Fitness Minutes: (36,342)
2,545 2/22/14 9:52 P
Brian, I agree that people need to take more responsibility for their health.
One of the biggest problems though is a lack of health literacy. Too many people have no idea how their body works and don't know enough to try and find out. I took care of a lovely man who was having his second major heart surgery. He quit taking his medications because he finished the prescriptions.
Think about how many people do things like that!
I think we would make more of an effort if we had to pay some thing for every doctors visit, every ED visit, every surgery and every hospitalization.
I think we need Health Class 101 in order to graduate from 8th grade, high school and college. I think foe every fast food ad, every beer ad and every junk food ad their should be a health ad.
We can't improve ourselves if we are uneducated.
Fitness Minutes: (9,921)
2,249 2/18/14 5:36 P
Before the Obama Care people that had to take medication for MS it was paid for. Now with the affordable care act the medication is no longer on the formulary list the cost for one medication is $62,0000 if the patient wants it. Guess what nobody in classes can afford that except the very rich!! Then I doubt they want to pay for that either. Premiums went from $40.00 to $ over 300.00 a month for one person since the act took place. I cannot even imagine what people with MS are thinking. Obama Care said the insurances have to take anyone with a preexisting condition,but they never once no doubt looked into the prices of the medication. I wonder why that was never looked into, it probably was,but did it any way!! Taking anyone with a preexisting condition sounds awesome until your told yes we take you,but your medications not covered to survive or leads somewhat a normal life to survive Judy
Edited by: JUDYAMK at: 2/18/2014 (20:10)
Fitness Minutes: (8,135)
2/18/14 4:30 P
I agree there are self pay policies and never claimed they didn't exist. I was merely mentioning how the vast majority of people get insurance.
I also noted that while third parties have dominated costs have increased and markets have adjusted to things, which means that the current climate does not lend itself to drastic changes in a short time. Also in my post I noted that the provider of the insurance would provide money into a health savings account. This of course does not apply to self pays.
Likewise I realize that obesity is not the only issue but message boards are not op-eds (limited space) and since this is a weight loss site I referenced obesity.
There is simply no change that can be made to 'fix' things over night including the changes taking effect currently with the 'Affordable care Act'. My suggestion simply states that if people had more responsibility for the costs and their own actions eventually behaviors will change for the better, not to perfection but for the better.
The current system has had good results as well. If people had to pay cash we would not have the frequency of MRI and other technology. On balance though I believe when people make the decisions for themselves they make the correct decisions more often than not.
You are of course are free to differ on that.
2/18/14 3:25 P
@BRIANLIEBERTH You are incorrect about how people get insurance. I've had a self-pay policy for almost 10 years which makes me absolutely and ultimately responsible for my healthcare decisions. I have NEVER gotten insurance through an employer or the government. I pay a large premium every month in addition to co-pays and deductibles. Now I'm responsible for larger co-pays and a percentage after my deductible. I absolutely have to pay every single time I see a health care provider. It sounds like maybe you've had great insurance through the years if you can visit a health care provider and not pay anything. I've never had that luxury. My health care insurance has only helped defray some of the costs a little, providing a lower rate owed to the doctor or facility. Your suggestion would only work if health care costs were reasonable. It is unreasonable to expect someone to pay $184 for a twenty minute appointment (or less if the doctor is running late) when the insurance companies pay only $54 for that same time. Being obese is not the only reason that people require medical care. I have been disabled since I was 8 years old, only because I grew too tall too fast. Sounds stupid, right? But weight has nothing to do with it. I would have been bankrupted a long time ago under your suggestions for health care at no fault of my own. What happens to the children who are born disabled under your plan? Since they have no savings of their own and they would run through their parents quickly are they just left to suffer? There is a difference between personal responsibility and a lack of compassion. It's true that some people use more health care money than others, just as some use more car insurance money than others. I agree that each person needs to question the costs of things (like why pain medication costs 500X as much as an inpatient than at the pharmacy) and to own their own struggles. But until costs are reasonable, requiring each person to pay the totality of their medical bills is untenable and for most people impossible.
I am fascinated by the discussion and conversations like it. For a very long time now health care payment and decisions have been removed from the individual and assigned to third parties either the government or an insurance company paid for by your employer. In both cases the individual is not the eventual customer. the government or company is, they pay the bills so the provider satisfies them not you.
