've tried.  Desperately.  I have my wife basically force-feeding me like something out of a military movie (force-feeding me good stuff, that is).  But, I continue to "sneak out", grab my fix.  Alcoholics, drug addicts...they're lucky.  They can, theoretically, quit cold turkey and never even have to SEE the stuff again.  An obese person, or an ex-obese person will have to continue to consume food on a daily basis.  I wouldn't knock obesity without having a clue.  Sure, an obese person has to actively go out and get his food, but you don't know the kinds of mental compulsions a person like me has on an almost constant basis.  I will literally drive up to a McDonald's drivethru lane, with my right hand gripping my left wrist, and I'm talking to myself, saying, "Get the fuck outta here...what the hell are you doing?", and not being able to stop myself from ordering.
I'm just a vanilla guy with a chocolate brain.

RubySlippers

I don't? My father was obese until he had his big scare and had a heart attack then just fixed it. I frankly am sick of people calling everything a disease.

Now I know you have to eat that doesn't mean you HAVE to eat at McDonald's- what they walk out and put a shotgun to peoples heads. People have choices. You can go to a nice restaurant and order a carefully selected meal. You can make food at home. You can opt not to buy certain foods.

I would put it this way because I have to everyday. If I eat this Whopper it could KILL ME! It can I have to be very careful if I eat a sweet - a rare treat - I have to be sure its with a good meal or I could die. I have to make my own food because most places I could eat out at don't meet my careful portion needs and the like. Or I have to share a meal to keep the portions down and the staff look at me strangely.

But Obesity is not the end all of things you can opt to eat better? Less salt, more fruit, less fatty foods, cut down the sugars, see a doctor for medical care for problems. But alcoholism is a character weakeness, drug abuse is a character weakeness I would not say that for overeating I'd blame your parents and the marketing system to not stopping that when you were younger. But when you have diabetes and/or a heart attack or some other illness and could have died (hope not) your going to have to change then. My father was like you and had a heart attack at 50 then he just changed. Its called having a BIG SCARE. I just hope it doesn't kill you. Then you will likely take care of yourself.

robitusinz

I had posted a rather angry reply, but I'll just leave it be.  Ignorant people will remain so, regardless of how much breath, or in this case computerized text, you throw at them.
I'm just a vanilla guy with a chocolate brain.

RubySlippers

I just point out people in general CHOOSE to drink or CHOOSE to take drugs with exceptions. I have Type I Diabetes and Epilepsy I didn't ask for them, I didn't get them due to lifestyle I have them. Hence the first is a disease or illness.

If one does something that they get into and get addicted its not a disease its moral weakness.

Overeating is more how one was raised and such I give that more leeway but its still NOT a disease in many cases.

Cancer is a disease and that in many cases someone doesn't CHOOSE to get- smokers excluded.

Zakharra

Quote from: RubySlippers on June 29, 2006, 08:49:45 PM
Cancer is a disease and that in many cases someone doesn't CHOOSE to get- smokers excluded.

Not totally true. There are many people who get lung cancer that do not and have not smoked. It's not just a smokers disease.

Swedish Steel

No, but when I last visited the lung cancer ward, at least 9 out of 10 were smokers. Pretty sad, some of them were still sneaking off to have a smoke.
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Zakharra

 My point stands. That is a 10%, at least margin of people who are not smokers. It's not a smokers disease. If it was, only smokers would get it.

Apple of Eris

I saw someone mention tort reform back a ways. I don't support that, and here's why:

When lawmakers pass a law capping damages, they don't normally just cap punitive damages, they also cap compensatory damages. Take for example the case of that lady who spilled coffee on herself from McDonalds.

I know, what a dumb lady, spilled coffee and sued mcdonalds, she's the reason my cheeseburger went from 45 cents to 65 cents!

Well no. Here is what happened. The actual facts of the case revealed th coffee was kept at 195 degrees F, a temperature high enough to partially melt the styrofoam that contained it. She put the coffee between her legs as she drove off and the lid which hadn't fit correctly came loos and the coffee spilled into her lap causing 3rd degree (or 1st? Which are the worst, I always forget) on her groin and vagina.

The medical treatment and cosmetic restoration tatalled over 2.2 million dollars to this woman.

McDonalds was found partially liable and held for 15 million. The judge reduced that to ten before the partial liability (mcdonalds was found half liable) reduced the award to 5 million. Legal fees took about 1.5 million and 2.2 or so went to cover her medical expenses, leaving her with about 1 million.

How many people want to burn their genitalia so badly it burns to the bone and has to be reconstructed for 1 million dollars? Any takers?

Now, to my point about Tort. The caps on damages (which also fail to account for inflation in every case I've seen) are arbitrary, they don't fluctuate to change and allow for a greater award if say bob had his arm burned off in an accident by the hospital and can't work at his job again. So how much is an arm worth, your lifes wages at your chosen career, etc?

