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New York, 6:14 AM
Sun Nov 29
12 posts in the last 24 hours
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11/20/08
11/20/08
This time, I can't afford to switch to their new plan because it has NO PRESCRIPTION coverage at all. And in my (not to go into it) that would be just impossible.
I also hate how it is always described as if they are giving us new and exciting options in health insurance.
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Ah, but the Republicans keep telling us that is the government administers health insurance, it will somehow screw it up. Get a clue: THE SYSTEM IS BROKEN. The government couldn't POSSIBLY do a worse job than private enterprise, because NO ONE could do a worse job than what we have now.
Sorry. I'll quite venting.
11/20/08
@pareenesobscene: rather than putting limits on the compensation plans for tobacco, oil, fast food and any other business which sells something we don't like, how about stop buying that good or service? Or buying less of it? There's only so much the government can and SHOULD do for us. Sometimes we vote with our feet and our wallet.
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Did a guy named "Nic Fit" really just complain about a lack of preventative health care in America? Did that just happen?
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The broader point is that "preventative care" espousal from someone who smokes is awfully hypocritical. One of my major criticisms of the Federal plans is that they don't effectively disincentivize bad behavior. For example, smoking, obesity, drinking, drug use, and violence. As an American I'm somewhat against paying more taxes so I can assist doctors in patching together fatties and smokers, which are a big part of why our nation has such a problem in the current system.
If we're going to Federalize health care, costs need to be kept down to keep it from being a runaway tax train. Step 1? Make smokers pay a lot more, because they cost a lot more.
11/20/08
11/20/08
"Sin taxes" on cigarettes and alcohol don't do enough to compensate for the health care costs of risky health choices. They would need to increase dramatically at point of sale or be removed at point of sale and baked into the income tax requirements of the health system.
"Sin taxes" also don't make a direct enough contribution to Federal revenues to offset a prospective Federal health plan - one of the major reasons why our budget/social security is so fucked up. That money shouldn't just go into a pot and pay for health care, defense, etc.; there should be a clear line drawn between the income tax contribution to the Federal health plan and the individual cost to you as a smoker/obese American/etc. That would encourage you to stop being part of the problem!
11/20/08
And then you want to tax fat people's food too?
11/20/08
We don't know the true cost, but there are reasonable estimates available to determine a ballpark surcharge. Do you want everybody to pay the same amount regardless of how many times they get shot, shoot up, smoke up, stuff their face, etc.? I don't see that flying with the American public. Heart disease is our leading killer, cholesterol and blood pressure medications make up most of our top-10 drugs...
Look, bottom line: Federal health insurance has to disincentivize behaviors that contribute to the cost base, because many of our health issues are self-made.
11/20/08
I also know that most of the people who smoke and eat too much are the poors. And guess who doesn't have any more money to spend?
The only reason why politicians advocate this sin tax bs is so that they don't have to raise taxes which is unpopular to do. Well guess what? All the corporate fatties who have been profiteering on America's addiction and vice may have to step up here and bare some of the load. It's called redistributing the wealth and we need some of it right now.
11/20/08
Universal health care is fundamentally redistributive because it relies on progressive taxation. But it seems silly to distribute wealth expressly to perpetuate self-destructive (and expensive) habits. As for "the poors" I disagree - obesity and drug use, in particular, know no class boundaries.
The system, if well-designed, makes Americans more healthy. Sometimes the only preventative care is punitive, as would be the case in surcharges for smokers etc. If you've got cost-increasing habits and you don't want to change and you're too poor to pay then -fuck- you; people like that don't deserve health care and should be refused care after a strike-based system or something. You're on my dime now, and I want a return on my investment.
11/20/08
I understand some people are genetically fucked. Piss-poor protoplasm, whatever we want to call it. The vast majority of people do not fall into that category. The vast majority of people don't do the basics to care for themselves, rather, they rely on the government (or their private health insurance) to do it for them, then complain about it when premiums go up and coverage goes down. We can't have our cake, eat it too, then bitch about the bill.
11/20/08
Agreed. That's really the only demand I have - if you're going to do this, create a logical structure around it.
What you really have to worry about isn't me. You have to worry about wingnuts who won't want to pay for legal procedures that conflict with their worldviews, like abortions.
11/20/08
Actually, the insurance industry plays a huge role in mushrooming health care costs. The whole system is a lumbering bureaucracy. Here are some interesting figures.
11/20/08
Yup, violence. If you've got a violent criminal record you can either pay for your own damn doctor or you can bleed out.
That's where I draw the line in legislating morality through Federal health care, but other people are far worse. Many utilitarians or bioethicists wouldn't support lifesaving care for badly defective fetuses/children, for example.
11/20/08
But wait, that means it comes out of the rich's piece of the pie! We can't have that right? It's everyone's right to keep what they earn right? Is that too punitive for you?
