This is going to make me sound like a callous a-hole

[Reggie]

I know the government shutdown should not be about the Affordable Care Act, but they are making it about that. It's all unfortunate, but I can't help but think about the ACA and how unfair it seems to me.

I realize that everyone wants healthcare and they all want it to be cheap, but is that even fair? I spend my life watching what I eat, exercising six days a week, maintaining my mental health (as much as possible), not smoking, seldom drinking, etc. The majority of our country is overweight. The biggest killer of our nation is heart disease. The strong and healthy are now supplementing the sick and weak. If it were an army, we would be doomed.

It's like all of the people who sat on the couch eating donuts get rewarded and all of the health nuts who pass on the cheesecake and get up for their morning run whether they feel like it or not, get to pay out the nose.

Of course there are exceptions, hereditary cancers and other diseases. But even many of the cancer patients are better off with a healthy diet and exercise.

Just seems like a few people sacrifice to build up a stockpile and those who didn't, get to come and raid it.

I am thankful for my health, but it doesn't get dropped in my lap. I really work hard for it. I should realize that it is it's own reward and leave it at that.

Would we allow everyone to pay the same amount for car insurance regardless of how reckless they drive?

[disneysteve]

I realize that everyone wants healthcare and they all want it to be cheap, but is that even fair? I spend my life watching what I eat, exercising six days a week, maintaining my mental health (as much as possible), not smoking, seldom drinking, etc. The majority of our country is overweight. The biggest killer of our nation is heart disease.

Would we allow everyone to pay the same amount for car insurance regardless of how reckless they drive?

Excellent point. Auto insurance is based on your driving record. Life insurance is based on your health status and risk. Even homeowners insurance is rated on various risk factors. But health insurance is the same for everyone on the plan. I have to get weighed and measured, drug tested, and blood tested before getting life insurance. Why not do the same thing for health insurance. If you smoke, higher rates. If your cholesterol is high, higher rates, if you use drugs, higher rates, if you are overweight, higher rates.

There have been many successful programs where patients were incentivized to take better care of themselves. When you impact people in the wallet, it makes a difference.

[hamchan]

Well, my husband walks to and from work every day. He goes to the gym six days a week and spends at least an hour. He carefully watches his diet, his blood pressure, his weight, his glucose levels. He does everything his doctor asks him to and then some, but he still needs a kidney transplant if he has any shot of making it for a few more years. He is blind and deals with bone infections in his feet that start out as a small blister or pressure wound. His sister is in the exact same boat. How is that fair? How is it fair that we both work our asses off and make good incomes but still have to worry about making ends meet, and have little left over to save, let alone ever be able to buy a home, or take even the least expensive vacation? Does that seem fair to you?

Or how about my mom and dad, who are 58 and 61. They don't eat out. They grow as much of their own food as they can. They put in hours every day of hard physical labor, and maintain healthy weights. But my dad has heart problems that are genetic, and my mom has had skin cancer three or four times because she grew up on a farm in Kentucky and sun screen wasn't even a thing. The risk wasn't even known. Even if it had been, they couldn't afford it. But because they have seen their incomes drop dramatically in the last decade they now cannot afford to buy health insurance at the $1000 or so a month it would cost them for a bare bones policy. How is that fair?

How is it fair that insurance companies reap record profits while dropping the policies of those who get sick after faithfully paying their premiums for years on end? Or refusing to cover some people at all? Is that fair?

[JoeP]

People want to be treated regardless of their habits, genetics, or ability to pay.

Some say that as the richest country on the planet, it is inhumane to feed the military machine and then withhold treatment from the poor just because they cannot afford it, while those with insurance or other means to pay the bills (i.e., the "rich") are allowed to get treatment. It goes further: how much is society obligated to subsidize the health care needs of people with very expensive health situations, or those who knowingly engage in dangerous activities?

Problem is, the ACA or ObamaCare as it is affectionately referred, will increase demand for medical treatment. And we all know what happens with increased demand.

