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Obesity Is A Disease

Discussion in 'The OT' started by Drucifer, Jun 18, 2013.

  1. houskamp

    houskamp New Member

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    one of the things that bugs me most is that they just won't let someone die.. you may be a doormat attached to a million dollars of equip, but you're still "alive"..

    it's almost like it's a contest or ego thing to save the most screwed up person no matter what..

    a long time ago I told my family not to ever let them do that to me..
     
  2. BattleScott

    BattleScott Hall Of Fame

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    You are completely leaving out the part where healthy people require less health care, leading to lower costs for the insurers. The reduction in costs far outweighs the loss in premums. A healthy person paying $500 a year is more profittable than a fat person paying $1000 because the $500 is pure profit. The fat guy has to take cholesterol pills, insulin shots, see his cardiologist 4 times a year for stress tests, ekgs and "new tickers". So he is a drain on their coffers.

    Disrributing the costs to members bases on their risk is the only way to make people change the risky behavior. The fat guy is not going to stop being fat as long as it costs the same a being healthy.
     
  3. Laxguy

    Laxguy Honi Soit Qui Mal Y Pense.

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    Winters,...
    I've heard you have to do a lot more than verbalize your wishes, such as notarized (obviously written) statements.
     
  4. Stewart Vernon

    Stewart Vernon Roving Reporter Staff Member Super Moderator DBSTalk Club

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    You still aren't understanding how insurance works.

    They don't profit on a per-member basis. They don't charge a fat guy $1000 to pay for his expenses and only charge a non-fat dude $500 and make "pure profit"...

    They do charge some people more than others... this is true... but all the money still goes into a big coffer that the insurance company uses to pay for everyone. And if they give all the healthy people a "deal" that's fine until they have to pay out... and eventually they need money to do that.

    The only way insurance even comes close to working is if they take in as much in premiums as the pay out... and they can't do anything but guess on who will need what kind of care... so yeah, they can "predict" somewhat that certain people are more at risk than others... but stuff happens... and even healthy people need something eventually.

    I'll give you a non-medical example.

    I got my driver's license at 16... I had an accident in my early twenties that my insurance paid out... I was not ticketed, but my insurance provider raised my rates for 3 years after paying out that claim. I have not had an accident since then, and I am 43 now... so about 28 years of driving, and one accident... and they still haven't charged me as much in premiums over all that time (including the 3 years at a higher rate) as they paid out in that one claim. So... where did the money come from that they used to pay my claim? Other people's premiums in the coffer.

    That's how insurance works... and it is why insurance premiums go up over time even for healthy/safe people. They constantly need to have more new healthy people paying into the system to keep up with what they pay out... except eventually that leads to a bunch of older people who need to use their insurance all at the same time... so our population has to keep growing by leaps and bounds to try and stay ahead of the curve... but ultimately it is a losing proposition.
     
  5. BattleScott

    BattleScott Hall Of Fame

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    They don't profit on a per-member basis?
    That's like saying "sure we might lose a little bit on each one, but we'll make it up in volume!"

    Healthy people cost the insurance companies less than unhealthy ones, you cannot possibly argue that point (at least sanely) when it comes to the big picture of health insurance.

    Just like in your example, bad drivers cost the insurance companies more than good drivers. And just as with my health care, my auto-insurer continues to give me discounts as long as my driving stays good.
     
  6. Laxguy

    Laxguy Honi Soit Qui Mal Y Pense.

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    Winters,...
    This sounds like our Social Security System, not health care.
     
  7. Stewart Vernon

    Stewart Vernon Roving Reporter Staff Member Super Moderator DBSTalk Club

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    Still missing the point, though....

    Insurance revolves around two bets, essentially.

    The insurance company bets that it can take in more money from all of its members than it will pay out in claims to all of those members. Simultaneously, each individual member is betting that they will pay less in premiums than they will get in benefit claims.

    IF you paid the same or more in premiums than the actual cost of health care over your life... why would you buy insurance? You wouldn't... you only buy insurance because you think it will save you money.

