Obamacare makes people less likely to exercise, more likely to smoke and drink
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04-12-2013, 09:24 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(03-12-2013 06:59 PM)frankksj Wrote:  When I was previously arguing that it's more logical to use health insurance to manage the risk of unexpected costly treatment, and to pay for routine care oneself, I suggested it logically introduced a moral hazard to have insurance companies pay for everything, and some people would take worse care of themselves than if they were on the hook themselves.

Naturally the Obamacare defenders disputed this. Today's CNN article shows the empirical data actually supports my “wild claim”:
“many men, at the time they obtained Medicare [which they now do under Obamacare], started behaving badly... Among those who didn't visit the doctor after getting insurance, the effect was dramatic: Their overall physical activity dropped by 40%; they were 16% more likely to smoke cigarettes and 32% more likely to drink alcohol.”

Naturally, there are positive effects from having comprehensive care, like “uninsured adults are more likely to be diagnosed at an advanced stage of cancer, more likely to die from a heart attack and less likely to recover from a serious injury.”

Now IF the Obamacare-defenders were willing to open their mind and acknowledge the moral hazard and the negative effects, then maybe they could have come up with a better plan that retained the positive effects without all the negative ones. Of course, that won't happen since they're too dogmatic to admit the negative effects even exist, and thus they do nothing to mitigate them.

If it's true that government run healthcare makes people lazier and prone to unhealthy habits, I wonder why we don't see a huge population of unhealthy people in France or England or Canada where they have a single payer system.

I get the idea of less motivation to perform if someone gives you something as opposed to having to earn it, but we just don't see these kinds of problems with other single payer systems throughout the world. It sounds more like the root causes lie in other aspects of American society which manifest themselves in government provisions.
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04-12-2013, 10:11 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
It does?
Fuckin A Thumbsup

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05-12-2013, 12:23 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(04-12-2013 07:51 PM)frankksj Wrote:  
(04-12-2013 05:32 PM)Impulse Wrote:  Without the health insurance, their cost could be $10,000 or more.

Please clarify. Are you talking about one specific family? Or families on average?
It was an example of one family and was an illustration of why it's beneficial for health insurance to cover not only major health problems, but even minor ones right down to the wellness exams.

(04-12-2013 07:51 PM)frankksj Wrote:  Do you accept this? So when you're referring to one family being decimated with $10,000/year medical bills, and insurances saves them by reducing the copay to only $2,500/year, you DO understand that all the other families pay more to cover the difference, right? You accept that the insurance company isn't just printing money to pay for the bills, and it all comes out of premiums, right?
Of course, and you do understand that's the definition of insurance, right? The majority pay in money that they will never use so that the money is available to be used by those who will need far more than what they paid in. To be consistent with what I said above, to also cover the minor health issues, the premiums will naturally be even higher. But everyone should be using that extra amount because it's largely proactive/preventative care. However, because not everyone will do so in practice, the extra amount total for everyone who actually uses it is lower than the total would be if everyone used it. Therefore, the extra premium doesn't have to be as high as the total for everyone which lowers the overall cost for those who do use it.

For example, an annual physical might cost $100. If 1 million people should be getting the physical, the cost is $100 million. However, if only 800,000 people actually get the physical, then the actual cost is only $80 million which is $80 per person. So the premiums go up $60 (the other $20 is the copay) and everyone that gets a physical pays $80 (extra premium + copay) instead of $100 straight out of pocket which is what it would be without insurance covering it.

"Religion has caused more misery to all of mankind in every stage of human history than any other single idea." --Madalyn Murray O'Hair
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05-12-2013, 01:42 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 12:23 PM)Impulse Wrote:  An annual physical might cost $100. If 1 million people should be getting the physical, the cost is $100 million. However, if only 800,000 people actually get the physical, then the actual cost is only $80 million which is $80 per person.... and everyone that gets a physical pays $80.

Sorry, but you forgot something which changes everything. You forgot to add in the insurance companies' profit! Historically, some insurance companies had as low as a 50% payout, so when the physicals cost $80 million, the insurance company charges the policyholders $160 million. So each policyholder is paying $160 for a $100 physical, even though many don't even get a physical. The only winner with your scenario is the insurance company, since they get to sit in the middle and take a cut of the transaction without adding any value! Even with Obamacare's mandated payout ratios, in your scenario, still nobody will pay less for a physical than they would have paying for it themselves, or through a buyer's club that negotiated the best rates.

