# Health Insurance & Medical 'Tests'



## LinathSuru (Apr 4, 2012)

_More U.S. employers tie health insurance to medical tests_ - Julie Appleby, Kaiser Health News.



> Once a year, employees of the Swiss Village Retirement Community in Berne, Ind., have a checkup that will help determine how much they pay for health coverage. Those who don't smoke, *aren't obese* and whose blood pressure and cholesterol fall below specific levels *get to shave as much as $2,000 off their annual health insurance deductibles*.
> 
> -snip-
> 
> Proponents say such plans offer people a financial incentive to make healthier choices and manage chronic conditions such as obesity, high blood pressure and diabetes, which are driving up health care costs in the USA. Even so, studies of the effect of such policies on lifestyle changes are inconclusive. *And advocates for people with chronic health conditions, such as heart disease and diabetes, fear that tying premium costs directly to test results could lead to discrimination.*



So the 'medical test' for obesity is presumably stepping on a scale so the doctor can calculate your BMI, right? I wonder if they penalize the anorexic. 



> And 5% of those tie the financial rewards or penalties to meeting specific medical-based standards.



And I misread 'specific medical-based standards' as 'specific _media_-based standards'. That honestly feels more genuine to me in regards to the fact that they are disqualifying people based on obesity. Not every fat person is unhealthy, just like not every thin person is healthy. I wonder if the people at the top of companies employing plans like that even care enough to know that.



> Employers will still have to craft plans to comply with federal and, in some cases, state requirements, Volpp says. The programs must be voluntary  meaning an employer can't require a worker to participate as a condition of coverage  and the employer must offer a "reasonable alternative" to qualify for the reward, or to avoid the penalty for those who can't achieve the goals.



That at least I'm thankful for, though I wonder what the "reasonable alternative" is, and if they are required to make those who don't meet the goals aware of said alternative or if the person in question would have to inquire.

The article also talks about people who have sued companies over instituting health incentive plans like that. I think that would be the road I took if my company started a program like that. At least if weight was a central part of it. I would be more understanding of something like this if they actually measured strictly your health rather than your health and poundage. Ugh.


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## willowmoon (Apr 4, 2012)

LinathSuru said:


> *I wonder if they penalize the anorexic. *



Good point .... and I'm guessing "highly doubtful."


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## EMH1701 (Apr 5, 2012)

My own does something similar. They use a point system and part of it is you have to get a checkup. You lose points if you don't meet the numbers. You gain points back if you jump through their "healthy" hoops -- i.e. the annual step-counting program, sign up to work with the online health coach...which I did last year and it's a pile of bunk. They assume if you're not meeting the numbers you never exercise and don't eat right, ever. 

You can easily meet the step-counting goal if you just wear your pedometer from sunup to sundown, at least I did. The criteria is a joke...it's like 360,000 steps in 5 months.

Yes, some fat people don't exercise and eat right, but not all of us, and I'm really tired of the assumption that just because I'm fat, I must never exercise or eat any fruit or veggies.


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## bigmac (Apr 7, 2012)

Yet another reason to have a government sponsored single payer system.


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## Keb (Apr 8, 2012)

bigmac said:


> Yet another reason to have a government sponsored single payer system.



Something that does NOT prevent weight-discrimination. Remember the nonsense about Japanese workers' waists being measured? It just means that the government can decide what health care you're worthy of receiving/allowed to access rather than the insurers.


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## musicman (Apr 8, 2012)

Keb said:


> Something that does NOT prevent weight-discrimination. Remember the nonsense about Japanese workers' waists being measured? It just means that the government can decide what health care you're worthy of receiving/allowed to access rather than the insurers.




Excellent point, Keb! Government is not a friend of fat people, and never will be. That Japanese atrocity is just a taste of what's coming. As government gets larger and larger, it will inevitably become the source of ALL discrimination. If you think fat people are treated poorly now, just wait until it is official government policy. Of course, it won't be called "discrimination", it will be The Law, and you'll have no recourse, legal or otherwise. That is the essential difference between Government and the private sector.

Can't happen here? History says otherwise.


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## EMH1701 (Apr 8, 2012)

bigmac said:


> Yet another reason to have a government sponsored single payer system.



I think the govt. would promote weight discrimination even more. Just look at how Michelle Obama tries to control what people eat. There are some fat people for who eating a diet based off of tofu and kale and whole grains would not lose weight. It's not only the diet for everyone, despite what everyone wants to believe. I myself do my best to eat what most people consider healthy, yet am still fat. So, there is a genetic component to weight, yet everyone seems to want to discount that fact. 

This is why I am not for a government mandate. It will only get worse under a government mandate. They will probably start fining...no, they'll call it "taxing" people for being fat.


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## Dr. Feelgood (Apr 8, 2012)

musicman said:


> As government gets larger and larger, it will inevitably become the source of ALL discrimination... it will be The Law, and you'll have no recourse, legal or otherwise. That is the essential difference between Government and the private sector.
> 
> Can't happen here? History says otherwise.





EMH1701 said:


> I think the govt. would promote weight discrimination even more.



