<p>Very slippery slope. One might argue that smokers, diabetics and obese people’s health care costs less over time, as they die younger.</p>
<p>Regarding people who don’t follow doctors orders, like the guy who didn’t wash and change his dressings as instructed: AIUI, the ACA will penalize the providers when that guy needs to be readmitted. Doctors will tell those patients to find another doctor rather than not be reimbursed. It’s not the doctors fault.</p>
<p>OTOH, healthy people who obey all the rules for keeping healthy have to pay for all kinds of services they don’t need and one size fits all healthcare insurance (three plans that closely resemble each other) so that people can engage in any reckless behavior that strikes their fancy.</p>
<p>argbargy, That’s why I’m glad that the insurance companies are playing hardball with Cedars. </p>
<p>Green Eyeshade: So, why are you charging twice as much as everybody else for that knee replacement?</p>
<p>Cedars: We have an espresso girl! And fewer scars!</p>
<p>Green Eyeshade: If you don’t bring your costs down we won’t include you in our network. We’re paying for health care, not servants.</p>
<p>While it’s useful to have patients with skin in the game, it’s more useful to have people who actually can evaluate the merits of one hospital versus another to have skin in the game. </p>
<p>So, for example, when I was eight and a half months pregnant with Fang Jr I went to the doctor with a swollen knee. The doctor said, you have to go to the hospital right now, and she sent me to Hospital X. </p>
<p>I was in no position to decide which hospital to go to. I wouldn’t have had the glimmer of an idea what questions to ask. I wouldn’t know how to decide between Solid Gold Hospital and Nice Community Hospital. But if my insurance company didn’t send routine patients to Solid Gold, then I wouldn’t go to Solid Gold, and everyone would be spared the ridiculous charges for Solid Gold’s luxurious art work on the walls, and brand new designer medical equipment when the old stuff works just as well (or whatever, I’m just making this up).</p>
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<p>Not slippery at all. It’s based on behavior. People can control how much they smoke and eat. Being born a diabetic is a preexisting condition that you can’t control. Become diabetic because you are fat is a controllable condition and I shouldn’t have to pay higher rates because fat people can’t eat smaller portions.</p>
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<p>True but irrelevant, because we pay for health insurance by the year, not by the lifetime.</p>
<p>However, I too don’t like the idea of punitive premiums for people whose health habits we don’t like.</p>
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<p>[Obesity</a>, Cholesterol, and Heart Disease - Weighing Your Risks](<a href=“http://www.webmd.com/cholesterol-management/obesity-health-risks]Obesity”>10 Health Conditions & Diseases Linked To Obesity)</p>
<p>Thanks Argbargy, I never heard of Nigella Lawson. Just looked her up and saw some pictures of her. :)</p>
<p>I’d rather that those who engage in bad health habits pay more than having older people pay more. Getting older is not within your control. Smoking, diet, exercise, etc. is.</p>
<p>I’m not paying for your car crash, you should have taken a job closer to your home so you didn’t have that long commute. Not paying for your heart attack, why didn’t you meditate. Not paying for your stomach cancer, you should have been a vegan. Not paying for that Downs baby, you should have aborted it. Not paying for the baby with spina bifida, you should have eaten more green vegetables. Not paying for your broken hip, you should have done balance exercises. Definitely not paying for your melanoma, haven’t you ever heard of sunblock and hats?</p>
<p>Not paying for your depression. Snap out of it and be happy for Pete’s sake.</p>
<p>CF, you’re making a caricature of a very sensible argument. Drug and alcohol addiction, gross obesity from eating too much, or refusing to treat dangerously high blood pressure are not behaviors I want to subsidize. Let me be responsible for myself, not every other person I have no control of.</p>
<p>You people are killing me! Between alternately annoying me, making me laugh, and nodding uh-huh, that’s right, the people sitting across the room think I’m nuts.</p>
<p>Your getting into the absurd and where the causal link isn’t certain. Obviously ACA allows smokers to be charged more for insurance because people have been warned for 50 years how dangerous it is. </p>
<p>Isn’t the rationale for heavily taxing cigarettes to get people to stop? The rationale for ticketing motorcyclists for not wearing helmets is to get them to avoid costly head injuries? Merely being healthy seems not to be its own reward for some people. So charging people who are alcoholics,obese, or drug addicts more for health insurance in order to change their behavior has precedents.</p>
<p>Are you guys gonna start on the less fortunate next? Cause some of that is self inflicted, too. And, it’s a lot of people.</p>
<p>I just don’t think charging people more for addictive behaviors is going to change anything, except they pay more or forego treatment.</p>
<p>BTW, in our society, you have a right to kill yourself or significantly shorten your lifespan, just don’t hold me responsible for it.</p>
<p>Same for ticketing people who don’t wear seatbelts. The rationale is that car crash injuries cost us all in higher health care costs. We have been on the slippery slope for years now. What is or is not punished at this point is a political and not an actuarial calculation.</p>
<p>[Alcoholism</a> - Is Alcoholism Inherited?](<a href=“http://alcoholism.about.com/cs/genetics/a/aa990517.htm]Alcoholism”>The Role Genetics Play in Alcoholism)</p>
<p>We all know people that drink and abuse drugs and they dont become alchoholics or addicts.</p>
<p>“Are you guys gonna start on the less fortunate next? Cause some of that is self inflicted, too. And, it’s a lot of people.”</p>
<p>I do wish we held people more accountable for their actions. There are consequences for certain behaviors and pretending their aren’t doesn’t help people.</p>