RE: health insurance not tied to employment

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LafayetteLady -> RE: health insurance not tied to employment (4/26/2013 10:53:15 PM)
quote: ORIGINAL: DesideriScuri So, the responsibility to pay for health insurance will be primarily on the taxpayer (especially if you are "rich")? What responsibilities are on the receiver of that largesse? Does a person have a responsibility to take up a lifestyle that requires as little medical care as possible? If so, who is going to make sure that responsibility is lived up to, and how? You completely missed the point didn't you? My father died of lung cancer. It was not caused by cigarette smoke, not his or second hand (he didn't smoke anyway). So by your theory, someone has to evaluate each instance of sickness and determine whether or not they had a "lifestyle that required as little medical care as possible." Just to be sure you are clear on this, prior to my father getting cancer, he was very, very rarely sick, even with a cold. Further, there are about 40 different types of lung cancer, and less than five (I actually think it is only one) types that are caused by smoking. Now, we already know that most of the people already evaluating the need for various treatments seem to lack a medical education, and their goal is to try to find a way NOT to cover any particular thing. Also, I already pointed out how even those with so called, "healthy lifestyles" can develop health issues that can be attributable to their lifestyle. I guess we should just forgive them for needing knee replacements because of their exercise activity that put too much stress on their knees because they were trying to live healthy. But really, under any circumstances, do you believe that your premium is put aside to pay only for YOUR medical needs? If that were the case, no one would be getting any decent treatment at all. Receiving decent healthcare should never be considered something you get from the "largesse" of others.

LafayetteLady -> RE: health insurance not tied to employment (4/26/2013 11:02:01 PM)
quote: ORIGINAL: tazzygirl Oh but didnt you know the belief is that medicaid is free care all the way around? (please note the sarcasm is not directed at you, erie [;)] ) Oh yea, on Medicaid, you get so many great benefits, such as no hospitalization, no vision care, no specialists (since none will participate), and the GPs that do take Medicaid are generally the bottom of the barrel, who given a choice, no one in their right mind would choose as a doctor. It does cover medication pretty well though, better than Medicare for sure. Interestingly enough, on my recent trip to Europe, I needed to purchase my medications. Metformin, which is about $65 for a 30 day supply here in the US with a prescription, was one euro, ninety-five cents there and no prescription was needed. So that is about $3 a month. Lyrica, which is close to $300 a month here, was sixty-five euros there, about $80, or about 1/3 of the cost. Ibuprofin, 600mg, available only be prescription here and at a cost of about $40-50 is about $3 bucks there. So while pharmaceuticals are going on and on about needing to price new drugs so high, and apparently generics as well because of the R&D and FDA testing and approval costs, why isn't Europe absorbing the cost for those same medications?

DesideriScuri -> RE: health insurance not tied to employment (4/27/2013 4:12:41 AM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri So, the responsibility to pay for health insurance will be primarily on the taxpayer (especially if you are "rich")? What responsibilities are on the receiver of that largesse? Does a person have a responsibility to take up a lifestyle that requires as little medical care as possible? If so, who is going to make sure that responsibility is lived up to, and how? You completely missed the point didn't you? My father died of lung cancer. It was not caused by cigarette smoke, not his or second hand (he didn't smoke anyway). So by your theory, someone has to evaluate each instance of sickness and determine whether or not they had a "lifestyle that required as little medical care as possible." Just to be sure you are clear on this, prior to my father getting cancer, he was very, very rarely sick, even with a cold. Further, there are about 40 different types of lung cancer, and less than five (I actually think it is only one) types that are caused by smoking. Now, we already know that most of the people already evaluating the need for various treatments seem to lack a medical education, and their goal is to try to find a way NOT to cover any particular thing. Also, I already pointed out how even those with so called, "healthy lifestyles" can develop health issues that can be attributable to their lifestyle. I guess we should just forgive them for needing knee replacements because of their exercise activity that put too much stress on their knees because they were trying to live healthy. But really, under any circumstances, do you believe that your premium is put aside to pay only for YOUR medical needs? If that were the case, no one would be getting any decent treatment at all. Receiving decent healthcare should never be considered something you get from the "largesse" of others. Oh, really? I don't get it? If you are "rich," you pay more than those who aren't. Those who receive help to pay for insurance, are receiving largesse from the Government. Do those who aren't paying their own way (those who are relying on tax credits to afford insurance) have any responsibility to maintain a lifestyle that will result in the lowest possible cost to the system? I know that you can do all the right things and still get the shaft and get some disorder or disease. I know it happens. But, in general, living a healthy lifestyle will result in a healthier life and a lower incidence of medical need. Shit will still happen, but it won't be as common if you live "clean." I think we can both agree on that, right? With all that said: Do those who aren't paying their way (that is, being subsidized) have any responsibility to do everything they can to limit their cost to the system? If so, who is going to make sure they are fulfilling their responsibility (the IRS is making sure the payers are doing so)? What is the mechanism for forcing compliance with that responsibility, if it exists? If it doesn't exist, why not?