I think you both have a good point, though I'm not sure I agree with musicman that there is ultimately ANY difference between government and the private sector. The government is a hand puppet. Politicians at all levels need to spend enormous amounts of money on their campaigns, and for this they must rely on selling their services to lobbyists. But I think we agree on the end result: the government will represent whoever pays it. And the insurance, pharmaceutical, and weight-loss industries have a lot more money than you and I.


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## lypeaches (Apr 11, 2012)

If anyone thinks that private insurers aren't already excluding and/or "fining" fat people, I'd like to get on their insurance plane. Try being a self employed fat person and buying your own insurance in New York state. The options that are offered are pathetic. If one gets down to the magical "overweight" category vs. the "morbidly obese" category, the menu choices increase dramaticaly, but still cost more. Mind you, this is when all other stats are "clean"...the only sin is being fat. The motivation for a private company to exclude customers is far, far higher than would be the motivation for the government to restrict access based on a weight. Private insurers have huge departments who do nothing but try to get out of paying for care for their patients, because that makes them more profitable. Note that of all the countries in the world with government health care, Japan is the only country you've heard of with this kind of rule. Just sayin'. Countries that are far more health and body conscious (australia, for instance) somehow have managed to escape this horror. So I'm not buying that it would be inevitable. Possible, yes, but inevitable, no.


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## bigmac (Apr 11, 2012)

Keb said:


> Something that does NOT prevent weight-discrimination. Remember the nonsense about Japanese workers' waists being measured? It just means that the government can decide what health care you're worthy of receiving/allowed to access rather than the insurers.




While Japan in a fully developed country it has its own social traditions and ideas. Western Countries are more concerned with due process and the rights of individuals. In western countries waist measuring would not be tolerated.

Keb, if I remember correctly from some of your prior posts you don't have health insurance and as a fat person you are basically uninsurable. Thus I find it very strange that you are against public healthcare.

The basic philosophical principle underlying public healthcare is that every citizen is entitled to the same basket of public goods (police and fire protection, access to the courts, due process of law, and in every country but the USA healthcare). In Canada, England, and all the other developed countries fat people have equal access to healthcare, they don't have to qualify, and they don't pay a dime more than anyone else.

People who are uninsurable -- fat people, people with preexisting conditions, disabled people ... -- they should be 100% for public healthcare. Its inconceivable that so many such people actively support a system that has shut them out.


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## Keb (Apr 12, 2012)

bigmac said:


> While Japan in a fully developed country it has its own social traditions and ideas. Western Countries are more concerned with due process and the rights of individuals. In western countries waist measuring would not be tolerated.
> 
> Keb, if I remember correctly from some of your prior posts you don't have health insurance and as a fat person you are basically uninsurable. Thus I find it very strange that you are against public healthcare.
> 
> ...



Since I went back to school, I have had insurance, but yes, for several years my employer did not provide insurance access and I was not insured. I got lucky, I agree, that I did not need any major health care until I was insured (and that just barely). And yes, I'm with you that everyone should have access to health care. 

I just don't think that the federal government is capable of running health care in a way that is efficient, cost-effective, or benefits patients and health-care workers over corporations and bureaucrats. I base this on the fact that as a child, I -was- on a government-provided health-care plan because my father was a military officer. The pros: We had access to health care and didn't have to worry about the costs most of the time. The cons: With a few exceptions (largely when the situation was so specialized that we were given access to non-military facilities), the care we received sucked. I've got plenty of examples of that, including how an inattentive emergency room doctor nearly caused my death from pneumonia. Lines were long, nurses were harsh, and we were often not listened to in important ways that hurt our overall health. 

The government is good at running very few things. Take military spending: While, yes, we need a good military and I support good pay and good quality weapons, armor, and equipment for the troops, you wind up with a lot of wasteful and ridiculous spending on stuff that isn't important for security or the safety of people in uniform. Political projects wind up creating bridges to nowhere and subsidizing things that turn out to be bad for the economy and people's health. Well-intentioned programs like social security are mismanaged and wind up digging our debt to ridiculous levels; subsidized school loans unintentionally inflate the price of a college education to the point where personal debt balloons; regulating the MPG for cars led to auto-makers and sellers pushing "trucks" like minivans that were no better than the station wagons they replaced onto the market; and, relevant to the health-care problem itself, insurance requirements for employers led directly to my not only not having insurance during those periods of my life, but having a harder time securing full-time work and stable employment. 

The government saw a problem: Not everyone had health insurance. So their solution was to tell companies (above a certain size, to limit hardship) that all full-time employees must be supplied with health insurance as a benefit. Companies complied, and then did three things that hurt employees: First, they got the least-expensive plans in collusion with the health insurance providers, who then relied on their group plans for income and felt no need to sell insurance to individuals or respond to consumer needs; second, they started hiring more part-time workers and fewer full-time workers, since they didn't have to give benefits to the part-time workers--I spent several years working 30-40 hours a week as a "part-time worker," because the company made it a policy not to hire full-time workers so that they would not have to provide benefits or higher salaries; third, companies did not increase salaries as much as they might have otherwise, with the justification that health insurance was part of the employer's compensation, so as health care costs skyrocketted, employees' salaries remained stagnant. All this is a direct and logical series of results from the government's intrusion into the market. 