But there's another thing you forgot which makes this EVEN worse. Everybody now is mandated to have insurance, and the insurance companies are mandated to cover a physical for everybody. So, what happens when the insurance company hires a lobby firm to petition the patent office to issue a patent on some key component of the physical, and this drives the cost of the physical from $100 to $300 across the board? The insurance companies profit just tripled! And there's no checks and balances, nothing to to stop them since everybody MUST buy insurance and every insurance company MUST pay for physicals. And with the system, who is in the driver's seat, who is in charge of healthcare? It's not the patient nor the doctor, it's the insurance company, and you've introduced a perverse incentive for them, the ones in control of the system, to make sure healthcare is as expensive as they can make it. And if you think the insurance execs are a bunch of nice people who wouldn't do that, watch the youtube video below, at the 1:06 mark, where an insurance company adjuster testifies before Congress that the insurance company rewarded her for killing off sick people. This is the kind of scum we're talking about. And we've completed surrendered our health to them, and they ARE doing everything in their power to drive up healthcare costs. Check the list of recent FDA approvals for drugs. How many of them are non-patented or available as generics? None. Or look at the stepped up enforcement to arrest Americans for going to Canada for their medicine. This is why, even though US wealth isn't even in the top 10 anymore, the US still pays way more for healthcare than any other country in the world, and gets worse results; shorter life expectancy, worse infant mortality, and worse care. According to the World Health Organization, US health care ranks #37 in the world! And we're dropping, and the drop is speeding up because the people who are defending the system haven't thought it through and haven't done the math. This is my gripe with liberals. We see something that needs fixing, like poor people with no access to medical care. Conservatives want to do nothing, but liberals, without stopping to do the math and think it through, create hasty laws which only make the problem much worse. And then they blame conservatives when things get worse. Check back in 5 years. US will pay MORE for healthcare than we do now, we'll get WORSE for it, and the liberals won't say "Yeap, we did that", they'll just blame conservatives.



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05-12-2013, 04:31 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 01:42 PM)frankksj Wrote:  
(05-12-2013 12:23 PM)Impulse Wrote:  An annual physical might cost $100. If 1 million people should be getting the physical, the cost is $100 million. However, if only 800,000 people actually get the physical, then the actual cost is only $80 million which is $80 per person.... and everyone that gets a physical pays $80.

Sorry, but you forgot something which changes everything. You forgot to add in the insurance companies' profit! Historically, some insurance companies had as low as a 50% payout, so when the physicals cost $80 million, the insurance company charges the policyholders $160 million. So each policyholder is paying $160 for a $100 physical, even though many don't even get a physical. The only winner with your scenario is the insurance company, since they get to sit in the middle and take a cut of the transaction without adding any value! Even with Obamacare's mandated payout ratios, in your scenario, still nobody will pay less for a physical than they would have paying for it themselves, or through a buyer's club that negotiated the best rates.

But there's another thing you forgot which makes this EVEN worse. Everybody now is mandated to have insurance, and the insurance companies are mandated to cover a physical for everybody. So, what happens when the insurance company hires a lobby firm to petition the patent office to issue a patent on some key component of the physical, and this drives the cost of the physical from $100 to $300 across the board? The insurance companies profit just tripled! And there's no checks and balances, nothing to to stop them since everybody MUST buy insurance and every insurance company MUST pay for physicals. And with the system, who is in the driver's seat, who is in charge of healthcare? It's not the patient nor the doctor, it's the insurance company, and you've introduced a perverse incentive for them, the ones in control of the system, to make sure healthcare is as expensive as they can make it. And if you think the insurance execs are a bunch of nice people who wouldn't do that, watch the youtube video below, at the 1:06 mark, where an insurance company adjuster testifies before Congress that the insurance company rewarded her for killing off sick people. This is the kind of scum we're talking about. And we've completed surrendered our health to them, and they ARE doing everything in their power to drive up healthcare costs. Check the list of recent FDA approvals for drugs. How many of them are non-patented or available as generics? None. Or look at the stepped up enforcement to arrest Americans for going to Canada for their medicine. This is why, even though US wealth isn't even in the top 10 anymore, the US still pays way more for healthcare than any other country in the world, and gets worse results; shorter life expectancy, worse infant mortality, and worse care. According to the World Health Organization, US health care ranks #37 in the world! And we're dropping, and the drop is speeding up because the people who are defending the system haven't thought it through and haven't done the math. This is my gripe with liberals. We see something that needs fixing, like poor people with no access to medical care. Conservatives want to do nothing, but liberals, without stopping to do the math and think it through, create hasty laws which only make the problem much worse. And then they blame conservatives when things get worse. Check back in 5 years. US will pay MORE for healthcare than we do now, we'll get WORSE for it, and the liberals won't say "Yeap, we did that", they'll just blame conservatives.