DesideriScuri -> RE: health insurance not tied to employment (4/27/2013 4:25:31 AM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: tazzygirl Oh but didnt you know the belief is that medicaid is free care all the way around? (please note the sarcasm is not directed at you, erie [;)] ) Oh yea, on Medicaid, you get so many great benefits, such as no hospitalization, no vision care, no specialists (since none will participate), and the GPs that do take Medicaid are generally the bottom of the barrel, who given a choice, no one in their right mind would choose as a doctor. Why don't doctors participate? quote: It does cover medication pretty well though, better than Medicare for sure. Interestingly enough, on my recent trip to Europe, I needed to purchase my medications. Metformin, which is about $65 for a 30 day supply here in the US with a prescription, was one euro, ninety-five cents there and no prescription was needed. So that is about $3 a month. Lyrica, which is close to $300 a month here, was sixty-five euros there, about $80, or about 1/3 of the cost. Ibuprofin, 600mg, available only be prescription here and at a cost of about $40-50 is about $3 bucks there. So while pharmaceuticals are going on and on about needing to price new drugs so high, and apparently generics as well because of the R&D and FDA testing and approval costs, why isn't Europe absorbing the cost for those same medications? This is most assuredly something that needs to be fixed here. Another thing you'd find, is that costs for medical procedures all tend to be an awful lot lower there than here. I have a friend in Germany that had to get various medical tests done. He walked into a provider, got them done and paid out of pocket (which was required by his US insurance company; he submits the cost and is reimbursed) without much of an issue. My biggest issue with Obamacare is that it isn't about medical care at all, really. It's about medical insurance. It does make insurance more affordable for those who can't currently afford it (or are seriously strapped paying for it). But, the issue isn't affordability of insurance, but that insurance is, essentially, necessary. That is, we have to buy insurance to even have a chance at affording medical care. You get car insurance for what reason? To cover the cost when something goes wrong. Do you have insurance to cover the cost of oil changes? New tires? Inspections? I doubt it. Those are all out-of-pocket things. Insurance is required to make sure that there is some ability to pay if you get in an accident. Unless you are wealthy, you can't afford health care without insurance. Health care is getting so expensive, that insurance costs are getting too expensive, too. Obamacare helps with the cost of insurance, but the underlying cost - growing cost of medical care - isn't. The chatter is in limiting reimbursement rates, but what happens when reimbursement rates are not high enough (as decided by providers, not by payers)?

tazzygirl -> RE: health insurance not tied to employment (4/27/2013 4:27:08 AM)
quote: Do those who aren't paying their way (that is, being subsidized) have any responsibility to do everything they can to limit their cost to the system? Those who cannot afford any care now are limited in what they can do to lower their cost to the system now. quote: If so, who is going to make sure they are fulfilling their responsibility (the IRS is making sure the payers are doing so)? More government? quote: What is the mechanism for forcing compliance with that responsibility, if it exists? If it doesn't exist, why not? There isnt one because one isnt needed. People want to be healthy. Much of that begins in the Doctors office. "Uh oh, I put on a few pounds" is far easier to ignore than to hear a physician say "Uh oh, your cholesterol is through the roof, which can lead to x,y,z if you dont get that under control now" "Man, I am so tired after eating, I need to get to bed earlier" is easier to ignore than your physician saying "Your blood sugar is 300, if we dont do something now, you will end up with x,y,z" People know they have problems, but those problems can be excused away without a factual medical basis.

tazzygirl -> RE: health insurance not tied to employment (4/27/2013 4:37:11 AM)
quote: Why don't doctors participate? http://www.kaiserhealthnews.org/Stories/2012/August/06/Third-Of-Medicaid-Doctors-Say-No-New-Patients.aspx quote: You get car insurance for what reason? To cover the cost when something goes wrong. Do you have insurance to cover the cost of oil changes? New tires? Inspections? I doubt it. Those are all out-of-pocket things. Insurance is required to make sure that there is some ability to pay if you get in an accident. http://www.carsdirect.com/car-insurance/disadvantages-of-car-repair-insurance And some cars come with tire rotations and oil changes as part of their maintenance schedule. Its the new thing. quote: My biggest issue with Obamacare is that it isn't about medical care at all, really. It's about medical insurance. It does make insurance more affordable for those who can't currently afford it (or are seriously strapped paying for it). But, the issue isn't affordability of insurance, but that insurance is, essentially, necessary. That is, we have to buy insurance to even have a chance at affording medical care. And other people's biggest issue is that people cant afford health care to survive. I dont need a car to live, makes life easier, but I can live without it. At this point in my life, I cannot live without access to health care.