While I'm glad that I now have health insurance, and worry about my ability to get it after graduation (cuz who knows whether this law, which I believe is unconstitutional, will stick around), I do understand the fears and risks of going uninsured. I also believe that the government regulation that ironically was designed to ensure I'd be insured was largely responsible for my previous inability to get insurance individually or through my employer. I don't trust President Obama to be ultimately in charge of what health care I may or may not get any more than you would have trusted President Bush. 

The ideal health care plan should be responsive to the needs of individuals, cutting out the middlemen (including the government) altogether. Forcing insurers to deal with individual customers rather than corporations or the government would be a great start; market forces can only work for you if you are a participant in the marketplace. Paying for the group plan your company buys into doesn't make you a participant, and nor does any system run by the government.


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## Keb (Apr 12, 2012)

Also, while Japan might be the only place where there has been a direct infringement of personal rights like this, think about places where fat-hatred is highest: One of the justifications is that your poor health suddenly affects me, because I'm paying higher taxes to take care of you. To think that governments will never be tempted to act against fat people when universal health care is involved is as naive as to assume that the insurance marketplace now is friendly to fat people. And when that happens, you won't have the ability to choose a different insurer or boycott insurance or any of the ways that you can fight discrimination in a freer marketplace; your only hope will be that the courts of your country agree with you that it's discrimination, and that will depend a lot on whether they agree with you that you don't have a choice about being fat or have a right to be fat. 

I hate how cynical this makes me sound, because I'm not usually, but I've seen little evidence that a government-run plan for health care is going to be better for us. Think about phone prices; deregulation made phone technology improve rapidly and prices plummeted, and we all benefited. Companies became more responsive to the needs of their consumers--which, as with health care, are just about all of us.

The health systems of other countries are nice in the same ways that the military system I was in as a child was nice, but there are drawbacks aside from higher taxes: Many of those nations are struggling to pay the bills (and yes, we're in a lot of debt, too--a large portion due to health care provided through the government like medicare/medicaid). Also, a lot of health care innovation takes place in the US, because there is not the same level of price controlling and so on (which makes such innovation less profitable), and many of those countries are benefiting directly by using our expensive innovations (which we pay lots for) at lower prices. 

I don't think that for a second Obama's solution will lower my health care costs, even if it does make it possible for me to stay insured. I had other solutions which I've proposed on this very board that I felt were more likely to help without unintended consequences; I'm not in the least denying that the present system is broken and is hurting people. I just don't think that Obamacare is going to be much of an improvement.


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## bigmac (Apr 12, 2012)

Keb, you are aware that the United States Government does already run the largest healthcare system in the country (possibly the world) -- Medicare. While far from perfect Medicare is quite well run with administrative costs that are much lower than those of private insurance plans.

I really don't understand my so many people have so little trust in the Federal Government. Democracy is by its very nature somewhat messy and sometimes less than efficient. However, the Government of the United States is remarkably scandal free. Every month checks go out on time with minimal administrative costs. Since the hated expansion of the federal government over the last 70 years we as a nation have enjoyed better transportation, better water, better air, a cleaner environment, and much more equality in both the work place and in society at large. All this with a minimum of waste or scandal (American scandals at the federal level tend to involve elected officials not civil servants).

In short post New Deal America has reaped many benefits from strong efficient institutions put in place by previous generations. We need to protect and expand these institutions not tear them down.

Also, federal government procurement is quite efficient -- the $500 hammer is a myth.

http://www.federalnewsradio.com/?nid=701&sid=1789279


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## EMH1701 (Apr 12, 2012)

Part of the problem is that many employers now outsource jobs to temp agencies to avoid paying health insurance costs. While I'm not for an individual mandate, I do think there need to be restrictions on said outsourcing. A person shouldn't have to be a "permatemp" because some companies are too cheap. (And yes, I have been a "permatemp." Thankfully, I'm not anymore.)


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## bigmac (Apr 13, 2012)

EMH1701 said:


> Part of the problem is that many employers now outsource jobs to temp agencies to avoid paying health insurance costs. While I'm not for an individual mandate, I do think there need to be restrictions on said outsourcing. A person shouldn't have to be a "permatemp" because some companies are too cheap. (And yes, I have been a "permatemp." Thankfully, I'm not anymore.)



Yet another reason to support single player government sponsored healthcare. Under our present system employers who actually want to do the right thing and provide health insurance are at a disadvantage in the marketplace. In all other developed countries businesses can just concentrate on business without playing games with healthcare. And employees are free to accept the jobs they want without having to worry about weather or not they'll have insurance.


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## lypeaches (Apr 13, 2012)

Dang it BigMac, I can't rep you anymore! Not to mention that it would in turn make life easier for small businesses. Currently, many people won't even consider working for a very small business because they have to have the medical insurance for themselves and their family. Remove that issue, and people have a lot more employment options, and small employers have more people to choose from.


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## curlyrachel (Apr 13, 2012)

the company i work for gives us the option of completing a health questionnaire online. they ask all kinds of questions about blood pressure, health issues, weight, height, smoking, etc. just for taking the test, you get a discount on your insurance. then, yes, they send you stuff about how to quit smoking, or lose weight, etc. but no one is discriminated against. thankfully.


