Comment by Workaccount2
1 day ago
The obvious retort to this is:
"If I focused on my health, ate clean and exercised daily, why should I also be subsidizing Billy "video-games-are-my-exercise" fatass's chronic health conditions?"
This is why there is a hyperfixation on shifting blame away from (failing) individuals. The logic breaks when Billy has to admit he just hates exercising.
And yes, before you comment, I know "maybe Billy has (condition outside all control) so it's not on him". Please, see what I just said in the previous statement.
In some respects, the ideal world is one in which everyone’s premiums are tied to a free and easy Apple Watch-like device that silently tracks exercise, blood sugar at a frequency that can tell when you ate a big dessert, air quality (and the presence of smoke or pollution), blood alcohol content, whether you are in speeding cars, whether you are participating in dangerous sports, etc. Such a system would directly confront individuals with the cost of their behaviors in an economic way, probably leading many or even most people to improve their habits in the aggregate.
But such a system comes at other costs that most people intuitively feel infringes on core values they have.
Edit to add: this system would actually have some great advantages over an “existing conditions” tax in that now you pay low rates until you have diabetes, all during the time you are leading the unhealthy lifestyle. But once you have it you are not rewarded for starting to exercise and eat healthy and get it under control. In the hypothetical scenario above, you’d be punished economically during the period you were building bad habits and you would be able to restore sane costs after course correction
There's a similar phenomenon when people grouse about paying taxes for "roads I don't even use." Even if we assume zero indirect benefits, the billing infrastructure necessary to truly achieve that goal would create a creepy panopticon of constant surveillance.
This is difficult to convey to certain brands of self-styled libertarians.
> creepy panopticon of constant surveillance
Which we have anyway. We might as well get some benefits from it.
The government already knows whether you have a car. What more information would they need?
It also fails to take into account the fact that eating clean and exercising daily doesn't eliminate your risk of getting cancer at age 40 or having your car's brakes fail randomly.
Its dumb to create an insurance program using anecdotes.
The system can accommodate (and frankly is the ideal many people strive for) some health nut getting long drawn out cancer battle at 41. Its rare enough to be noise in the giant money payout pool.
Obesity and it's litany of health effects are not rare, and next to age, are a dominating signal drawing money from the pool.
Is the obvious retort to this:
I don't think we should play arbiter for who has and hasn't lived a healthy enough life to still believe they should get healthcare?
Yeah, I think what Workaccount2 is not realizing is that there's no bottom to "you have higher risk factors, why should I pay for you?", and so once you start down that way you may not like where it ends up. Some hobbies have higher injury rates, why should I pay for your health care if you choose to play those? Some parts of the country have lower life expectancies, why should I pay for your health care if you choose to live there?
The actual realization, which usually comes years after the realization that there is no bottom, is that there is no top either.
The battle along the spectrum of privatizing gains (lower healthcare premiums for a healthy lifestyle - high premiums for unhealthy lifestyle) vs socializing losses (paying $20/mo to get $1200/mo of care - paying $1200/mo for $0/mo of care) is constant and boundless in either direction.
2 replies →
The entire purpose of health insurance is spreading risk across a wide and diverse risk pool.
> why should I also be subsidizing Billy "video-games-are-my-exercise" fatass's chronic health conditions?"
Nobody is asking you to: enrolling in insurance is a choice in the USA.
Also, replace "chronic health conditions" with "unavoidable inherited genetic risk factors". We don't want Billy to be screwed for life just because he was born to a suboptimal combination of parents.
The most cataclysmic thing that could happen to healthcare would be chronically healthy individuals creating their own health insurance.
Not really (in fact that doesn't even make sense), but in any case, I think you replied to the wrong post. Your reply doesn't seem to have anything to do with the post it replied to
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> "If I focused on my health, ate clean and exercised daily, why should I also be subsidizing Billy "video-games-are-my-exercise" fatass's chronic health conditions?"
Then why are you not asking your insurer why they cover a lot less preventative health or other options. For example, Kaiser flat out refuses to prescribe GLP-1s for weight loss, others insurers are the same with gym subsidies or not covering nutritionists.
But they'll happily pay for your gastric bypass.