Tort fees account for less than 1-2% of insurance companies expenditures. Don't let them fool you into thinking thats why they raise their rates. Before Katrina, insurance companies were making record profits and they'll be doing so again before long. But they have a great lobby and are wonderful at spreading disinformation. Tort reform hurts the public and helps big companies, is that really what we want? I sure as hell don't.

(oh and yes, I'm a lawyer, but I do NOT do personal injury cases)
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robitusinz

Quote from: RubySlippers on June 29, 2006, 08:49:45 PM
I just point out people in general CHOOSE to drink or CHOOSE to take drugs with exceptions. I have Type I Diabetes and Epilepsy I didn't ask for them, I didn't get them due to lifestyle I have them. Hence the first is a disease or illness.

If one does something that they get into and get addicted its not a disease its moral weakness.

Overeating is more how one was raised and such I give that more leeway but its still NOT a disease in many cases.

Cancer is a disease and that in many cases someone doesn't CHOOSE to get- smokers excluded.

  Life's not that black and white.  I wish things were as simple as the "Me-Me" conservatives' god wills it to be.

  I actually started this on this thread in support of "selective" healthcare, but now I realize how much it disgusts me to be this selfish and judgemental.  The real "truth" is that everyone has something to contribute to society, yet, everyone also has a ton of garbage that they add in.  If a smoker smokes...eh, fuck it...there's still the chance that she's a good mother, a loving person.  She spews a few carcinogens into the air...but she's got 2 great kids who may one day grow up to make a positive difference in the world.  How can I judge that person?  What criteria would I use?  How wide would the scope be?  On the flip side, you've got people in pristine health who beat their wives, rape children, commit fraud, or commit a wide variety of other crimes.
  I posted somewhere that my mother was a smoker and it disgusted me.  It does, truthfully.  Her stench gives me nausea at times.  But, you know what?  My family emigrated here in the late 60s from Cuba.  They got here poor.  They remained poor...my grandfather was a carpenter, and he wouldn't allow my grandmother to work (ironically, in Cuba, she started working when she was 8 years old as a maid)...my mother and aunt were teenagers at the time.  My aunt finished high school, then had to go to work...that's what happens when you're poor.  My mother actually dropped out early, but got her GED in night school...again, when you're poor, college is a luxury.  They struggled, and actually managed to get some decent jobs.  All throughout my life, my mother struggled HARD.  My dad left us when I was a baby...to this day, I've never met him, and have no desire to.  She decided that I was going to get the best education possible, so she worked extra hours at the bank so that I could attend a private school.  When it was time for high school, my aunt and mother both quit their jobs so they could afford a private high school.  Because of her sacrifice, I was able to go to college on a free ride.  Because they pushed me and sacrificed, I won scholarships.  Right now, I'm at the early stages of a successful career, and I owe it all to my mother.  But, my mother smokes.  Now, I'd really like to know how exactly my mother's to be judged.  How would the ultra-religious neo-cons judge my mother?

  You people that see things in such a black and white manner, tossing out judgement on others before inspecting your own glass house, I pity us.

  And to stay on topic, we should still reward those who stay healthy, but you can't simply axe health care away from people you judge unfit.
I'm just a vanilla guy with a chocolate brain.

RubySlippers

There are exceptions like I said a child getting into drinking is not to blame that is their families fault in many cases. Drugs I know there is reason for example if someone got addicted to pain killers from a doctor again I don't blame the person but their doctor.

In cases like this disease fits.

But lets say a person is predisposed to be alcoholic or something genetically so are gays. Yes one you say is a disease and the other a choice of lifestyle. This is both confusing and is dangerous some like certain fundamentalist religious figures would say well if ONE is a disease and and the other one is also. Yet I treat neither as a disease- I feel people are predisposed to certain behaviours and to a fair degree can choose to do them. I could opt to get therapy and be with a man. I choose not to but being a lesbian in not in its nature destructive. If on the other hand I drink heavily then that IS destructive and must be fought. Its a matter of willpower, ones character and personal morals.

Now there was a local case of a 16 year old woman taken, drugged with narcotics against her will, raped and raped and prostituted is she a victim and in that case is addiction a disease? Yes it was not her choice and she was forced to do that.

And I'm NOT a neo-con but a conservative on many issues and drug use and drinking and overeating traditionally have been a moral issue not medical. Choice goes both ways I will fight for anyone and I personally think gay marriage is a great idea marriage is stabilizing and a societal good. And an amendment to ban it Federally I think sets a dangerous precedent. But the issue must be decided state by state. Abortion should NEVER have been Federalized what is a medical practice is very much more a states issue- Federally they make sure basic credentials are recognized in the nation from state to state for common sense reasons. But if Kentucky wanted to ban all abortions it should have been their right to do that.