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## Keb (Apr 13, 2012)

bigmac said:


> Yet another reason to support single player government sponsored healthcare. Under our present system employers who actually want to do the right thing and provide health insurance are at a disadvantage in the marketplace. In all other developed countries businesses can just concentrate on business without playing games with healthcare. And employees are free to accept the jobs they want without having to worry about weather or not they'll have insurance.



On this point I actually agree largely with you. Separating insurance from employment is essential. That does not require a government system to implement, however; simply removing the mandate that all large employers provide it would be a good start.


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## Isa (Apr 13, 2012)

bigmac said:


> Keb, you are aware that the United States Government does already run the largest healthcare system in the country (possibly the world) -- Medicare. While far from perfect Medicare is quite well run with administrative costs that are much lower than those of private insurance plans.



Bigmac, If you have any type of reference material that supports that last line I would really appreciate a link to it, it would be an interesting read. Medicare is filled with fraud due to dishonest providers. It is easy to do and providers, especially in home health, are all but pros at it. Look no further than the motorized wheelchair debacle over the past years for proof.


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## bigmac (Apr 14, 2012)

Isa said:


> Bigmac, If you have any type of reference material that supports that last line I would really appreciate a link to it, it would be an interesting read. Medicare is filled with fraud due to dishonest providers. It is easy to do and providers, especially in home health, are all but pros at it. Look no further than the motorized wheelchair debacle over the past years for proof.




No problem:


http://healthcarereform.procon.org/view.resource.php?resourceID=004083


People being people there will always be some abuse and/or fraud in any large system. People scam private insurance too.


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## bigmac (Apr 14, 2012)

lypeaches said:


> Dang it BigMac, I can't rep you anymore! Not to mention that it would in turn make life easier for small businesses. Currently, many people won't even consider working for a very small business because they have to have the medical insurance for themselves and their family. Remove that issue, and people have a lot more employment options, and small employers have more people to choose from.



Also, American companies are at a competitive disadvantage. Competitors in other developed countries are not saddled with huge healthcare costs. A single payer government sponsored plan will not only (as you pointed out) help small companies compete with large ones -- it will also help large companies compete internationally.


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## Keb (Apr 14, 2012)

Another aspect of the whole thing is that when the government takes charge of health care provisions, you get stuff like the so-called war on women. Just as Obama could suddenly order Catholic organizations to buy insurance that violated their beliefs, a future president could order all insurance companies to stop providing birth control or abortion coverage. Assuming that government-directed (and sure, Obamacare might not be government-run, but it's already being government-directed) care will not be subject to political debate is absurd; putting the power in one place makes it that much easier for your care to be limited by the whims of one political party or another, rather than your actual needs. And just as other services are cut or limited when money runs out, your health care will also be limited when the budget can't cover everything. 

The idea that costs will go down because everyone has to buy insurance doesn't really wash with me, as logical as it sounds on its face; insurers are going to be no less greedy when everyone must buy their product than they have been when employers have had to buy their product. Prices aren't going to fall. The problems with not enough medical personnel to go around aren't going to be solved by this, either--in fact, the issue will be exacerbated because more people with insurance will mean more people in the waiting rooms of the doctors who are already in practice. (That could change over time, of course, but there's nothing in Obamacare that I've heard of so far that deals with the supply part of the problem here. Medical school is expensive and time-consuming, which deters plenty of people who could potentially do well in the field, and resources are limited, preventing others from being able to study medicine; in many cases, unnecessarily so--while good training is essential, there's a strong case to be made for less-stringent requirements for some kinds of doctors.) 

Anyway, a lot of the nonsense we're seeing with regards to reproductive health care at the state level is being driven by a reaction to Obamacare. These things were less of an issue without the specter of being forced, by the government, to purchase plans that pay for things some groups feel are morally abhorrent. Obama promised people that if they were happy with their plans, nothing would change; the Catholic church found out that he was not being sincere about that very quickly. Rather than promoting choices, Obamacare is removing them.


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## EMH1701 (Apr 14, 2012)

bigmac said:


> Yet another reason to support single player government sponsored healthcare. Under our present system employers who actually want to do the right thing and provide health insurance are at a disadvantage in the marketplace. In all other developed countries businesses can just concentrate on business without playing games with healthcare. And employees are free to accept the jobs they want without having to worry about weather or not they'll have insurance.



The problem I have with the govt. running things is not only am I Libertarian, but they tend to screw things up more than they actually do it properly. When our govt. becomes like the Vogons in Hitchhiker's Guide, requiring the sick person to fill out a form in triplicate and having it signed by umpteen people, it will take months and months before anything actually happens. By that time, the sick person in question will either be well again or dead from lack of treatment, and the govt. won't have to spend any money. That is how it will eventually become.


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## Isa (Apr 15, 2012)

bigmac said:


> No problem:
> 
> http://healthcarereform.procon.org/view.resource.php?resourceID=004083
> 
> People being people there will always be some abuse and/or fraud in any large system. People scam private insurance too.



Thanks for the link. While no insurance is scam proof, my specific area of interest is Medicare and I admit to being amused at some of those percentages. After working in both sides of health insurance, I will never believe the fraud is lower on the governmental end. Just based on what I've personally seen, I cannot.