I recognize that my example using the $100 physical is way over simplified and so is yours. In reality, insurance companies don't determine premium amounts that way. Naturally, they have to make a profit - at the very least, they have to pay their employees and managers. And we all know the profits don't stop there. But they figure all their expenses, income, projected changes, etc. and put it all together to determine the premiums. I was just trying to show how a group pool of money can work out to cost less per person than each individual paying for him/herself.

You don't need to convince me of the insurance company greed. I fully agree. My premiums went up by almost $200 per month this year and I consequently had to switch from a PPO to an HMO plan, which I despise. But it's also what I can afford. There is no doubt in my mind that the increase was due to the insurance companies, not Obamacare. They're doing all they can to make Obamacare look bad so it will be repealed.

"Religion has caused more misery to all of mankind in every stage of human history than any other single idea." --Madalyn Murray O'Hair
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05-12-2013, 05:04 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 04:31 PM)Impulse Wrote:  I recognize that my example using the $100 physical is way over simplified and so is yours.... they figure all their expenses, income, projected changes, etc. and put it all together to determine the premiums.

Can you clarify what specifically you think is wrong with my example? I agree that the insurance companies "put all the expenses together", but that's what's covered in their markup, which right now is fixed at 25%.

(05-12-2013 04:31 PM)Impulse Wrote:  I was just trying to show how a group pool of money can work out to cost less per person than each individual paying for him/herself.

We're still not connecting. I understand that SOME individuals in the group may pay less than if they paid for themselves. But only at the expense of other individuals. You do agree that if you look at the group as a whole, they ARE paying more for insurance than if they paid for it themselves, right? I mean the insurance company collects more money in premiums than they pay in claims and the difference covers the insurance company's overhead + profit, so if the group paid those expenses themselves, the group as a whole would pay less.

Insurance is NOT a tool to save money. On average, everybody will pay MORE with insurance than without it. Insurance is designed to manage risk, and you pay a premium (in this case 25%) to have the insurance companies manage the risk for you and to level out your costs so they do not fluctuate from one year to the other. But that is a service, and you DO pay for it, and the group as a whole would pay less if they paid directly.

That's why insurance in normal circumstances only covers large, unplanned expenses. Car insurance covers a crash, not gas, because there's no risk with gas--you know you're going to buy it. So it's cheaper to pay Chevron $100 for a tank of gas than to pay Geico $125 and have them pay Chevron $100 in your behalf. Same thing with health insurance. If everybody needs a $100 checkup, it's cheaper to pay the $100 yourself, than to pay the insurance company $125 and have them pay it for you.

If you feel that insurance saves you money, please tell me why we don't have our car insurance pay for gas, repairs, car washes, etc.? Certainly those are major expenses and we'd like to reduce them, right? So why not run them through insurance?
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05-12-2013, 07:11 PM (This post was last modified: 05-12-2013 07:14 PM by GirlyMan.)
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 04:31 PM)Impulse Wrote:  You don't need to convince me of the insurance company greed. I fully agree. My premiums went up by almost $200 per month this year and I consequently had to switch from a PPO to an HMO plan, which I despise. But it's also what I can afford. There is no doubt in my mind that the increase was due to the insurance companies, not Obamacare. They're doing all they can to make Obamacare look bad so it will be repealed.

Uh. Mine went up $10, but my co-pay went from 20% to 15% and my deductible dropped from $2500 to $2000. Weird.

