Obamacare makes people less likely to exercise, more likely to smoke and drink
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03-12-2013, 08:16 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:01 PM)BnW Wrote:  Obamacare eliminated the disaster-type plans that you apparently had...but the system where 3rd party payors sit between the insured and the doctor on every transaction is the result of the HMO Act of 1973, not Obamacare. You were in that system regardless of what type of insurance you had.... Anyone who does not have a policy or a policy that covers routine care was payin the "non-negotiated" rates from doctors, which were jacked up to cover the discounts they gave to the insurance companies.

So, yes, Obamacare may have cancelled your personal policy but it did not do anything to create the 3rd party payor system we operate under.

That's totally not true. Even when I lived in the US full time I would never go to a US doctor. I always went to a medical tourism clinic in Mexico City for my checkups, where they had amazing doctors (mine went to Harvard, interned at John's Hopkins), the latest equipment, in a posh environment, and it cost about 1/10 the price of the US. And I invested the money I saved by not buying comprehensive US care, and now, at age 43, that investment account has over $1 million that is solely attributable to managing my routine care myself and not participating in the US HMO system.

Everything you say about Nixon and the HMO system IS correct. Obamacare didn't create that system. But it _DOES_ mandate that everybody must participate in it.
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03-12-2013, 08:18 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:12 PM)GirlyMan Wrote:  Renounce your citizenship and be done with it.

I'm working on it. I've already married a foreigner, and in another year or so I hope to have my second citizenship. It's just not practical to renounce your US citizenship without first obtaining second citizenship because then you'd be left as a stateless refugee unable to live legally in any country.
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03-12-2013, 08:21 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:15 PM)cjlr Wrote:  Everything is Obama's fault.
Everything.

I've always said the Republicans are exactly the same and follow the same policies. I know the "stimulus" which transferred massive wealth from the poor & middle class to the rich these past few years would have gone on the same no matter which party was in charge. The only reason I bash the Democrats is because if I bash Republicans on an atheist forum, it'd just be preaching to the choir. My REAL goal is not say Democrats are WORSE than Republicans, it's to prove that they're not much better.
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03-12-2013, 08:25 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
That you have a unique sitution is wonderful but it doesn't change the fact that what seemed to be your contention - that Obama created this mess - was absolutely not true. He did not.

And yes, the new law does mandate that everyone must participate in it. Like I said, it didn't improve the situation but it equally didn't create it. What it did do was pretty much screw the generation that is now coming out of college and create a windfall for the health insurance companies. I'm still stunned the Republicans have so many issues with it. I guess they are just upset that they didn't get to implement it. Oh well.

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03-12-2013, 08:27 PM (This post was last modified: 03-12-2013 08:38 PM by Elesjei.)
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
Well, I was bored so I tried reading the studies, or at least the summaries in them.

I think Gupta missed the importance of the Oregon study. His article said;
Quote:The newly insured Medicaid population did go to the doctor more often, used more preventive health services and received more medications. Problem was, in nearly every area, they weren't any healthier. The scientists sat down with more than 12,000 people and compared some of the most important health indicators. They found having insurance did not improve measures of blood pressure, cholesterol or how well diabetics controlled their blood sugar. Furthermore, the 10-year risk of having a heart attack didn't change in those who had Medicaid. It wasn't at all what the proponents of universal access to health insurance hoped they would see.

So, access to healthcare doesn't change lifestyle or lower disease risk. Okay.

But from the study;
Quote:This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.

The effect was positive, from the point of disease detection, treatment, and the costs of care.

In the Dhaval Dave & Robert Kaestner paper, it's not as simple as Gupta puts it.

The numbers he gives are out of context. People didn't actually exercise 40% less after receiving Medicare coverage. The numbers are from a mathematical formula in the paper that adjusts for the positive effect of doctor visits to find the ''ex ante moral hazard''. From reading the paper, it should have been obvious.

For example;
Quote:Estimates indicate that receipt of Medicare is associated with a significant 1.9 percentage point decrease in the incidence of daily cigarette consumption before controlling for physician visits. Controlling for physician visits, Medicare is
associated with a 1.4 percentage point increase in the incidence of daily cigarette consumption among those who do not visit the doctor, and visits to the doctor are associated with significant decreases in cigarette use.

The conclusion of the paper describes the findings concisely;

Quote:The pattern of results shows consistent evidence of an ex ante
moral hazard effect for males. Among elderly men, the ex ante moral hazard effects associated with receipt of Medicare are as follows:

•a 39.7 percent decrease in the probability of engaging in vigorous physical exercise;
•a 18.0 percent lower probability of quitting cigarette use;
•a 15.8 percent higher prevalence of daily smoking;
•a 22.7 percent higher cigarette consumption;
•a 14.8 percent increase in the probability of daily alcohol consumption;
•and a 31.8 percent increase in the probability of current alcohol use.

We did not find consistent evidence of an ex ante moral hazard effect for females, although estimates generally indicated that Medicare was associated with an increase in unhealthy behaviors.

These estimates provide evidence that Medicare (health insurance) is associated with less prevention as manifested by an increase in unhealthy behaviors among elderly males. The effect sizes appear to be large enough to adversely affect health. But evidence also suggests that Medicare was associated with an increase in visits to the doctor and that doctor visits are
associated with significant improvements in health behaviors. Often these two effects associated with Medicare are sufficient to yield a combined effect that is small and usually not statistically different from zero. One policy implication of our findings is that Medicare should be designed to encourage visits to the doctor, particularly among those who were previously uninsured. This could be accomplished by removing co-payments and annual deductibles, and covering routine doctor visits, perhaps for low-income adults only. Greater community outreach would also expand contact between individual s in vulnerable populations (low SES and more likely to be uninsured) and medical professionals.