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## bigmac (Apr 15, 2012)

Isa said:


> Thanks for the link. While no insurance is scam proof, my specific area of interest is Medicare and I admit to being amused at some of those percentages. After working in both sides of health insurance, I will never believe the fraud is lower on the governmental end. Just based on what I've personally seen, I cannot.




Private sector scams tend to be large companies taking advantage of many little people. Most are never prosecuted because no one individual has enough of a stake to bring an action. Every now and then a class action will be successful. Here's a couple of links regarding two class actions I worked on.


http://www.girardgibbs.com/case/79/providian-financial-class-action-lawsuit/


http://www.citizen.org/litigation/forms/cases/getlinkforcase.cfm?cID=109


Having seen many (thousands) of incriminating corporate documents let me assure you that medicare recipients getting a few power wheel chairs they didn't technically qualify is small potatoes. When it comes to fraud and abuse the private sector is were its at.


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## Miss Vickie (Apr 15, 2012)

EMH1701 said:


> The problem I have with the govt. running things is not only am I Libertarian, but they tend to screw things up more than they actually do it properly. When our govt. becomes like the Vogons in Hitchhiker's Guide, requiring the sick person to fill out a form in triplicate and having it signed by umpteen people, it will take months and months before anything actually happens. By that time, the sick person in question will either be well again or dead from lack of treatment, and the govt. won't have to spend any money. That is how it will eventually become.



But you do know that the Vogons are a fictitious group, right? And that the Hitchhiker's Guide to the Galaxy is a work of fiction?

And have you ever tried to get a procedure covered by an insurance company? I promise you that it's not far from what you describe. I have patients who need pre-authorization for various procedures and time is of the essence. It takes weeks, if not months, to get through the red tape and paperwork and hours of physician time to talk to the insurance company reps to justify the procedure. Meantime, the patient's condition deteriorates.

I'm not saying the government will be perfect at managing health care. No organization is. But leaving it in the hands of the insurance companies sure isn't working. Even for those who have insurance, it can be a nightmare. And that's IF you can get insurance. Which, for many of the people on this site, is a huge "if".


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## EMH1701 (Apr 17, 2012)

Miss Vickie said:


> But you do know that the Vogons are a fictitious group, right? And that the Hitchhiker's Guide to the Galaxy is a work of fiction?



Yes, I am a science fiction nerd. It was a reference, and I thought, a rather apt one.



> And have you ever tried to get a procedure covered by an insurance company? I promise you that it's not far from what you describe. I have patients who need pre-authorization for various procedures and time is of the essence. It takes weeks, if not months, to get through the red tape and paperwork and hours of physician time to talk to the insurance company reps to justify the procedure. Meantime, the patient's condition deteriorates.



Yes, hence my reference.



> I'm not saying the government will be perfect at managing health care. No organization is. But leaving it in the hands of the insurance companies sure isn't working. Even for those who have insurance, it can be a nightmare. And that's IF you can get insurance. Which, for many of the people on this site, is a huge "if".



But they will discriminate even more against fat people. Have you not seen Michelle Obama's war on fat kids? Soon there will be laws that anyone above a certain size *must* join a gym, regardless of whether you can afford it (and the gyms will be subsidized, at least until America goes bankrupt from the govt. sponsored health care). 

There will be laws that anyone above a certain size is prohibited from buying things like potatoes, and white rice, and baking supplies, and whatever else the food Nazis think we shouldn't have (despite potatoes being a good source of potassium for our already overloaded with sodium diets). You will not be able to eat what you want and get health care when the govt. has control of it. They will use your eating patterns as an excuse to deny you coverage. Unless you are a "good" fat person and eat your tofu or white meat and 5 servings of fruit and veggies a day, and only the kinds of carbs they dictate to you, you're not going to get coverage. They will control every aspect of our lives, given the chance.

If govt. sponsored health care goes through, I foresee a world in which weight becomes the be-all and end-all of our society. Job applicants will be increasingly denied jobs because of their weight, even for a desk job. The bigotry will be even more rampant, and it will be govt. sponsored bigotry, which will make it worse than what we have now.


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## Webmaster (Apr 17, 2012)

All I know is that I am close to dropping out of the system. Kaiser is charging me and my wife US$1,100 per month with a high deductible plan that covers very little. So little that we're literally afraid to go to the doctor for fear of getting stuck with endless uncovered charges. Neither of us has pre-conditions, and neither has had any health issues.

So if it'll be mandatory for middle class folks like us to buy what by 2014 will likely be $1,500/month health care insurance that's practically useless, I cannot see how that'll be enforceable or realistic.


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## bigmac (Apr 17, 2012)

Webmaster said:


> All I know is that I am close to dropping out of the system. Kaiser is charging me and my wife US$1,100 per month with a high deductible plan that covers very little. So little that we're literally afraid to go to the doctor for fear of getting stuck with endless uncovered charges. Neither of us has pre-conditions, and neither has had any health issues.
> 
> So if it'll be mandatory for middle class folks like us to buy what by 2014 will likely be $1,500/month health care insurance that's practically useless, I cannot see how that'll be enforceable or realistic.