DesideriScuri -> RE: health insurance not tied to employment (4/27/2013 4:51:44 AM)
quote: ORIGINAL: tazzygirl quote: Why don't doctors participate? http://www.kaiserhealthnews.org/Stories/2012/August/06/Third-Of-Medicaid-Doctors-Say-No-New-Patients.aspx Not going to answer the question? Don't worry. I already knew the answer. Thanks for the link, though. [:D] quote: For years, some states have struggled to attract doctors to treat patients enrolled in the state-federal health insurance program for the poor, largely because of their low pay. New Jersey’s reimbursement rate for Medicaid doctors, compared to what Medicare pays, is the lowest in the nation, according to the study. quote: quote: You get car insurance for what reason? To cover the cost when something goes wrong. Do you have insurance to cover the cost of oil changes? New tires? Inspections? I doubt it. Those are all out-of-pocket things. Insurance is required to make sure that there is some ability to pay if you get in an accident. http://www.carsdirect.com/car-insurance/disadvantages-of-car-repair-insurance And some cars come with tire rotations and oil changes as part of their maintenance schedule. Its the new thing. But, that is a perk offered by the dealership, not your insurance company. Different thing altogether. You buy the car, you get these things included. Has nothing to do with insurance. quote: quote: My biggest issue with Obamacare is that it isn't about medical care at all, really. It's about medical insurance. It does make insurance more affordable for those who can't currently afford it (or are seriously strapped paying for it). But, the issue isn't affordability of insurance, but that insurance is, essentially, necessary. That is, we have to buy insurance to even have a chance at affording medical care. And other people's biggest issue is that people cant afford health care to survive. I dont need a car to live, makes life easier, but I can live without it. At this point in my life, I cannot live without access to health care. People can't afford health care, which makes insurance pretty much a necessity. The cost of care is growing so much, the cost of insurance necessarily has to go up. Now, not only can people not afford to pay for health care, they cant' afford to pay for insurance to help them afford to pay for health care. Why not get health insurance insurance to help pay for health insurance that helps pay for health care? Or, find ways to reduce the cost of health care in the first place. That is, reduce the cost of individual medical procedures, medications, etc. That will reduce the cost of insurance (because the cost of the care is reduced). Reducing the cost of the care itself will also reduce the necessity of insurance, or will relegate insurance to be necessary only for those conditions that require more health resources. Is it unreasonable to think that going to a doctor shouldn't require insurance to be affordable? A $10-20 co-pay for a doctor visit with insurance vs. a $42 no-insurance reduced rate cost?

LafayetteLady -> RE: health insurance not tied to employment (4/27/2013 7:01:37 AM)
quote: ORIGINAL: DesideriScuri Oh, really? I don't get it? If you are "rich," you pay more than those who aren't. Those who receive help to pay for insurance, are receiving largesse from the Government. Do those who aren't paying their own way (those who are relying on tax credits to afford insurance) have any responsibility to maintain a lifestyle that will result in the lowest possible cost to the system? Also, what you are implying is that if you ARE rich and can afford insurance, you shouldn't have to have any responsibility towards a healthy lifestyle because you can afford not to. Does that really make sense? Especially when you consider that would raise costs just as much. I know that you can do all the right things and still get the shaft and get some disorder or disease. I know it happens. But, in general, living a healthy lifestyle will result in a healthier life and a lower incidence of medical need. Shit will still happen, but it won't be as common if you live "clean." I think we can both agree on that, right? Theoretically, if you are rich, you also pay more income tax than those who aren't. Does that mean that those who are rich should be more entitled to the benefits of being a US citizen (free speech for example)? You are also implying that the poor are always intentionally living unhealthy lifestyles, which is false. Don't even think of finding some statistics indicating that more poor people are in need of medical treatment for "horrific" diseases. Because that discounts the reality that they are needing this treatment now, because they couldn't afford preventive care that would have found the problem earlier. Poor people have more health problems because they can't afford to eat "healthy." Fresh fruits and vegetables aren't affordable to poor people. Ground beef and pasta can be stretched to feed a family more than chicken breasts. Fish? Poor people can't afford most of the so called "healthy" fish at all. Salmon, cod? Not within reach. So no, I don't think that suddenly someone should be able to dictate how people live their lives, and frankly, if everyone suddenly started living "clean" as you put it, then other health issues would arise. quote: With all that said: Do those who aren't paying their way (that is, being subsidized) have any responsibility to do everything they can to limit their cost to the system? No more than those who can afford insurance have the same responsibility. quote: If so, who is going to make sure they are fulfilling their responsibility (the IRS is making sure the payers are doing so)? So you suggest adding to medical costs by having these people be required to submit to mandatory health screenings? Or perhaps we should have them followed 24/7 with someone reporting whether they are committed to a healthy lifestyle. quote: What is the mechanism for forcing compliance with that responsibility, if it exists? If it doesn't exist, why not? See the first two answers.