The outcome of this is first of all it is no longer insurance. We don't use auto insurance to pay for oil changes for example, but we use health insurance to pay for everything from urgent care visits for the sniffles to any other visit you can think of. What this does is removes the immediacy from our behavior. If we don't take care of ourselves and become obese we may not see the effects for decades. By that time the treatment is catastrophic in cost. if we had to shoulder more of the cost we may take more interest in it.
But we can't just put the Jeanie back into the bottle. Costs have risen, new products have been invented so now we have the system we have. My recommendation has been for a while that we return the control and responsibility to the individual. Health savings accounts and insurance only for catastrophic care. With your heath savings account you accumulate funds while you are young and more healthy so that you have it built up when you are less healthy. Of course no system is perfect and won't work out for some, but that is the case now to the extreme, but I believe this would return control and responsibility back to the user of services. Also the individual now has a reason to ask why they are being billed $14 for a vicatin (my actual bill a few years back) Employers or gov. services would put money into the savings account and provide for the catastrophic plan and the individual takes care of the routine expenses themselves. If they use them carelessly they do without or pay for them themselves.
2/18/14 12:56 P
2/17/14 2:34 P
But :S... don't they have to pay taxes too? I mean... meh I don't understand anything lol but I agree with REBECANOLA
Fitness Minutes: (11,285)
2/17/14 1:34 P
I think we owe it to ourselves to live as healthy a life style as possible. What we owe society I am not sure of.
2/17/14 1:10 P
There are always going to be people who behave in some way that doesn't fit either the "mainstream" of whatever each person decides is how others should act. We owe it to OURSELVES not society to be the best we can be. Some of the situations the OP mentioned do have lasting effects on a lot of people, but the fact is there are a lot of behaviors that have lasting effects. A lot of people are on disability that maybe shouldn't be. But the fact remains, everyone no matter what decisions they've made has some value, has worth. Reading some of these posts makes me feel like there are some who have decided that unless each person is making a decision approved of by themselves they are not worthy of receiving any help. The saying "but for the grace of god, there I be" (not trying to talk about god, only making a point!) has a lot of meaning. I can't tell you how many times my mom has been accused of doing something wrong during her pregnancy to make my sister the way she is. It's been proven that her disease is a genetic mutation formed when specific chromosomes split. But no one wants to hear that. They're too busy looking at what a "burden" she is to society. I would never wish my family's struggles on another person, but I definitely am sick and tired of being judged for it. Of being told that my sister has "used more than her fair share of health care". Why does she matter less than anyone else? Why does she have less value? Anyone can have a child with special needs through no fault of their own, but no one thinks that way. Yes, addiction can and does hurt lots of people. So if everyone is sure that people should stop doing drugs why does meaningful and helpful treatment costs tens of thousands of dollars? Sometimes hundreds of thousands of dollars? Mental health is just as important as physical health, yet it's so readily neglected and relegated to the back of the line that it's disheartening. If people were serious about truly treating those who struggle with drug addiction there would be affordable programs that work. But they are few and far between now. I absolutely agree that people need to own their personal struggles and become the best person they can be, but who gets to decide what is their best? Not everyone is created the same, not everyone wants to be the same, and not everyone has the same expectations. I could get disability if I wanted, based only on the problems I currently have without embellishment. But I choose to work because I enjoy it. Insurance companies are there for a reason, especially the for profit companies. Car insurance is much the same. I've never made a claim on my insurance, but had to because I live in a no fault state and was rear ended. Should I have paid for the $5,000 damage to my car because oops, other people are paying the same insurance company and they shouldn't have to pay out for me? That's what they are there are. That's the way they were designed.
Personally, I think we should be willing to pay more taxes so that people have basic needs met like healthcare and education without going into massive debt (the lack of general care providers/family practice doctors is also tied to the cost of education). These are things that support the society we live and help us prosper as a whole. As much as we like to think of ourselves as individuals we live in a cooperative society and we depend on each other quite a bit.
We're already giving the money to insurance companies, banks, and finance companies. Why not just pay taxes and have these resources available to everyone?
Fitness Minutes: (36,342)
2,545 2/15/14 3:50 P
I'm definitely not judging anyone ..I have too many issues of my own to take care of before I can judge what others do!
