Does it make sense to provide health insurance to smokers and drug users?

[MvM]

No one should be excluded, everyone should pay.

I agree 100% ABSOLUTELY - EVERYONE should pay their premium.

Of course, those healthy people 18-30 old won't need medical help as much as people 60-70 year old will.
But even 18-30 old get into accidents.
The trick is (I presume) that EVERYONE should pay their mandatory premium.

As yes, as you get older, the premiums will be higher, but then again, older people usually also make more money.

I currently pay FIFTEEN THOUSAND DOLLARS A YEAR. That is ludicrous, but here is the real stab in the eye. Renee had some problems last month and had to go to the hospital by ambulance, we just got ~4k in medical bills that are not going to be covered by insurance. So I pay 15k plus another 4k, WTF is that??? Not to mention thousands in other bills I paid over the year which were not covered. Meanwhile one of my tenants goes to the ER (by ambulance) FOR FREE just so they can get some drugs to sell on the street.

Your are paying 15K US$ per year ??
That IS ludicrous (again, my opinion). Of course, I don't know for how many persons that premium is, but it still amounts that muchos $$.

I'll give you an idea of what we pay. My premium is 1360 Euros per YEAR at the moment. That is, for 1 person 46 years of age with a somewhat extended dental coverage in my packaged. That would amount to about 1950 US$ per year at the current exchange rate.

Again, I state.
EVERYONE should be insured but yes, also, EVERYONE should pay.
I believe that ONLY if you make this mandatory you can keep the costs in check.

 

[AR]

Everyone should have insurance and it can be funded from everyones Social Security contributions. Dental is a different thing. Basic coverage but no fancy stuff, same for cosmetic medicine.

There seems to be ( looking from afar ) so much fraud, malpractice, people abusing the system, that I have no idea how they are going to sort it out.

 

[steveny]

I agree 100% ABSOLUTELY - EVERYONE should pay their premium.

Of course, those healthy people 18-30 old won't need medical help as much as people 60-70 year old will.
But even 18-30 old get into accidents.
The trick is (I presume) that EVERYONE should pay their mandatory premium.

.

When I was in my 20's I fell off a roof and landed on a handrail then flipped over the handrail and dropped another 15 feet onto concrete steps. I went to the hospital and I paid the entire bill out of my pocket. Other young people could do the same but they don't. They get the service then never pay for it, ruin their credit, then think the system has SCREWED THEM, then they give up and collect public assistance.

Your are paying 15K US$ per year ??
That IS ludicrous (again, my opinion). Of course, I don't know for how many persons that premium is, but it still amounts that muchos $$.

I'll give you an idea of what we pay. My premium is 1360 Euros per YEAR at the moment. That is, for 1 person 46 years of age with a somewhat extended dental coverage in my packaged. That would amount to about 1950 US$ per year at the current exchange rate.

Again, I state.
EVERYONE should be insured but yes, also, EVERYONE should pay.
I believe that ONLY if you make this mandatory you can keep the costs in check.

Before I was married I paid about what you paid. After I got married I started paying 15k a year. I pay 15k a year because no matter how many kids I have I will pay 15k a year. I could have no kids or 150 kids, still 15k a year.

Problem is, and maybe it's just I am too busy to meet the right people but most people I know, not friends, have 4-9 kids and don't pay a friggen dime for health care.

Can someone on here please chime in and tell us you have 3 to 4 kids and pay your own insurance??

 

[MvM]

When I was in my 20's I feel off a roof and landed on a handrail then flipped over the handrail and dropped another 15 feet onto concrete steps. I went to the hospital and I paid the entire bill out of my pocket. Other young people could do the same but they don't. They get the service then never pay for it, ruin their credit, then think the system has SCREWED THEM, then they give up and collect public assistance.

If you description above is the SYSTEM right now in the US, then it is (my opinion) a very flawed system.
I do not see how such a system would work at all if people are able to avoid paying for healthcare but yet can still claim the right for treatment when they need it.