tazzygirl -> RE: health insurance not tied to employment (4/27/2013 7:33:06 AM)
quote: quote: ORIGINAL: tazzygirl quote: Why don't doctors participate? http://www.kaiserhealthnews.org/Stories/2012/August/06/Third-Of-Medicaid-Doctors-Say-No-New-Patients.aspx Not going to answer the question? Don't worry. I already knew the answer. Thanks for the link, though. And guess who manages over half of the medicaid programs?

defiantbadgirl -> RE: health insurance not tied to employment (4/27/2013 9:50:19 AM)
quote: ORIGINAL: DesideriScuri I'm sure there is something within the HR world that prevents a company from firing an employee simply because they are causing their insurance premiums to rise. My father knows a woman who was fired from Walmart because her child's cancer treatment was too expensive not to affect health insurance premiums. Walmart employee insurance is Blue Cross of Arkansas. One of my college professors has a friend that was terminated shortly after being diagnosed with an illness that's expensive to treat. In most states, companies can fire employees with or without reason at any time. Even if there is something in the HR world as you say, how would an ex employee prove it?

ThatDaveGuy69 -> RE: health insurance not tied to employment (4/27/2013 10:00:01 AM)
In the good ol' U.S. of A. an employee can be fired for no reason at all - there is no law that requires an employer to justify terminating an employee. The only exceptions to this are when a union is present or when the employee has a contract (CEO's, etc). This very probably crosses the line of HIPAA but the person would have to prove their rights were violated. And in the current pro-business environment of our judicial system, tat is a very difficult task.

erieangel -> RE: health insurance not tied to employment (4/27/2013 10:11:09 AM)
quote: ORIGINAL: tazzygirl Oh but didnt you know the belief is that medicaid is free care all the way around? (please note the sarcasm is not directed at you, erie [;)] ) The thing with the dental clinic, is my client would still have a co-payment. It may actually be cheaper for him and definitely cheaper for all taxpayer for him to go to the dentist that has the sliding fee scale (that dentist is subsidized by a church).

tazzygirl -> RE: health insurance not tied to employment (4/27/2013 12:31:52 PM)
quote: ORIGINAL: ThatDaveGuy69 In the good ol' U.S. of A. an employee can be fired for no reason at all - there is no law that requires an employer to justify terminating an employee. The only exceptions to this are when a union is present or when the employee has a contract (CEO's, etc). This very probably crosses the line of HIPAA but the person would have to prove their rights were violated. And in the current pro-business environment of our judicial system, tat is a very difficult task. And unemployment is cheaper than cancer treatment.

defiantbadgirl -> RE: health insurance not tied to employment (4/27/2013 1:20:01 PM)
quote: ORIGINAL: tazzygirl quote: ORIGINAL: ThatDaveGuy69 In the good ol' U.S. of A. an employee can be fired for no reason at all - there is no law that requires an employer to justify terminating an employee. The only exceptions to this are when a union is present or when the employee has a contract (CEO's, etc). This very probably crosses the line of HIPAA but the person would have to prove their rights were violated. And in the current pro-business environment of our judicial system, tat is a very difficult task. And unemployment is cheaper than cancer treatment. Unfortunately, there's no public option in the Affordable Care Act. But American should at least have the right to choose whether or not they want their health insurance tied to their employer. Why can't everyone sign up on the exchange? Wouldn't more companies be hiring if health insurance wasn't tied to employment? It's as if the government doesn't want the job market to improve.

tazzygirl -> RE: health insurance not tied to employment (4/27/2013 1:31:51 PM)
Initially they cant. We are trying to cover more, not simply cover those who have it available to them.