(05-12-2013 05:04 PM)frankksj Wrote:  Can you clarify what specifically you think is wrong with my example? ... Same thing with health insurance. If everybody needs a $100 checkup, it's cheaper to pay the $100 yourself, than to pay the insurance company $125 and have them pay it for you.

'Cause it don't work that way. More like the insurance company pays $40. You're ignoring their negotiation power with providers. Individuals have much less negotiation power.

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As it was in the beginning is now and ever shall be, world without end. Amen.
And I will show you something different from either
Your shadow at morning striding behind you
Or your shadow at evening rising to meet you;
I will show you fear in a handful of dust.
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05-12-2013, 07:19 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 07:11 PM)GirlyMan Wrote:  'Cause it don't work that way. More like the insurance company pays $40. You're discounting their negotiation power with providers. Individuals have much less negotiation power.

Come on Girly, that's not fair. In anticipation of this argument, in my post I wrote that purchases could be done "through a buyer's club that negotiated the best rates". Price Club (now Costco), for example, began as a buyer's club for collective negotiation, with a very low fixed markup on goods (7%), where you can get medical care (drugs, etc.) at low prices. And they could also offer physicals. However it's even easier now with the internet since .com's exist to do collective negotiation for you (ie priceline, groupon, etc.).

However, even if a buyer chooses not to use collective negotiation and wants to go on his own, he STILL is in a better position because he can pit all the doctor's against each other, exactly like things are supposed to work in a free market. "Dr. Smith, your competitor, Dr. Jones, offered to provide X service at Y price. If you want my business you have to do better.". However, with an insurance company, you lose this power. The insurance company picks the doctor and negotiates the rate, and the insurance company has a financial incentive to make sure the rates go up and up across the board.

Besides, if you're right, that it's cheaper to get routine expenses through insurance, why did you ignore my question asking why we don't run car washes, gas, and oil changes through our car insurance? If insurance gets us a better price on routine human car, logically they could also get us a better price on routine car care. Why ignore that issue?
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05-12-2013, 07:22 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 07:19 PM)frankksj Wrote:  
(05-12-2013 07:11 PM)GirlyMan Wrote:  'Cause it don't work that way. More like the insurance company pays $40. You're discounting their negotiation power with providers. Individuals have much less negotiation power.

However, even if a buyer chooses not to use collective negotiation and wants to go on his own, he STILL is in a better position because he can pit all the doctor's against each other, exactly like things are supposed to work in a free market. "Dr. Smith, your competitor, Dr. Jones, offered to provide X service at Y price. If you want my business you have to do better."

Good luck trying to negotiate that hospital bill down from $25,000 to $8,750.

As it was in the beginning is now and ever shall be, world without end. Amen.
And I will show you something different from either
Your shadow at morning striding behind you
Or your shadow at evening rising to meet you;
I will show you fear in a handful of dust.
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05-12-2013, 07:38 PM
RE: Obamacare makes people less likely to exercise, more likely to smoke and drink
(05-12-2013 07:22 PM)GirlyMan Wrote:  Good luck trying to negotiate that hospital bill down from $25,000 to $8,750.

But we already had this debate in a thread. I have been very successful doing that. Remember my post about how I get a checkup for $90, from a Harvard-educated doctor, in a posh medical facility, that includes a bunch of tests and 1 full hour with the doctor? Compare the prices in "medical tourism hospitals", which have a model of selling medical care directly to the patient and do not accept insurance, vs. the traditional hospitals that go through insurance. Independent studies have been done showing you get better care at 1/10 the price at the "self-pay" facilities. And I gave you a spreadsheet showing how the AVERAGE middle-class American could have over $3 million saved up at the end of his life ONLY by using these self-pay facilities instead of insurance!

If you really care about the average, working class man, shouldn't you consider this with an open mind, and not dismiss it just because it's contrary to the Democrats' agenda? Just watch that trailer of Michael Moore's "sicko", at the 0:50 mark when he shows how many health insurance lobbyists exist per congressman, and how much the industry lavishes on congressman to get the privilege of gaming the system. Should you really drink the coolaid and be adamant that these Democratic Congressmen who are on the payroll of the health insurance industry have YOUR interests at heart, and not the companies that are funding their campaigns?
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