    Similarly... if the insurance company pays more in claims than it takes in then they couldn't stay in business.

    So... you argue that healthy people get discounts and unhealthy people pay more... except that doesn't work long term because the unhealthy people would stop paying into insurance that costs them more than paying their bills...

    Thus, the insurance scenario only works IF they can sign up enough healthy people that will pay in enough premiums to offset the additional cost they pay out in claims over unhealthy people... except it is a house of cards destined to fail since we all get old and eventually die, and usually some need for health care crops up even for the healthiest people.

    Insurance isn't like buying a toaster where they profit off each sale and try to sell a high volume to get mega-profits... Insurance tries to spread out the liability by taking in a smaller amount from everyone and relying on most people not needing serious/major claims over their lifetime... but history shows us this isn't working with health-care because the whole house of cards is dependent on the same thing that actually makes it vulnerable... that being more and more people.

    Basically... it is the same thing now.

    Social Security was not originally supposed to be, though... Social Security originally was you pay in and the money vests and you get to one day take out what you paid in... but at some point they changed it so that current paying-in is used to pay out... which means Social Security is basically insurance of a sort now instead of an investment program.
     
  8. djlong

    djlong Hall Of Fame

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    And here's a problem with the healthcare "system" happening to me RIGHT NOW.

    My wife went for some bloodwork at her normal doctor. They sent it to a lab. Up to this point, we've had reasonable co-pays so we had no reason to suspect any other difficulties.

    We get the statement back and the insurance company paid $87 for the tests. No problem so far. Our balance? OVER $250!!!

    We looked up a local lab that did the SAME EXACT BLOOD TEST. Their price? $89.

    We had NO choice in selecting our 'vendor'. Even when choosing our doctors, we STILL find ourselves without choice!

    My wife is basically going to go to the hospital that analyzed the test (oddly enough it's the hospital that is NOT on the list if we have to go to their emergency room!) and refuse to pay - showing them the price list and telling them they can get it from the doctor that sent it there without consulting us. Then we'll do the same thing with the doctor's office. We have no problem paying a fair and reasonable bill. But I would imagine this is probably the last time my wife goes to that doctor. This is racketeering by any other name.

    Now - do you want to take every overweight person in the country and do the same to them? (This is a fundamental problem with our health care 'system')
     
  9. MysteryMan

    MysteryMan Well-Known Member DBSTalk Club

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    Well, if they can say obesity is a disease I don't see why they can't do the same with racketeering. :sure:
     
  10. Jul 1, 2013 #110 of 114
    BattleScott

    BattleScott Hall Of Fame

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    So why do you get to insert that I said unhealthy people pay more than what they cost? That is not even remotely close to what I said (and couldn't be further from the truth, only healthy people get that honor). I said that they should have to pay more than healthy people for insurance.

    The current trend in coverage (especially in the private sector) is to offer discounts or reduced premiums for not smoking and for having favorable results in several key health screening metrics (cholesterol, bp, etc.). This has been a big savings for those that choose a healthy life-style. It is also the best way for the insurers to entice people to get healthy, reduce their premiums and eventually cost the insurer less. Those who choose to continue an unhealthy life-style are left to pay higher premiums as it should be. This trend in rewarding positive behavior, along with high-deductible plans paired with HSAs, is reducing the coverage costs for the responsible healthy workers on a BIG level.

    My only point in all of this is that by labeling obesity a "disease", there could be negative impacts on that progress. If there is enough negative pressure from discrimination lawsuits by the "diseased obese", the insurers will likely revert back to the socialist model where the responsible people subsidize the irresponsible thru equal cost distribution.
     
  11. Jul 1, 2013 #111 of 114
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator DBSTalk Club

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    When all works right it does save you money. The better insurance plans try to keep people well and catch illness before it gets expensive. People may not know they are saving money until they get sick. Or they may receive benefits along the way (such as zero deductible regular checkups, heath coaching, etc) that gives perceived value for the premium.

    It changes the gamble.