No instead let's tax fatties on a per pound basis and start chucking people out of the system when their addictions get the better of them.
11/20/08
Corporations provide the options. People make the choices to consume unhealthy products to unhealthy excess are to blame for their poor health, not the providers of those products.
You can have a pack of cigarettes without creating a long-term health risk. You can have a McDonald's cheeseburger without murdering your heart. Corporations that provide "unhealthy" products are not to blame because it's not one cigarette or one burger; it's subsisting on fat and sucking on cancer. The issue is with people who incur long-term health care costs through consistent, unmitigated self-destruction and expect me to subsidize their behavior consequence-free. That's unacceptable, and unsustainable.
11/20/08
Your issue is switching the tax burden back on to the poor without politicians having to admit that you are paying more to the government. Enough with the tortured logic, you want poor people to pay for their own health care with money they do not have. It's the same screw job the rich have done to the poor for years.
11/20/08
Universal health care that means "come as you are" is not cost-effective, not humane, not responsible, and not smart.
If I'm subsidizing your health care, you have to take responsibility for the personal decisions you make to make that more expensive for me. By doing so, I reduce the costs to me and I increase the health of you. Doesn't that improve BOTH of our lots? From a utility perspective it's bulletproof. What in the world is your argument against?
11/20/08
Also, quit talking like it's a securities investment for you. It is a tax you are going to pay for the general health and welfare of your fellow citizens. It ain't commodities futures, Keynes.
11/20/08
I have no idea where you're coming from. Put aside your class warfare strawman for 10 seconds. You haven't given me one good reason why smokers, the obese, etc. shouldn't pay more for health care. Not one! There is a mountain of evidence that the obese, smokers, and so on incur vastly more in health care costs. I'm suggesting that making them feel those expenses makes it more likely that they will modify their behavior, reducing the overall costs while increasing overall health! And you oppose that because why, exactly? Because you don't think paying a smoking surcharge will encourage someone to quit?
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What?
Are you schizophrenic? Are you hearing voices? When did I say any of that?
Private enterprise ISN'T always the best solution - I'm in favor of subsidies for alternative energy, for example. But look, hey, I understand it's much more fun to argue by putting words in the mouths of caricatures. Don't let me stop you.
11/20/08
A smoking surcharge is already paid through sales and excise taxes. The poor people in this country are the ones who are basically supporting the tobacco industry and they are paying what little they have to the state for their sin. If you want to increase that tax, let's see how long that revenue stream lasts compare to how long people will continue to come down with lung cancer.
As for your obesity argument, there are a million reasons why people get fat. Genetics, illness and injury are three big reasons but you want to focus on fast food today? Fine. Propose something. Tax on greasy burgers? What about Mom and Pop operations or fine dining burgers? Should they get it too? Tax fries? What about the potato industry and vegetable oil producers?
Here's the best idea. Make the rich fuckers start paying their fair share in taxes. That way, they can have their overweight maids still bring them martinis because she'll have her insulin shot.
11/20/08
You haven't given me one good reason why smokers, the obese, etc. shouldn't pay more for health care.
Maybe the cost analysis of an individual's lifetime healthcare consumption is much more complex than just "Are you fat, do you smoke?"
I wonder how much experimental cancer treatments cost? How about the surge in use of MRIs? How much total money is spent keeping people alive past 90 years old?
And are we going to start measuring someone's total health risk factors? We can start taxing people at higher rates for genetic risk of heart disease, or for riding a motorcycle or traveling to less developed parts of the world...
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It's a tough situation and will require tough answers. Starting with the $ is the only logical place it can be done.
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Finally! A reasonable point.
We already evaluate risk, and have great stats to do so. Good models, like the car insurance model, bill people for acting like idiots and disincentivize risky behavior. We shouldn't force families to choose between eating and care, but while we're at it, we SHOULD force them to choose about behaviors like smoking. Willfully subjecting me to higher costs by engaging in an activity that knowingly and reliably increases your risk factors for disease should make things more expensive for you. If they do, we create an economic reason to be healthier and improve the efficiency of the system.
As for the trickier parts of the debate, like the utility of care that extends the lives of people in their 90's, that's one of the big reasons why I worry about Federal care. We're going to have to make hard decisions about covering specific treatments nationally. It's going to get political, become a wedge issue, and be a huge pain in the ass - it's a good reason, in my eyes, to make the system less Federal.
11/20/08
Ah, but currently they pay directly into state budgets in most cases and wind up paying for roads or statues. I'm fine if we're cost-neutral based on those taxes, but if that's the case we should align the sales taxes directly to the health care program. Do the Al Gore "lockbox" thing so we match costs and revenues - you've seen how Congressional grassfuckers job the social security fund.
I'd like to see your numbers on the cost and revenues on taxes, though - can you email me?
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