This is exactly why we need a Canadian style system. If you lived in Canada you'd pay slightly higher income taxes but wouldn't have to pay over 13K a year for suspect coverage. Also, all your doctors visits would be free (no co-pay).

Also, a Canadian style system helps even the playing field between small companies and large corporations. In Canada people can take a better or more interesting job with a small company without worrying about loosing coverage for themselves or their family (also makes it easier to for people to leave big organizations to form their own start-ups). In sum a Canadian Style system is small business friendly.


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## Miss Vickie (Apr 17, 2012)

EMH1701 said:


> Yes, I am a science fiction nerd. It was a reference, and I thought, a rather apt one.



It's an awesome reference, but it's fiction, not fact. Sure it's an exaggeration of the perception of what Douglas Adams no doubt perceived as the faults in the British system of bureaucracy. But that doesn't mean it's real and it doesn't mean it'll happen here. And since to one extreme or another it does happen with private insurance companies, wouldn't it then be better to have a single payer system?



> But they will discriminate even more against fat people. Have you not seen Michelle Obama's war on fat kids? Soon there will be laws that anyone above a certain size *must* join a gym, regardless of whether you can afford it (and the gyms will be subsidized, at least until America goes bankrupt from the govt. sponsored health care).



Insurance companies already do discriminate against fat people. And pregnant people. And people with heart conditions, cancer histories, diabetes, chronic illnesses, etc. Which is why I think that a single payer system that bypasses insurance companies is a good idea. It's the only way to prevent what you're talking about.

Michelle Obama doesn't have a "war" on fat kids. She is working to try to improve the health of the next generation, a generation which -- if things continue as they are -- stands a good chance of a shorter life expectancy than we enjoy. If teaching kids about cooking and gardening and encouraging them to unplug and be active is a "war", then we're doing it all wrong in Afghanistan.



> There will be laws that anyone above a certain size is prohibited from buying things like potatoes, and white rice, and baking supplies, and whatever else the food Nazis think we shouldn't have (despite potatoes being a good source of potassium for our already overloaded with sodium diets). You will not be able to eat what you want and get health care when the govt. has control of it. They will use your eating patterns as an excuse to deny you coverage. Unless you are a "good" fat person and eat your tofu or white meat and 5 servings of fruit and veggies a day, and only the kinds of carbs they dictate to you, you're not going to get coverage. They will control every aspect of our lives, given the chance.
> 
> If govt. sponsored health care goes through, I foresee a world in which weight becomes the be-all and end-all of our society. Job applicants will be increasingly denied jobs because of their weight, even for a desk job. The bigotry will be even more rampant, and it will be govt. sponsored bigotry, which will make it worse than what we have now.



Rampant paranoia. You see that because you want to see that. I just do not see that happening here, for many reasons. It would take too many resources to control people to that level. We value freedom far too much to allow that happen. And food is a necessity. Not to mention the food lobbies, which would be all over the kind of draconian laws you describe.


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## Webmaster (Apr 17, 2012)

That would be great, and from what I can tell, both Switzerland and Taiwan also have mandatory healthcare systems that both work very well at reasonable cost. However, I cannot see that happen in the US. Simply can't. So for self-employed folks like me, whether Obamacare stays or goes, health insurance is now borderline unaffordable, and will be totally unaffordable within a few years.


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## Miss Vickie (Apr 17, 2012)

Webmaster said:


> That would be great, and from what I can tell, both Switzerland and Taiwan also have mandatory healthcare systems that both work very well at reasonable cost. However, I cannot see that happen in the US. Simply can't. So for self-employed folks like me, whether Obamacare stays or goes, health insurance is now borderline unaffordable, and will be totally unaffordable within a few years.



Unfortunately, I agree. I think that the insurance companies will never let go of their death grip on our health, and putting them in charge of our health care (which Obamacare, as much as I like Obama did) was a bad idea. So now, we're not only stuck needing insurance because it's a good idea, but also because it's the law. 

Sure, the insurance companies "have to" cover us now, but you can bet your bottom dollar that it'll cost us.


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## EMH1701 (Apr 17, 2012)

Webmaster said:


> So if it'll be mandatory for middle class folks like us to buy what by 2014 will likely be $1,500/month health care insurance that's practically useless, I cannot see how that'll be enforceable or realistic.



I agree. I think most people will pay the fines rather than pay the health care fees. That is, assuming the Supreme Court lets the mandate go through. I don't believe they will, but I do think they may choose to keep some parts of the legislation. 

Unlike some small govt. conservatives, I don't think it's entirely bad. We need something to force these companies to cover people with pre-existing conditions. A coworker of mine has Aspergers, and her younger sister is worse on the Autism spectrum. The younger sister, IIRC, has a myriad of other health issues and she can't get coverage. Something needs to be done to make these companies do the right thing, but I don't think it's realistic (or constitutional) to enforce all Americans being covered. Not to mention, the country cannot afford it.

What I wonder about is what the govt. will do with all of the homeless folks who won't even be able to afford the fines. Most states wouldn't have enough jail space if that is to be the punishment.