[Nika]

You are paying for it one way or the other. Same applies for overweight co-workers. They drive up your company's rates which is divided equally among all employees. Where is outrage about that?

And who do you think should pay for a heart attack or appendix removal of a minimum wage Papa John's worker?

Currently, it is either the state, or the hospital has to eat the cost when that patient does not pay and declares bankruptcy.

Do you think that a worker who cannot afford a health insurance premium, will be able to pay that medical bill? really?

So affordable care act will increase, according to Papa John's most outraged high estimates, the cost of their pizza by 25c.

That is outrageous. The part that the local hospital has to never see any money for care it provides, does not seem as outrageous. )Besides, would 25c affect the number of pizza's sold? really? As if those customers are all have those kind of margins, self control and order that pizza while completely sober.)

Having state pay for minimum wage worker's health insurance is a part of business model of many giant corporations. We as taxpayers are heavily subsidizing companies like Wallmart by providing huge percentage of their workforce with state health insurance. Managers give out info to new workers on how to qualify and how to apply.

Taxpayers are already paying for it! Now, requiring everyone to carry insurance is shifting a small percentage of that cost from taxpayer/medical institution to the business and individual is getting a huge push back from business interests.

[ua_guy]

Healthcare was unfair before the Affordable Care Act, and the Act isn't understood by drawing simple comparisons between health insurance and other lines of insurance. Healthcare is a right in this country, and if you don't believe me, please do some reading on EMTALA. Bonus points if anyone can tell me WHO enacted that law. Which party and political ideology did he represent?

Also, people ridiculously take away or overlook due blame on the health insurance industry which is largely private. If you're mad that you pay the same premiums as your fat coworker who smokes and eats candy all day long, go piss on United Healthcare's front door, or maybe Cigna. Not all the rates and reimbursement are regulated by the federal government.

[Petunia 100]

It seems you are assuming people who can afford health insurance can do so because they have healthy habits. Is that really true? Doesn't money come in there someplace? Aren't there healthy people with healthy habits who cannot afford to pay for health insurance? Aren't there unhealthy people with unhealthy habits who do have health insurance?

You are fortunate to enjoy good health. Yes, some people have poor health due to their own poor choices. Other people have poor health through no fault of their own.

[stoney508]

I have a problem with what some of you are saying about how there should be increase in health insurance for being considered obese. Now I am addmitantly not in my best shape for reasons I dont believe I need to share. But going back to my point is when I was in shape my BMI states that I should be between 180-190lbs. Now I was at 245lbs when I was at my best that is because I worked out and was an athlete in HS where it was good to be heavy (lineman) I was in very good shape working out 3 days a week weight lifting for 2+ hours and 2 nights a week did foot work and sprints or core work now by all the insurance would go off is my BMI I had those elector testers that put me at 17-18 percent which is alright not the best but not unhealthy at all the BMI test would state that I was obese or overweight. In all your eyes that means a healthy person should have there health insurance increased becausae that is what I am clasified on my medical records. My genetics gave me a predisposition to be heavier as well as run an even greater chance to be overweight. I do not believe I would be able to get under but probably between 205-225 without drastically reducing my muscle mass which I would never do. And to get under that weight I would probably have to log on average 5-6 hours a day 5-7 days a week and I would have no life at all, just so I could reach a bmi were my health provider would not raise my rates.

[disneysteve]

And to get under that weight I would probably have to log on average 5-6 hours a day 5-7 days a week and I would have no life at all, just so I could reach a bmi were my health provider would not raise my rates.

I'm curious. Do you have life insurance? Do you know if your weight was a factor in the rate you pay for that insurance?

I know every time I've applied for life insurance, including just a few months ago, part of the evaluation was taking my height and weight. I assume that the reason for doing that was to rank my risk. I weigh 165 but if I weighed 265 I imagine my rate would be a lot higher, if they would have written a policy for me at all.