    The sick will never pay more than their bills. They will pay more that the well by paying deductibles up to their annual limit. And when they hit the limit of their coverage they may lose everything they have paying the excess.

    It is a better good deal to stay well.

    Gotta keep new people signing up. Healthier young people paying for the old as they die. Kind of like social security ... but I digress.

    The trick is to have enough paying in to cover the payout plus profit. Increasing the number of people paying in by providing health benefits along with the insurance is a plus. Forcing people to buy in helps fill the pot. Limiting payouts helps keep the pot full.

    There are a lot of people with diseases collecting insurance payouts. Their malady being a disease doesn't seem to change that. But the "disease" label helps identify it as something that needs to be fixed. Not a choice - it is no longer OK that you are obese - but one of those things that should be addressed in the annual checkups as people work to get well.
     
  12. Jul 1, 2013 #112 of 114
    MysteryMan

    MysteryMan Well-Known Member DBSTalk Club

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    You hit the nail on the head when said "labeling obesity a disease". Perhaps the name of this thread should be changed to "Obesity Has Been Labeled A Disease" making it a more truthful title.
     
  13. Jul 1, 2013 #113 of 114
    Stewart Vernon

    Stewart Vernon Roving Reporter Staff Member Super Moderator DBSTalk Club

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    Now that we have come full circle... let me try again.

    What originally started the latest round and round... was that I said this is all short-term premium benefits for being healthy.

    What I meant by that was...

    Yes, right now getting you to partake in less services means the insurance payout is lower and so they throw you a bone for being healthy... BUT the insurance company isn't the product... the hospitals and doctors sell the product... that being health-care.

    IF people become healthier on average... then the doctors and hospitals and drug companies don't make as much money... so then what do you think happens? They will raise the price on their services to make up for what they aren't getting in volume customers.

    As I gave an example earlier... in NC when we have drought conditions they ask us to conserve water... we do that and the water company loses money... so the water company raises the rates and your water bill goes up even though you are using less water!

    So... Insurance encourages you to be healthy and need less health-care... insurance pays out less in claims... insurance lowers your rates... hospitals and doctors make less money and increase their rates... the people who still need health-care (including healthy people who need services too) have to pay more... insurance has to payout more... insurance needs to raise the premiums on everyone.

    My initial point was... it is a strawman argument to say that encouraging people to be healthy will lead to lower insurance premiums over the long term... I stand by that. In the short term, yes... only until the health-care industry price-corrects upward to make up for lost business due to healthy people... and then your premiums will go up.

    Insurance has been around for a while now... and the population has been increasing... and insurance premiums have been going up over time.
     
  14. Jul 1, 2013 #114 of 114
    James Long

    James Long Ready for Uplink! Staff Member Super Moderator DBSTalk Club

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    The marketplace is changing. While it is still called "insurance" by many what you are buying is a health care plan. One needs to get away from the thought of old school "insurance" like one buys for their house or car or other item.

    Those types of insurance are the gamble put forth: One pays a premium hoping to never collect (a loss of a home or car can be more than just a financial replacement). One can get employment insurance on debt ... lose your job and we pay your bill (under certain terms). There are all sorts of insurances like that in the world.

    Medical insurance is becoming a health maintenance plan ... similar to the "protection plans" that DBS companies sell for their products. Yes, there is an "insurance" aspect involved where a loss covered by the plan reduces the cost out of pocket when the customer suffers that loss. But there is also maintenance - a service contract involved.

    A modern medical plan is more than a company and a customer betting against each other ... and as we move away from a "fee for service" model into a "managed care" model local health care providers will be paid a fee per person in their defined community to serve that person. Whether they need advice on staying healthy or complicated medical treatments. If the medical community can keep the person well then they make more money.

    It is a way of getting away from medical providers ordering expensive and occasionally unneeded tests and procedures just to pad their bill. The risk is that a provider would pocket the money they are paid for maintaining that person's health and not treat their patients.

    It is a new world ... and there are probably some derogatory words that can be applied to it. Health insurance is changing into managed health care. It is the future. Coming soon to a country under your feet.
     

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