Before I was married I paid about what you paid. After I got married I started paying 15k a year. I pay 15k a year because no matter how many kids I have I will pay 15k a year. I could have no kids or 150 kids, still 15k a year.
Can someone on here please chime in and tell us you have 3 to 4 kids and pay your own insurance??

In the Netherlands, you can change your healt insurance every year (if you want). I just did a comparision of my (imaginary) family with three kids.
Monthly premium for basic coverage + dental for me, my wife and three children aged 9, 6 and 4 would be around 175-220 Euro PER MONTH or 2100 Euro to 2600 per YEAR. That would amount to about 3800 US$.
Make that 4000-4400 if I would want more extended coverage, but it would still be far short of 15K. For normal stuff (not dental) in that case, my own risk would be 165 Euro per person per year.

Mind you, of course, there are people in the Netherlands who don't pay their premium (usually because they can't afford it or are just too lazy).
BUT since coverage is mandatory by law and this is relatively well enforced, they usually end up paying anyway, including the also mandatory 25% fine. Last year, about 170.000 people had not done so. However, the control system on this seems to work quite well end the premium are usually collected anyway.

 

[steveny]

If you description above is the SYSTEM right now in the US, then it is (my opinion) a very flawed system.
I do not see how such a system would work at all if people are able to avoid paying for healthcare but yet can still claim the right for treatment when they need it.

Not only can they claim the right to use it they don't have to pay if they don't want to. They have nothing to take and refuse to work. Jobs around here pay 10-15 and hour. welfare with benefits is ~50k a year for doing nothing. The 10-15 dollar an hour jobs usually don't include health insurance BUT if someone has a 10-15 dollar an hour job they are making too much money for Medicaid SO the person quits their job and collects welfare which comes with, free housing, free medical care, free food, heat and electric bills paid, free prescriptions, free cab rides, free, free, free, and it adds up to ~50k a year in free stuff. This is why people don't work. Then they have 5 kids and get even more money BUT because they are not in the work force they are teaching their children NOTHING and cycle continues but now TIMES FIVE!!

In the Netherlands, you can change your healt insurance every year (if you want). I just did a comparision of my (imaginary) family with three kids.
Monthly premium for basic coverage + dental for me, my wife and three children aged 9, 6 and 4 would be around 175-220 Euro PER MONTH or 2100 Euro to 2600 per YEAR. That would amount to about 3800 US$.
Make that 4000-4400 if I would want more extended coverage, but it would still be far short of 15K. For normal stuff (not dental) in that case, my own risk would be 165 Euro per person per year.

Mind you, of course, there are people in the Netherlands who don't pay their premium (usually because they can't afford it or are just too lazy).
BUT since coverage is mandatory by law and this is relatively well enforced, they usually end up paying anyway, including the also mandatory 25% fine. Last year, about 170.000 people had not done so. However, the control system on this seems to work quite well end the premium are usually collected anyway.

3800$US is what I I pay per 1/4, just got the bill. I like the fine idea but it would never go over in this country. I have 500k in judgments that people owe to me and I will never recover it. There are MANY people here who know how to work the system and avoid paying anything.

 

[MvM]

Not only can they claim the right to use it they don't have to pay if they don't want to. They have nothing to take and refuse to work. Jobs around here pay 10-15 and hour. welfare with benefits is ~50k a year for doing nothing. The 10-15 dollar an hour jobs usually don't include health insurance BUT if someone has a 10-15 dollar an hour job they are making too much money for Medicaid SO the person quits their job and collects welfare which comes with, free housing, free medical care, free food, heat and electric bills paid, free prescriptions, free cab rides, free, free, free, and it adds up to ~50k a year in free stuff. This is why people don't work. Then they have 5 kids and get even more money BUT because they are not in the work force they are teaching their children NOTHING and cycle continues but now TIMES FIVE!!

That REALLY doens't sound like the way the capitalist system is/was supposed to work I think.

3800$US is what I I pay per 1/4, just got the bill. I like the fine idea but it would never go over in this country. I have 500k in judgments that people owe to me and I will never recover it. There are MANY people here who know how to work the system and avoid paying anything.