DesideriScuri -> RE: health insurance not tied to employment (4/27/2013 2:04:11 PM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri Oh, really? I don't get it? If you are "rich," you pay more than those who aren't. Those who receive help to pay for insurance, are receiving largesse from the Government. Do those who aren't paying their own way (those who are relying on tax credits to afford insurance) have any responsibility to maintain a lifestyle that will result in the lowest possible cost to the system? Also, what you are implying is that if you ARE rich and can afford insurance, you shouldn't have to have any responsibility towards a healthy lifestyle because you can afford not to. Does that really make sense? Especially when you consider that would raise costs just as much. I know that you can do all the right things and still get the shaft and get some disorder or disease. I know it happens. But, in general, living a healthy lifestyle will result in a healthier life and a lower incidence of medical need. Shit will still happen, but it won't be as common if you live "clean." I think we can both agree on that, right? Theoretically, if you are rich, you also pay more income tax than those who aren't. Does that mean that those who are rich should be more entitled to the benefits of being a US citizen (free speech for example)? Nope. quote: You are also implying that the poor are always intentionally living unhealthy lifestyles, which is false. Don't even think of finding some statistics indicating that more poor people are in need of medical treatment for "horrific" diseases. Because that discounts the reality that they are needing this treatment now, because they couldn't afford preventive care that would have found the problem earlier. Poor people have more health problems because they can't afford to eat "healthy." Fresh fruits and vegetables aren't affordable to poor people. Ground beef and pasta can be stretched to feed a family more than chicken breasts. Fish? Poor people can't afford most of the so called "healthy" fish at all. Salmon, cod? Not within reach. 1. Bullshit. 2. Bullshit. 3. Bullshit. Eyes turning brown? I didn't say they live healthy or unhealthy lifestyles. I asked if they have a responsibility to live a healthy lifestyle so as to be less of a burden on the system? quote: So no, I don't think that suddenly someone should be able to dictate how people live their lives, and frankly, if everyone suddenly started living "clean" as you put it, then other health issues would arise. You are right on that. We'd have more people living longer and dying of "old age" rather than some of the other killers. quote: quote: With all that said: Do those who aren't paying their way (that is, being subsidized) have any responsibility to do everything they can to limit their cost to the system? No more than those who can afford insurance have the same responsibility. So, there is no responsibility to live so as to be as healthy as possible, yet there is a responsibility on others to pay for it? What are you placing a relative incentive on with that? quote: quote: If so, who is going to make sure they are fulfilling their responsibility (the IRS is making sure the payers are doing so)? So you suggest adding to medical costs by having these people be required to submit to mandatory health screenings? Or perhaps we should have them followed 24/7 with someone reporting whether they are committed to a healthy lifestyle. I didn't suggest anything. I'm asking you questions. quote: quote: What is the mechanism for forcing compliance with that responsibility, if it exists? If it doesn't exist, why not? See the first two answers. So, because someone makes more money, which could very easily be because he or she may have taken more risks, applied him or herself more, and been more successful, they get to pay more for health insurance than others who may not have applied themselves as much? Nice.

tazzygirl -> RE: health insurance not tied to employment (4/27/2013 2:15:32 PM)
quote: 1. Bullshit. 2. Bullshit. 3. Bullshit. Eyes turning brown? I didn't say they live healthy or unhealthy lifestyles. I asked if they have a responsibility to live a healthy lifestyle so as to be less of a burden on the system? Part of a healthy lifestyle is visiting your physician.

LookieNoNookie -> RE: health insurance not tied to employment (4/27/2013 2:22:03 PM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri So, the responsibility to pay for health insurance will be primarily on the taxpayer (especially if you are "rich")? What responsibilities are on the receiver of that largesse? Does a person have a responsibility to take up a lifestyle that requires as little medical care as possible? If so, who is going to make sure that responsibility is lived up to, and how? You completely missed the point didn't you? My father died of lung cancer. It was not caused by cigarette smoke, not his or second hand (he didn't smoke anyway). So by your theory, someone has to evaluate each instance of sickness and determine whether or not they had a "lifestyle that required as little medical care as possible." Just to be sure you are clear on this, prior to my father getting cancer, he was very, very rarely sick, even with a cold. Further, there are about 40 different types of lung cancer, and less than five (I actually think it is only one) types that are caused by smoking. Now, we already know that most of the people already evaluating the need for various treatments seem to lack a medical education, and their goal is to try to find a way NOT to cover any particular thing. Also, I already pointed out how even those with so called, "healthy lifestyles" can develop health issues that can be attributable to their lifestyle. I guess we should just forgive them for needing knee replacements because of their exercise activity that put too much stress on their knees because they were trying to live healthy. But really, under any circumstances, do you believe that your premium is put aside to pay only for YOUR medical needs? If that were the case, no one would be getting any decent treatment at all. Receiving decent healthcare should never be considered something you get from the "largesse" of others. LL...did they ever determine the source/cause?