[hamchan]

It seems you are assuming people who can afford health insurance can do so because they have healthy habits. Is that really true? Doesn't money come in there someplace? Aren't there healthy people with healthy habits who cannot afford to pay for health insurance? Aren't there unhealthy people with unhealthy habits who do have health insurance?

This.

[stoney508]

I'm curious. Do you have life insurance? Do you know if your weight was a factor in the rate you pay for that insurance?

I know every time I've applied for life insurance, including just a few months ago, part of the evaluation was taking my height and weight. I assume that the reason for doing that was to rank my risk. I weigh 165 but if I weighed 265 I imagine my rate would be a lot higher, if they would have written a policy for me at all.

I have some life insurance that my mother purchased for me at birth that because she kept funding it I believe is up to 60k. I believe I also have life insurance through my work but I maybe mistaken.

I am almost certain as of this date I would be a walking calamity to any life insurance company I were to walk into. I am 26 but have been on high blood pressure meds, have sleep apnea, as well as a form of insomnia, diabetes runs in my family (dad just diagnosed) im sure I ran into depression/anxiety (undiagnosed) smoke, and drink (maybe go out once a month and drink a 6 pack from time to time). All are treatable without medication and with the first thing losing weight. I believe my sleep apnea could be relieved a little if my tonsils were taken out because they are a little enlarged and I suffer from cronic sinus infections which kinda prevents me from ever going in with strep because I catch the sinus infections early and by the time I get strep im already on meds and it clears up.

My weight was much higher I was around 305 when very depressed but got done to 245 around a year ago and now im back up to I would say 260-280 havent stepped on a scale but im also not gaining more weight. I will be moving out on my own quiting smoking moving in with someone that wants to actually change there lifestyle for the better unlike the situation im in right now (long story).

But I know I will be fighting an uphill battle if it comes to life insurance. I will always have sleep apnea because my neck is 18"+ and my sleep doctor has admitted that I will probably never have a smaller neck even if I lost weight. BMI is not the best way to tell a persons health but it is the benchmark for a doctors as well as I am assuming insurance companies assesment on how healthy they are.

I mean to this date even with being overweight I could run 5 miles without stopping I wouldnt be fast but I could. Is this a measure of how healthy I am not at all but if someone looked on my medical charts and saw I was obese do you think they would believe me if I said this?

[disneysteve]

Aren't there healthy people with healthy habits who cannot afford to pay for health insurance? Aren't there unhealthy people with unhealthy habits who do have health insurance?

Absolutely. Whether or not you have health insurance isn't based on your health or your habits. For most people, it is based on your employer and how good and affordable of a plan they offer. That's the problem that the ACA is trying to fix.

How many people are stuck in dead end jobs because if they leave the job, they lose their insurance?

How many people remain out of work just so they continue to qualify for Medicaid?

How many people are uninsured because of a pre-existing condition making it unaffordable or even impossible to get coverage even if they have the means to pay for it?

The system is broken for sure.

[cardtrick]

The real problem that no one is addressing is the shortage of doctors. The reason they make so much money is because there aren't enough of them. It would cost far less for the government to open up a bunch of med schools all over the country or let more doctors immigrate.

On the one hand, it is unfair that with the new law, healthy people will be subsidizing insurance for the unhealthy. Most of the costs of healthcare come from bad lifestyle choices. But then, you have plenty of situations where people have done the right things all their lives and still get sick.

[disneysteve]

The real problem that no one is addressing is the shortage of doctors. The reason they make so much money

The first sentence is true. I only wish the second sentence were also true.

[hamchan]

On the one hand, it is unfair that with the new law, healthy people will be subsidizing insurance for the unhealthy. Most of the costs of healthcare come from bad lifestyle choices. But then, you have plenty of situations where people have done the right things all their lives and still get sick.

Actually the bulk of our healthcare costs come from the elderly. The longer you live the more your medical care costs.