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Okay, but are we also going to stop subsidizing treatment for smokers with lung cancer, alcoholics with cirrhosis, and fat people with ... everything?
Yes.chad is an argument I'll accept (though not agree with). But if you start finely parsing which people should be let die for their moral failures, then you're just making disgust-based judgments. There is much more of a public health argument to be made for treating STDs. (The health problems of smokers, drunks, and fatties generally do not impact other people directly.)
(That said, yeah, I also find it galling to pay for treatment for people who have preventable catastrophic health bills.)
Weren't smokers a net cost savings as they died younger and quicker before their medical costs really started escalating in old age?
Smokers and drinkers are also taxed heavily on their vice to discourage consumption and reimburse the state. Are the degenerates and sexual devients paying some sort degeneracy tax? I think their 'tax' had been shame and exclusion from 'polite society' but those taxs were repealed.
I'd like to tax sugar and HFCS to dissuade the fatties and recover some revenue for their care.
What really needs to be taxed is clearly "healthy lifestyles" that allow people to reliably live to 80+.
Free cigarettes at 50?
Unless you're at like 40 BMI.
Heart Attack Grill is a medicare psyop to discount the NPV of future payouts. Insurance companies should go full throttle on this: if youre covered and expected to be a significantly negative coverage incident, you should be offered the choice of premiummaxxing or a hyperindulgence event. Die now, get the a discount of the expected value of your future insurance payouts given as a cash dividend so your loved ones enjoy that bet.
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Presumably the difference would be that the state invests a lot of effort in disincentivising smoking, alcoholism, and obesity. All of those are understood to be important public health issues and the state does what it can to discourage them. There aren't anti-promiscuity campaigns on the same order as anti-smoking campaigns.
One might argue that there are state sexual health campaigns, so safe sex is analogous to moderate drinking, if that counts?
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If we wanted to do it only for public health reasons, we could add some sort of punishment high enough that the recipients arent better off, that would eliminate the fairness concerns.
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The writers of Obamacare were willing to explicitly call out and allow higher insurance premiums for smokers, so to some extent we're already there. I have to solemnly swear I don't use any tobacco products annually at open enrollment, which is easy for me as I never have used. It's politically, but not practically, inconceivable to similarly have to swear I'm not an IV drug user or particularly promiscuous.
On that note I've long wondered whether nicotine pouches are classified as tobacco products.
As I recall they are pretty specific there -- I think something like 5-10 cigars per year was still considered "non-smoker" for life insurance purposes, last I renewed.
Not sure their stance on pouches and vapes nowadays -- but I've heard that the main purpose of the blood/urine test that life insurance providers (sometimes?) do is checking for nicotine so people can't just lie about smoking, so I could imagine some issues there. (do they do tests for health insurance in the US? if not, "non-smoker" is accurate, and there's no tobacco in Zyn, so even "no tobacco products" seems defensible)
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Paying for preventable catastrophic health bills because of stupid behavior is one thing. Yes, there's some moral hazard in giving a skydiver the same life insurance rate as everyone else, but insurance companies actually look at the risks and decide it's only worth charging more if you're an instructor or other high jump-count enthusiast. And the risk of base jumping will make your insurer laugh in your widow's face if she tries to collect.
But what's worse is the skydiver asking his life insurance to pay for his parachute and training on the theory that him dying by jumping without a parachute would cost them more money. This is the prep situation.
And what's even worse than that is the government forcing the insurer to pay for this (and raise costs on everyone else) because the national skydiving federation somehow became a powerful lobby that dictates government policy.
The sane solution, like we use for skydivers irl, is making paying for prep out of pocket a condition of obtaining health insurance at a base rate, just like not smoking or buying your own parachute before jumping.
If they don't, their insurance is void and we saddle them with non-dischargeable medical debt in exchange for their treatment (or we charge city gays with 6-7 figure incomes an actuarially fair rate for their coverage)
And if people can't deal with this, the only answer is "right, first we eliminate the influence of the national skydiving federation and fire any bureaucrat who had dealings with them. As well as any agency who gave federal grants to the "Chutes Over Chicago 501c" that seems creepily obsessed with holding skydiver storytimes at local kindergartens
Isn't that how kidnapping insurance works?
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It's not a matter of life insurance rates, when a motorcyclist riding a crotch rocket smashes into a bridge, the ER docs will stitch him back together. When an associate in inner city crime gets shot in the stomach, the same ER is gonna pull the bullet out and patch him up.
It goes well beyond the world of insurance. And it's long past the point of arguing that we should leave the uninsured victims of motorbike crashes to die on the side of the road.
I don't think you read the post, specifically the end of paragraph 3.
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Yes.chad.
Put people on those Christian healthsharing plans that are allowed to just not cover things they think come from unChristian behavior. These exist and have enough people on them to stay in business; clearly it's doable.
Now obviously I have a much stronger objection to paying for prep than I do for dialysis; I just said sodomy should be punishable by law. But, you know, it's pretty reasonable to tell type II diabetics that they have to pay for their own treatment until they can lose weight.
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