My interest in this issue has been aroused by the many articles that I have recently read in various journals about reining in health care costs (always at the patient care level... not the insurance company level), the decreasing number of general care providers, penalties to hospitals over things they really can not control (like making sure you take your heart meds), Managed Care, Accountable Care, Meaningful Use Initiatives and on and on and on....
I just think it's an interesting discussion topic.
The flip side go this question is what do WE as a society owe the individual? And with that question goes the question of: How much are WE willing to pay to give everyone what WE think they should have?
Some European countries have tax rates around 50%. Are WE willing to pay 50% of our income to take care of other people?
I think we are slowly moving towards a one payer system, something along the lines of Medicare or England's National Health System.
I also agree with the idea that any of our systems are currently spend too much on treating diseases and not enough on prevention.
It's a fascinating topic... how will our healthcare needs be met in the future? How much will we pay? Will there be rationing, long waits, denials based on personal habits?
Will we go bankrupt paying for it? Will we tax cigarettes, alcohol and fatty foods into oblivion?
What is the alternative? Are we supposed to deny care to people who are sick because "it's their fault" or look down on our fellow human beings and call them moochers and freeloaders? That's not a society I want to live in. I think as a society we owe it to each other to take care of each other the best we can, no matter what. We are all fallible.
We do owe it to ourselves to take care of ourselves the best that we can so that we don't have to be on medications or dialysis or need long term care, since I think most of us would like to avoid those things. But, I think as a society we should be moving towards making sure everyone has access to healthcare - and it would be great to get the money grubbing insurance companies out of the picture.
For the OP: I'm not sure what you do at a hospital, but your judgment makes me feel uncomfortable. I'd hate to think if I get injured that someone is looking down at me and saying she should have just lost weight. I do, however, reserve a special kind of judgement for the anti-vaccine crowd. That's just ignorance and blatant disregard for other people.
Fitness Minutes: (31,210)
103 2/15/14 1:53 P
An interesting discussion - and it's a tough question to answer! I live in the UK and our system, in my opinion, is superior to your profit-oriented private insurance system - but it's far from perfect (in fact, we have to deal with health tourists from countries like the USA where people cannot afford the treatment they need, but can afford a flight to the UK, and so come and abuse our system!)
From what I understand, neither your system or ours encourages enough prevention, with the focus on illness rather than wellness - although we go some way towards it - for example, our GP's can provide free Weight Watchers attendance for 12 weeks to overweight patients - I'm not sure whether your system offers a similar service.
In both systems there is abuse by people who don't turn up for appointments, who don't look after their bodies (aren't many of us guilty of that by letting ourselves get overweight?) and who are given lots of help but don't make the changes necessary to be well.
The bigger picture of course is that, in both systems, many people who deserve help get the treatment they need, and make the lifestyle changes that are suggested to them. So I think the focus needs to be on the many who are helped rather than those who abuse the system - but we also need to work out how to get people to comply - for their own benefit and everyone else's.
Prevention must become a priority or our NHS system will collapse under the strain, and yours will get too expensive for anyone to be able to afford anything but very basic cover.
Edited by: TKA54321 at: 2/15/2014 (13:54)
Fitness Minutes: (36,342)
2,545 2/15/14 12:12 P
It's not necessarily "freeloaders" who abuse the system. Many people are either working or have worked. It's not even about going to the doctor on a regular basis.
To me the question is do we owe it to others to take care of ourselves?
To those who say "it's my body and I can do what I want with it, I'm not hurting anyone else" I offer these real life scenarios:
Guy using cocaine has a heart attack at age 21. Continues to use cocaine and has a stroke at 26. Has been on disability ever since. Which WE pay for.
28 year old who drank so much that he went into liver failure and died. Left behind several small children who now have no daddy and a mom collecting SS benefits .
Parents didn't vaccinate their child, he went overseas and caught measles. Came home and spent several days riding the BART and may have infected 400K people on the BART and at his university. How many pregnant women did he put at risk? How many blind/deaf babies will be born because of this? How many miscarriages? (Current event in SF)
Diabetic patient ignores that little sore on his foot. 3 months later foot is gangrenous and he gets an amputation. He can't drive a truck anymore ...on disability till he learns as new job.
To me the point is that none of us live in a bubble and our actions affect others. I may pay the immediate price but WE pay too.