I'm beginning to understand why your US system doesn't work.
Of course, there should be a social system for making sure people who are unable to work or who are (temporarily) out of a job should be provided for.
But getting 50K plus benefits for doing nothing all the time is just crazy.

Mind you, of course there are people in the Netherlands also who 'work the system' and do nothing all the time, but normally, if you are unable to work, you get a maximum of 70% of the minimum wages.

 

[BATMANs]

How about have cigarette companies charge extra $$$ to provide smokers' health insurance?

The same applies for anything that has "un natural" health conditions.

That may be good on 2 fronts:

1. offset "regular" insurance rates designed for people with a "healthier" living style/habit

2. Make the cost of cigs so high that it becomes cost prohibitive for a % of the populace to commence or continue smoking.

 

[steveny]

I'm beginning to understand why your US system doesn't work.
Of course, there should be a social system for making sure people who are unable to work or who are (temporarily) out of a job should be provided for.
But getting 50K plus benefits for doing nothing all the time is just crazy.

Mind you, of course there are people in the Netherlands also who 'work the system' and do nothing all the time, but normally, if you are unable to work, you get a maximum of 70% of the minimum wages.

There are few people who can't really work. If you have a drivers license you can work, if you have a cell phone you can work. What you can't do is graduate high school and instantly become a CEO. People refuse to do anything they feel is beneath them. I have a reasonable amount of wealth, on any given day you can find me at Home Depot with ragged out clothes on and paint all over me. Those on welfare think I am a sucker because they are in clean cloths playing video games all day or partying and screwing all day long. These people are costing this country Billions of dollars and giving nothing back.

I would love to do a undercover documentary about this crap over here. I would have loved to tape record the conversation I over heard between two tenants a while back. They were going to move to another city so they could get the relocate fee. With that relocate fee they planned to buy drugs so they could start a distribution in the new city, which according to them up to that point had no distributers. Don't tell me these people are too dumb to work. They just want the money from the drugs and from welfare. The crazy thing is none of them have anything. Where does all the money go???

OR the guy who was laughing his ass off as he described how he faked claustrophobia so he could get disability. He faked a freak out when the social worker closed the door to her office. Now he get 1k a month free health care, food stamps, rent, etc for the rest of his life. Friggen loser.

 

[steveny]

2. Make the cost of cigs so high that it becomes cost prohibitive for a % of the populace to commence or continue smoking.

Smoking is really a habit mostly found amongst the poor. If ciggs get too expensive the stores will stop sell them because of theft. IMO I think they should just outlaw them and be done with it. Make it hard to get most people will quit. Someone smoking on the street, arrested.

I think all the cigg companies should have to pay the cost to help people quit.

 

[Tom239]

When I was in my 20's I feel off a roof and landed on a handrail then flipped over the handrail and dropped another 15 feet onto concrete steps. I went to the hospital and I paid the entire bill out of my pocket. Other young people could do the same but they don't. They get the service then never pay for it, ruin their credit, then think the system has SCREWED THEM, then they give up and collect public assistance.

Steve,

I take all of your points, but I want to add that if someone pays their own hospital bill today they usually get roundly screwed. Hospitals routinely charge self-pay patients a lot more than they accept from insurance (that has the negotiating power of a group). Some will say this is fair (the hospital is free to charge whatever they want, and you're free to not use their services) but the end result is twisted.

 

[steveny]

Steve,

I take all of your points, but I want to add that if someone pays their own hospital bill today they usually get roundly screwed. Hospitals routinely charge self-pay patients a lot more than they accept from insurance (that has the negotiating power of a group). Some will say this is fair (the hospital is free to charge whatever they want, and you're free to not use their services) but the end result is twisted.

Cost of service 10k

10 people use, 10 people pay 1k each

10 people use, 1 person pays 10k

That is how the system currently works not just for health care but all services.

People steal from a store shrinkage is added and prices increase.

people don't pay their credit card bills rates go up for all those who do.

it's how the whole system works and it's wrong. The biggest problem is the people who don't pay still get to have pride, LOL what a joke. They should put their names on the front page of the paper and embarrass them until they get a damn job.