Insurance has a negative effect on health decisions, but doctor visits have a positive effect. Overall, Medicare is actually beneficial for people's health, as long as they make use of coverage for doctor visits.

If something can be destroyed by the truth, it might be worth destroying.

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03-12-2013, 08:33 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:27 PM)Elesjei Wrote:  Well, I was bored so I tried reading the studies, or at least the summaries in them.

I think Gupta missed the importance of the Oregon study. His article said;
Quote:The newly insured Medicaid population did go to the doctor more often, used more preventive health services and received more medications. Problem was, in nearly every area, they weren't any healthier. The scientists sat down with more than 12,000 people and compared some of the most important health indicators. They found having insurance did not improve measures of blood pressure, cholesterol or how well diabetics controlled their blood sugar. Furthermore, the 10-year risk of having a heart attack didn't change in those who had Medicaid. It wasn't at all what the proponents of universal access to health insurance hoped they would see.

So, access to healthcare doesn't change lifestyle or lower disease risk. Okay.

But from the study;
Quote:This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.

The effect was positive, from the point of disease detection, treatment, and the costs of care.

In the Dhaval Dave & Robert Kaestner paper, it's not as simple as Gupta puts it.

The numbers he gives are out of context. People didn't actually exercise 40% less after receiving Medicare coverage. The numbers are from a mathematical formula in the paper that adjusts for the positive effect of doctor visits to find the ''ex ante moral hazard''. From reading the paper, it should have been obvious.

For example;
Quote:Estimates indicate that receipt of Medicare is associated with a significant 1.9 percentage point decrease in the incidence of daily cigarette consumption before controlling for physician visits. Controlling for physician visits, Medicare is
associated with a 1.4 percentage point increase in the incidence of daily cigarette consumption among those who do not visit the doctor, and visits to the doctor are associated with significant decreases in cigarette use.

The conclusion of the paper describes the findings concisely;

Quote:The pattern of results shows consistent evidence of an ex ante
moral hazard effect for males. Among elderly men, the ex ante moral hazard effects associated with receipt of Medicare are as follows:

•a 39.7 percent decrease in the probability of
engaging in vigorous
physical exercise;
•a 18.0 percent lower probability of quitting cigarette use;
•a 15.8 percent higher prevalence of daily smoking;
•a 22.7 percent higher ciga
rette consumption;
•a 14.8 percent increase in the probabili
ty of daily alcohol consumption;
•and a 31.8 percent increase in the probability of current alcohol use.

We did not find consistent evidence of an ex ante moral hazard effect for females, although estimates generally indicated that Medicare was associated with an increase in unhealthy behaviors.

These estimates provide evidence that Medicare (health insurance) is associated with less prevention as manifested by an increase in unhealthy behaviors among elderly males. The effect sizes appear to be large enough to adversely affect health. But evidence also suggests that Medicare was associated with an increase in visits to the doctor and that doctor visits are
associated with significant improvements in health behaviors. Often these two effects associated with Medicare are sufficient to yield a combined effect that is small and usually not statistically different from zero. One policy implication of our findings is that Medicare should be designed to encourage visits to the doctor, particularly among those who were previously uninsured. This could be accomplished by removing co-payments and annual deductibles, and covering routine doctor visits, perhaps for low-income adults only. Greater community outreach would also expand contact between individual s in vulnerable populations (low SES and more likely to be uninsured) and medical professionals.

Insurance has a negative effect on health decisions, but doctor visits have a positive effect. Overall, Medicare is actually beneficial for people's health, as long as they make use of coverage for doctor visits.

Wait, wait, wait.

You mean to tell me that a click-bait opinion piece at a non-scientific source didn't give a wholly accurate summary of the study's conclusions?

I'm shocked. Shocked!

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03-12-2013, 08:36 PM (This post was last modified: 03-12-2013 08:43 PM by Elesjei.)
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:33 PM)cjlr Wrote:  Wait, wait, wait.

You mean to tell me that a click-bait opinion piece at a non-scientific source didn't give a wholly accurate summary of the study's conclusions?

I'm shocked. Shocked!

I'm quite familiar with Sanjay Gupta and his quackery, so I didn't have high expectations for his article. Didn't disappoint.

Tongue

If something can be destroyed by the truth, it might be worth destroying.

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03-12-2013, 08:40 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:01 PM)WeAreTheCosmos Wrote:  Well the OP makes a pretty good point:
Then - "If I smoke and drink, and develop some fatal medical problem, I'll have to pay for my last days in the hospital"
Now - "I can smoke and drink and die and its all covered!"

It makes sense... That is of course, for those who WANT to suffer and die from poor health. Rolleyes

Thanks, my long winded explanation is no longer necessary, that is of course if "
frankksj" understands your point you made.

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03-12-2013, 09:02 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 08:18 PM)frankksj Wrote:  
(03-12-2013 08:12 PM)GirlyMan Wrote:  Renounce your citizenship and be done with it.

I'm working on it. I've already married a foreigner, and in another year or so I hope to have my second citizenship. It's just not practical to renounce your US citizenship without first obtaining second citizenship because then you'd be left as a stateless refugee unable to live legally in any country.

Godspeed to you, Frank. Godspeed. Keep the lighthouse in sight.




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03-12-2013, 09:17 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
It's apples and oranges. Projecting the behaviors of sub-retirement age people, in a program that hasn't EVEN STARTED YET, on the basis of an anecdotal sample of retirees, is REALLY BAD science.
http://www.nytimes.com/2013/06/16/busine....html?_r=0

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