I don't think the majority of people who receive medical benefits are abusing the system. They are part of the system that everyone who is able to pays into so that everyone, rich, poor, elderly, young, at whatever weight or situation in life can access and receive the medical care they need and that all people deserve, whether they are taking care of themselves or not.
Edited by: EMPRESSAMQ at: 2/15/2014 (11:27)
Fitness Minutes: (5,698)
2/15/14 10:44 A
Why should those who work hard foot the bill for the freeloaders? Teach them, train them to take care of themselves. To get a job, skills, etc. But DO NOT "enable" them to mooch.
2/15/14 6:47 A
Well I live in UK and get my medical treatment 'free'. I even get free prescriptions now I'm over 60. I really appreciate what we have in UK, especially when we hear horror stories from USA about people who need so much treatment that insurance won't pay up, or a baby needing loads of treatment from birth - not covered by insurance.
It's not quite free though as we pay National Insurance throughout our working lives. Even people on benefits have their NI payment covered. And obviously we pay income tax as well.
The NHS doesn't cover certain treatments - very few people would get cosmetic treatment (or loose skin removed) on NHS and, even as an NHS patient, we pay quite a lot for dental treatment. Some people still take out private medical insurance so they can get quicker care and more luxurious hospital treatment. (Hospital food is still notorious in UK except in a very few hospitals.)
I do agree with the OP about people misusing the system. A key issue in UK at present is people going to A&E with minor ailments that should be treated elsewhere.
One woman who made me really angry was a woman who complained to me for days about how her leg was hurting. I kept saying, 'Have you been to the doctor?' and she always said she'd get round to it. Then, a week or so later, I asked how her leg was and she said, 'Oh I had to call the doctor out at 3 o'clock this morning because it was so painful!' That was a woman who thought society owed her everything.
Fitness Minutes: (111,212)
2/15/14 2:51 A
Online Now • ))
Fact: communism has already been tried AND FAILED. Why is it being shoved down our throats?
Someone thinks they know better and has decided to force it on our country. We let it happen. So much for our representative form of gov't.
Frankly, if people don't OWN their own health, how is that someone else's burden???
Going to the doctor often doesn't solve anything. (Someone can have my dr. visits. They don't work for me. I'm not looking for any medication to band-aid my issues. And my insurance doesn't cover anything that works. Go figure!)
Making healthy choices daily would be a better place to start.
What do you think about socialized medicine like in the UK? Prevention is the way to go and making sure that everyone can go to the doctor is the real way to take care of your people.
Fitness Minutes: (353,207)
16,693 2/14/14 11:50 P
If we all did our part, our Society would be in a much better state!!!!
Fitness Minutes: (36,342)
2,545 2/14/14 8:55 P
What do the collective "WE" owe our society? In particular, what do WE owe regarding our health and self care on a moral and ethical level?
With the Affordable Care Act, Obama Care, Managed Care Homes etc and the push to insure every one and provide all health care services to everyone either for free or at a low cost, what does the recipient owe the "WE" who are paying?
My health insurance fees QUADRUPLED this year. Yep, I now pay FOUR times as much as I did last year. So much for affordable.
I look at people admitted to my hospital and wonder about:
The person who skipped outpatient dialysis for a week and has to be admitted for treatment. Reason, she was too busy to go. But not too busy for 3 days in the ICU and 2 more days on the floor. Does she owe it to the "WE" who are paying to go to dialysis as scheduled?
The diabetic who doesn't control his diet and continues to smoke now gets a 100K 5 vessel heart surgery. Does he owe society to take care of his new heart by taking care of his diabetes, stopping smoking etc?
The patient who doesn't take his blood pressure medicine and has a stroke. Now we are paying for rehab after a 14 day hospital stay. Does he owe society compliance with medications?
The 400 pound guy who slipped on ice and broke 3 out of 4 extremities. Now needs prolonged rehab after an extended hospital stay. Does he it owe society a better diet and weight loss?
The drug addicted mom who got pregnant from a drug addicted dad and now has a special needs drug addicted kid. Do they owe us on a moral level?
Even people who have health insurance rely on others who are paying for health insurance to help cover the costs of their health care.
So do we owe others in our society to take care of ourselves, especially since "WE" are footing the bill?
Note: This is just a discussion question. It's not about people not taking meds because they don't like the side effects, don't have the money or any other reason. It's just, I hope, a thought provoking question about the individuals responsibility to the society in which they live.