 

[Tom239]

Cost of service 10k

10 people use, 10 people pay 1k each

10 people use, 1 person pays 10k

That is how the system currently works not just for health care but all services.

That's only half the story. Even providers with no collection issues still charge the self-pay customers more. Plenty of pharmacies, who won't hand you the prescription unless you hand them the cash, charge self-pay customers more than the insured.

Add to this the opaque-by-design nature of many medical offices. A conversation I had with a doctor's office about two years ago:

office: Self-pay patients have to put a $300 deposit down before the doctor will see you.

me: How much does a consultation cost?

office: I don't know.

me: I can't do business with you then.

 

[steveny]

That's only half the story. Even providers with no collection issues still charge the self-pay customers more. Plenty of pharmacies, who won't hand you the prescription unless you hand them the cash, charge self-pay customers more than the insured.

Add to this the opaque-by-design nature of many medical offices. A conversation I had with a doctor's office about two years ago:

office: Self-pay patients have to put a $300 deposit down before the doctor will see you.

me: How much does a consultation cost?

office: I don't know.

me: I can't do business with you then.

Sure I know someone who needed a shot in his back. It took him a month, in pain, to get the cost of the shot out of the provider. If he had shopped around it may have been cheaper but at that point he was in so much pain he couldn't shop around. You know what he did? He quit working and went on public assistance and got the shot with-in a week because he couldn't afford the cost of the shot out of pocket.

 

[BATMANs]

..... I have a reasonable amount of wealth, on any given day you can find me at Home Depot with ragged out clothes on and paint all over me. ......

This is a very common scene in the SF Bay Area.

You can sit or stand next to some guy dressed in ragged attire worth gazillions.

perhaps that's why we like to wear jeans to work in a White collar setting everyday.

East Coast - suits everyday.

 

[steveny]

Can someone on here please chime in and tell us you have 3 to 4 kids and pay your own insurance??

.......

 

[Tom239]

Sure I know someone who needed a shot in his back. It took him a month, in pain, to get the cost of the shot out of the provider. If he had shopped around it may have been cheaper but at that point he was in so much pain he couldn't shop around. You know what he did? He quit working and went on public assistance and got the shot with-in a week because he couldn't afford the cost of the shot out of pocket.

I didn't have to shop around, and I wasn't trying to nickle-and-dime the office that I walked away from. It's just a matter of principle. Why should doctors give us the kind of runaround we would never put up with from any other professional?

I got more straightforward, fair service from the guys who pumped my septic tank than I get from the typical doctor's office.

I also wanna say that dentists are an exception in the medical business. Most dentists I've dealt with were up-front guys.

 

[steveny]

I didn't have to shop around, and I wasn't trying to nickle-and-dime the office that I walked away from. It's just a matter of principle. Why should doctors give us the kind of runaround we would never put up with from any other professional?

I got more straightforward, fair service from the guys who pumped my septic tank than I get from the typical doctor's office.

I also wanna say that dentists are an exception in the medical business. Most dentists I've dealt with were up-front guys.

The thing is the doctors don't know what the procedure costs. I was in for a check up a couple of weeks ago and my doctor and I always get to talking about this or that. I asked her how to fix the current system. She pointed at the computer and said "It would be nice if I could see what this costs you so I could decide what the best approach would be." She went on to say the same about prescription fill too. And she is right. With computers everything and all the prices should be right there. It wouldn't be that hard to do EXCEPT it would make it impossible for the medical system to rip people off. It's not the doctors ripping people off it's the system and those who do the billing.

Even in my business I don't know the rents for apartments I have other people take care of that for me. I keep tight stops in place but if my company was larger someone in the office could easily charge the tenant more than they told me the rent was and then they would pocket the difference. I think a lot of that goes on in the medical world of billing. I bet there are tons of bills that get a 10% to 1,000,000% mark up and all the bill did was cross a desk. There is another guy around here who use to do rental property but he got into medical billing. He quickly stopped doing real estate and now does medical billing only and he makes A LOT more money than he use to with far less headaches.