angelikaJ -> RE: health insurance not tied to employment (4/27/2013 2:22:04 PM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: tazzygirl Oh but didnt you know the belief is that medicaid is free care all the way around? (please note the sarcasm is not directed at you, erie [;)] ) Oh yea, on Medicaid, you get so many great benefits, such as no hospitalization, no vision care, no specialists (since none will participate), and the GPs that do take Medicaid are generally the bottom of the barrel, who given a choice, no one in their right mind would choose as a doctor. It does cover medication pretty well though, better than Medicare for sure. Interestingly enough, on my recent trip to Europe, I needed to purchase my medications. Metformin, which is about $65 for a 30 day supply here in the US with a prescription, was one euro, ninety-five cents there and no prescription was needed. So that is about $3 a month. Lyrica, which is close to $300 a month here, was sixty-five euros there, about $80, or about 1/3 of the cost. Ibuprofin, 600mg, available only be prescription here and at a cost of about $40-50 is about $3 bucks there. So while pharmaceuticals are going on and on about needing to price new drugs so high, and apparently generics as well because of the R&D and FDA testing and approval costs, why isn't Europe absorbing the cost for those same medications? Benefits vary state-by-state, but according to the dotGOV website, hospitalisations are universally covered. I get vision care with glasses every 2 years. I get basic dental coverage. I have a great pcp, who I began with 5 years before going on medicaid, and have had no issues with being referred to specialists. In my state most of the best hospitals and physicians take medicaid. Edit to add: btw: Metformin is one of the $4.00/month RXs at Walmart.

LookieNoNookie -> RE: health insurance not tied to employment (4/27/2013 2:23:48 PM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri Oh, really? I don't get it? If you are "rich," you pay more than those who aren't. Those who receive help to pay for insurance, are receiving largesse from the Government. Do those who aren't paying their own way (those who are relying on tax credits to afford insurance) have any responsibility to maintain a lifestyle that will result in the lowest possible cost to the system? Also, what you are implying is that if you ARE rich and can afford insurance, you shouldn't have to have any responsibility towards a healthy lifestyle because you can afford not to. Does that really make sense? Especially when you consider that would raise costs just as much. I know that you can do all the right things and still get the shaft and get some disorder or disease. I know it happens. But, in general, living a healthy lifestyle will result in a healthier life and a lower incidence of medical need. Shit will still happen, but it won't be as common if you live "clean." I think we can both agree on that, right? Theoretically, if you are rich, you also pay more income tax than those who aren't. Does that mean that those who are rich should be more entitled to the benefits of being a US citizen (free speech for example)? You are also implying that the poor are always intentionally living unhealthy lifestyles, which is false. Don't even think of finding some statistics indicating that more poor people are in need of medical treatment for "horrific" diseases. Because that discounts the reality that they are needing this treatment now, because they couldn't afford preventive care that would have found the problem earlier. Poor people have more health problems because they can't afford to eat "healthy." Fresh fruits and vegetables aren't affordable to poor people. Ground beef and pasta can be stretched to feed a family more than chicken breasts. Fish? Poor people can't afford most of the so called "healthy" fish at all. Salmon, cod? Not within reach. So no, I don't think that suddenly someone should be able to dictate how people live their lives, and frankly, if everyone suddenly started living "clean" as you put it, then other health issues would arise. quote: With all that said: Do those who aren't paying their way (that is, being subsidized) have any responsibility to do everything they can to limit their cost to the system? No more than those who can afford insurance have the same responsibility. quote: If so, who is going to make sure they are fulfilling their responsibility (the IRS is making sure the payers are doing so)? So you suggest adding to medical costs by having these people be required to submit to mandatory health screenings? Or perhaps we should have them followed 24/7 with someone reporting whether they are committed to a healthy lifestyle. quote: What is the mechanism for forcing compliance with that responsibility, if it exists? If it doesn't exist, why not? See the first two answers. I think rich folks should get wider freeway lanes.

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