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## EMH1701 (Apr 17, 2012)

Miss Vickie said:


> Insurance companies already do discriminate against fat people. And pregnant people. And people with heart conditions, cancer histories, diabetes, chronic illnesses, etc. Which is why I think that a single payer system that bypasses insurance companies is a good idea. It's the only way to prevent what you're talking about.



I agree with you about the discrimination, but I don't think it would be any better under the govt.



> Rampant paranoia. You see that because you want to see that. I just do not see that happening here, for many reasons. It would take too many resources to control people to that level. We value freedom far too much to allow that happen. And food is a necessity. Not to mention the food lobbies, which would be all over the kind of draconian laws you describe.



Not yet, but they have already banned trans fat in certain states run by Democrats. Oh, I don't think there will be an outright ban on "bad" foods, at least, not for thin people. What'll happen is either prices will rise on "bad" foods (look at what it is for red meat already), or they will start going by weight and what your purchases are and start taxing you more. If you keep giving the govt. enough power to the point where they are 100% central planning communists, outright food bans will eventually happen.

I do not want to see the bigotry increase, but we will have more freedom to choose non-bigoted health insurance companies if we go the free market route. Heck, start your own non-bigoted health insurance company if you so choose. Compete with the bigots, and run their companies into the ground (financially speaking, of course). That is what the free market system is about. 

I would love to see a health insurance company that specifically focuses on the needs and care of fat people, and which does *not* rampantly discriminate against us and assume we never exercise or eat right, and that every single medical issue we have is our fault. I would love to see such a company start up and compete with the likes of Blue Cross and Medica, and kick their rear ends in the marketplace. 

Treating everyone with dignity and respect should be a priority in the health care industry, yet fat people are too often ignored or abused. We need health care providers that focus on us and our rights. Sadly, if the govt. is in control, I believe the opposite will happen.


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## lypeaches (Apr 18, 2012)

Miss Vickie said:


> Michelle Obama doesn't have a "war" on fat kids. She is working to try to improve the health of the next generation, a generation which -- if things continue as they are -- stands a good chance of a shorter life expectancy than we enjoy. If teaching kids about cooking and gardening and encouraging them to unplug and be active is a "war", then we're doing it all wrong in Afghanistan.



This. Love the imagery of our new war tactics in Afghanistan...lol


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## bigmac (Apr 18, 2012)

EMH1701 said:


> ...
> 
> Treating everyone with dignity and respect should be a priority in the health care industry, yet fat people are too often ignored or abused. We need health care providers that focus on us and our rights. Sadly, if the govt. is in control, I believe the opposite will happen.




I agree 100% that dignity and respect should be a priority in the healthcare sector. However, I fail to see how the bill is paid will have any effect.

Example: I've been present for the birth of four of my five kids. Both mothers were on the smaller end of super-size (300 and 360 respectively). The first two children were born in hospitals in Edmonton Alberta. The last two in hospitals in central and southern California. Thus the first two hospitals operated under Canada's single payer system -- while the second two operated under the American system. However, from the perspective of the patient there was little difference between the hospitals (I doubt a patient who woke up in one would have been able to tell which country she was in).


All four hospitals provided very good service and never once was either mother's weight an issue. How the bill was settled after discharge had absolutely no effect on treatment.

And by the way the American hospitals are actually run by quasi-governmental agencies (http://www.communitymedical.org/about-us ; http://www.cmhshealth.org/cmh/index.shtml). The Canadian hospitals are run by the University of Alberta (http://en.wikipedia.org/wiki/University_of_Alberta_Hospital ) and the a Catholic order (http://www.caritas.ab.ca/Home/Hospitals/GreyNuns/default.htm).

The biggest difference between the Canadian and American hospitals was the bills we received from the American hospitals.

So, in sum, I don't understand why you think a government funded system would be any less compassionate.


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## Keb (Apr 18, 2012)

bigmac said:


> I agree 100% that dignity and respect should be a priority in the healthcare sector. However, I fail to see how the bill is paid will have any effect.
> 
> Example: I've been present for the birth of four of my five kids. Both mothers were on the smaller end of super-size (300 and 360 respectively). The first two children were born in hospitals in Edmonton Alberta. The last two in hospitals in central and southern California. Thus the first two hospitals operated under Canada's single payer system -- while the second two operated under the American system. However, from the perspective of the patient there was little difference between the hospitals (I doubt a patient who woke up in one would have been able to tell which country she was in).
> 
> ...



I can counter that directly with my mother's experiences. She had three children, two in a military-affiliated facility and one in a civilian hospital because the base they lived on when I was born was too far away from the nearest military hospital (all three were in different states). I, being very young all three times, was only present for the first, but I've heard the stories. 

Her experiences in a government-run facility were downright miserable and ridiculous compared to her experience with me in the civilian facility. With me, she was treated like a human being, and was consulted about how she wanted to do things. She was comfortable and had a very pleasant experience overall. 

In the first of the military hospitals with my brother, he was born with a severe condition that hadn't been detected earlier. They whisked him away...and told my mother absolutely nothing about where her baby was until some hours later when she couldn't figure out why she was the only mother in the ward whose baby hadn't been brought for feeding. She had to take the initiative to find out where my brother was for herself. What kind of hospital doesn't tell the mother what's going on with her own baby? (Things turned out okay for him, but it was not at all a good start.)