 

[SilverStone05]

Finally...

Take a few moments and watch these videos...

http://www.youtube.com/watch?v=3WnS96NVlMI

http://www.youtube.com/watch?v=nCInQF12QaY&NR=1

Those videos are so accurate....and so scary.

I'll say it again....God help us.

 

[JonBoy]

I'll say it again....God help us.

I think it would take a flood to fix this country (wipe out most of the population). Honestly, there is such a sense of entitlement without work, reward without risk, and success without sweat that it makes me sick. I'm getting to the point where I'm actually considered "successful" (I call it "blessed") and I give a lot of my money away, of my own free will. The idea of giving more of it away to people that REFUSE to work to get ahead galls me like you wouldn't believe.

I can always move back to Canada, I guess. The system isn't great but I'm positive it'll be better than what is being proposed for here.

 

[steveny]

I think it would take a flood to fix this country (wipe out most of the population). Honestly, there is such a sense of entitlement without work, reward without risk, and success without sweat that it makes me sick. I'm getting to the point where I'm actually considered "successful" (I call it "blessed") and I give a lot of my money away, of my own free will. The idea of giving more of it away to people that REFUSE to work to get ahead galls me like you wouldn't believe.

I can always move back to Canada, I guess. The system isn't great but I'm positive it'll be better than what is being proposed for here.

Have you read Atlas Shrugged?

 

[SilverStone05]

I Honestly, there is such a sense of entitlement without work, reward without risk, and success without sweat that it makes me sick.

When I lost my job out of college, I took a temporary gig selling vacation packages at one of those boiler rooms that sends you free stuff in the mail to get you in. It paid well, but wasn't very glamorous.

I remember interviewing at banks and when people asked where I was working in the meantime, they sometimes laughed at me because I sold vacation packages. Like working and making money was somehow shameful.

 

[nsxotic911]

++++++ to what Sahhtt said.

If he continues to make the same social, political and economic assessments that are mostly in line with mine, my work on Prime is done :smile:

You go g.. guy!:biggrin:

 

[JonBoy]

Have you read Atlas Shrugged?

No (had never heard of it) but I just asked for it for Christmas from my wife. Looks interesting. Thanks!

 

[JonBoy]

When I lost my job out of college, I took a temporary gig selling vacation packages at one of those boiler rooms that sends you free stuff in the mail to get you in. It paid well, but wasn't very glamorous.

I remember interviewing at banks and when people asked where I was working in the meantime, they sometimes laughed at me because I sold vacation packages. Like working and making money was somehow shameful.

I painted houses, worked as a law firm librarian, mowed lawns, and then did engineering internships to get through college and make ends meet. I made $34K for the first three months of my first job out of college, even, and that was pretty embarrassing for a top-10% engineering graduate.

My wife worked temp jobs and even spent a few months working at Tim Horton's (Canadians should know this place) during the NIGHT while pregnant. We've worked our tails off to get where we are and anyone that thinks they deserve what we've earned is sorely mistaken.

 

[Jetpilot3]

I painted houses, worked as a law firm librarian, mowed lawns, and then did engineering internships to get through college and make ends meet. I made $34K for the first three months of my first job out of college, even, and that was pretty embarrassing for a top-10% engineering graduate.

My wife worked temp jobs and even spent a few months working at Tim Horton's (Canadians should know this place) during the NIGHT while pregnant. We've worked our tails off to get where we are and anyone that thinks they deserve what we've earned is sorely mistaken.

I did the same thing while in College...busted my arse to finish college with no student loans. While class mates partied and bought new cars with loans I kept driving my civic that I shared with the girlfriend. I made little to nothing when I finished school but became fortunate due to hard work years after.

Now potentially moving back to Canada it will be a tough go supporting my family on a single income etc. but well worth the hard work in years to come.

Alot of people just aren't willing to work hard and you hear and see it alot when back in Canada.

Its too bad the U.S. Gov't can't model the Canadian Health Care system and start out with a similar one.