In the second with my sister, the doctors completely ignored her evidence from two previous pregnancies plus family history that her baby coming late by a couple of weeks was completely normal. (I was three weeks late myself.) They insisted that she induce the baby, even though there were no other complications going on and she did not want to do so. Being of stubborn stock, my sister refused to be born on time even when they did try to induce her, but the attempt certainly put additional stress on both my mother and her baby. 

Beyond those particular horrors, my mother has said that the experience was just completely different from the first time around, in the ways that she was treated by the doctors and the staff in general. The main difference was that with my siblings, she was giving birth in a government-run military hospital. 

Do you begin to see why I am skeptical that letting the government run health care will be a nirvana for everyone? My experiences and those of my family seem to suggest otherwise. The best care we've gotten has been outside the military system in one way or another, as grateful as I am that my dad's career in the military made it possible for him to afford the care that we needed.


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## EMH1701 (Apr 19, 2012)

bigmac said:


> I agree 100% that dignity and respect should be a priority in the healthcare sector. However, I fail to see how the bill is paid will have any effect.



It's not really an issue of how to pay for it, it's an issue of whether or not people can be forced to buy something in order to be U.S. citizens. If we give the govt. enough power, they may force you to buy spinach (not that spinach is bad, but I want the freedom to decide whether I will be eating spinach, lettuce, or something completely different. What if I want apple pie instead of spinach?). This is about the freedom to decide how and where we spend our money, and whether or not that can be taken away from us.

I am for a free market solution to the issues we all face in the health care industry. One thing that could be done, and is rarely discussed, is opening up the markets to more competition. Letting people in Minnesota buy cheaper health insurance from say, Georgia, would make the health care companies compete for our dollars. Competition leads to more value in the marketplace for the consumer.

(I am actually studying this particular subject...just had an economics class a couple of months ago for my MBA and got an A. Health care was one thing we discussed in the class.)

Under a government-funded, single payer system, the example I brought up would never exist -- a health care company focused on fat people. If the govt. makes us go to them for our health care, such competition won't be allowed. I think the time is right for more focused health care, especially with the growing rate of autism. What if there was a health insurance company completely focused on the autism spectrum, and they were actually ethical? I think autistic kids would get more and better treatments.

I have rather strong opinions on this particular subject...I know. I'm Libertarian and not Republican for a reason, though. There are many things that I disagree with Republicans on. Health care isn't one of them.


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## bigmac (Apr 20, 2012)

Free market competition works great in some sectors (i.e. production and sale of commodities and consumer goods). However, some sectors work best when they are publicly funded with tax dollars. Police and fire protection used to be privately funded. However, almost all municipalities long ago realized publicly funded protection was the way to go (the fact that "competing" fire companies often fought each other for the right to fight a fire while the building burned made the decision to go public easy).

To my mind provision of healthcare is not at all like the production and sale of consumer goods -- but very much like police and fire protection. Healthcare is best characterized as a public service to be paid for with public money (like police and fire protection).


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## Tracyarts (Jun 29, 2012)

" Currently, many people won't even consider working for a very small business because they have to have the medical insurance for themselves and their family. "

I know this is an older thread, but we're facing this now. My husband works for a very small business (7 employees total) that offers medical insurance for employees and spouses/dependents. The monthly premium for employees is affordable, but my monthly premium has gone up to almost $1200 a month. It's not just *my* premium, but ANY spouse or dependent of an employee. At least one other employee has had to find an alternative way to provide coverage for his wife and child. It's just not affordable for the income level they make at that job. The other employees are single or have no dependents to provide coverage for, so they're not having a problem with it.

For now, we're paying it and having to tighten the budget down considerably. We've been looking into private insurance for me but the quotes I'm getting have high monthly premiums and offer limited coverage with very high deductibles and copays. I'm not to a point physically where I can go out and find a full time job with benefits to cover my own insurance, but hopefully that'll be an option in the not too-too distant future. It looks like he may have to find work elsewhere with more affordable insurance, or at least enough of a pay increase to cover a decent private policy. Something's going to have to give though. I don't blame the company owner, because he can only provide what insurance companies offer. But still it's going to make it hard for employees with dependents who they need to insure to be able to work there.

Tracy


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## LinathSuru (Jun 30, 2012)

Been a while since I posted here, though I've had a good read from what all the other contributors have said.

I'm in a similar position, Tracyarts. I work for a company that has six employees (though it should be eight come December) total. I'm in a similar position right now. Thank God my husband doesn't have anything he _needs_ to go to a doctor for right now because currently he isn't on my insurance.. But my monthly health care cost for me alone is $200 (half is covered by my employer, so it's $400 a month total). If I add him I will be expected to pay around $800 (of $1,600). I don't know how we could afford that. We cut things pretty close already what with car maintenance and our puppies.

I've been fretting about this for a long while now, but worrying doesn't do any good. And yet if we look for outside quotes (he's pretty big too), the prices are just as bad. Not sure what we'll be doing down the road, but reading through this thread again the idea of an insurance company that specializes in fat people sure sounded nice.

In dreams.. I suppose.


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