View Poll Results: Should medically judged fat people pay higher medical costs?

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  • Yes

    48 52.75%
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    43 47.25%
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Thread: Should medically judged fat people pay higher medical costs? [W:87]

  1. #441
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by Dittohead not! View Post
    Yes, but Medicare is not free. There is a charge to be on Medicare. So, the question remains: Should obese people pay more for their Medicare than those of normal weight? Currently, they don't, but do use more health services.
    I think thats a bad assumption.

    Do Obese people use more health services? I'm not sure about that.

    I see lots of emaciated people with pretty severe health problems. In fact, if you look at long term health figures, being overweight generally leads to greater health and less medical expenditure than being underweight. So do we charge the underweight too? Should models be surcharged for insurance?

    The question is...how do you know someone is obese thru bad lifestyle or thru bad genes or thru disease? Some patients have thyroid issues that lead to obesity. Some people have need for medications that can cause obesity (antipsychotics, for example). Some patients probably have gut flora that is wrong and leads to obesity - this is a pretty promising angle in modern obesity science.

    Obesity tends to skew toward the more healthy people, to be honest, except for T2 Diabetes - and frankly, most of the type 2 diabetes patients cannot reduce their weight - they would not be "medically judged" to be able to lose weight. Its really hard to do that when you have a massive amount of insulin in your system from diabetes, which is an anabolic hormone, and the treatment for it is.. give more of this hormone that makes you gain weight.

    Heart failure paitents are often obese.. but I've diuresed 40 lbs of water off some of those.. so I'm not sure we can classify them as "medically judged" obese.
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  2. #442
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by imagep View Post
    What do we do when the medicare reciepient can't afford to pay a higher rate? Do we then just let them die?

    And the weight that they have gained is often accumulated over decades, it didn't just happen the day they turned old enough to qualify for medicare. If we more heavily taxed sugar and foods with excess fat in them we are killing two birds with one stone. the first is that we are disincentizing the types of products that heavily contribute to us becoming fat. the second is that we are raising revenue to pay for the results of their food (or smoking) sins.

    We could charge everyone the same (low) rate for insurance, and then just subsidize the cost of insuring fatties and smokers out of the sin taxes that they paid in. Seems pretty straightforward to me, especially when we are talking about government paid for heathcare (Medicare/Medicade/etc).
    Alternatively and more easily, we could Tax Wholesale Sugar and Corn/Corn-sweeteners.

    Instead, and not coincidentally, we Subsidize Both!
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  3. #443
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by Threegoofs View Post
    I think thats a bad assumption.
    Do Obese people use more health services? I'm not sure about that.

    I see lots of emaciated people with pretty severe health problems. In fact, if you look at long term health figures, being overweight generally leads to greater health and less medical expenditure than being underweight. So do we charge the underweight too? Should models be surcharged for insurance?

    The question is...how do you know someone is obese thru bad lifestyle or thru bad genes or thru disease? Some patients have thyroid issues that lead to obesity. Some people have need for medications that can cause obesity (antipsychotics, for example). Some patients probably have gut flora that is wrong and leads to obesity - this is a pretty promising angle in modern obesity science.

    Obesity tends to skew toward the more healthy people, to be honest, except for T2 Diabetes - and frankly, most of the type 2 diabetes patients cannot reduce their weight - they would not be "medically judged" to be able to lose weight. Its really hard to do that when you have a massive amount of insulin in your system from diabetes, which is an anabolic hormone, and the treatment for it is.. give more of this hormone that makes you gain weight.
    Heart failure paitents are often obese.. but I've diuresed 40 lbs of water off some of those.. so I'm not sure we can classify them as "medically judged" obese.
    Along that same line...

    Everyone dies of something.
    Is it better, Strictly from a financial/mercenary point of view, to have then die at 55 or 95?

    Who costs the system more?
    A smoker who dies at 55 from Lung Cancer after having paid into the (Medcare/SS) system for 30 years and withdrawing nothing..
    Or the 95 Year old whose been Nailing the system from Many chronic conditions of old age for 30 years.. and finally dies of.. Lung Cancer.. too.
    Last edited by mbig; 07-03-14 at 01:21 AM.
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by mbig View Post
    Along that same line...

    Everyone dies of something.
    Is it better, Strictly from a financial/mercenary point of view, to have then die at 55 or 95?

    Who costs the system more?
    A smoker who dies at 55 from Lung Cancer after having paid into the (Medcare/SS) system for 30 years and withdrawing nothing..
    Or the 95 Year old whose been Nailing the system from Many chronic conditions of old age for 30 years.. and finally dies of.. Lung Cancer.. too.
    That's true. We keep people alive much longer than they probably should be with procedures and medications. I don't know how some patients can keep all their medications straight because they are on so many!!

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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by mbig View Post
    Along that same line...

    Everyone dies of something.
    Is it better, Strictly from a financial/mercenary point of view, to have then die at 55 or 95?

    Who costs the system more?
    A smoker who dies at 55 from Lung Cancer after having paid into the (Medcare/SS) system for 30 years and withdrawing nothing..
    Or the 95 Year old whose been Nailing the system from Many chronic conditions of old age for 30 years.. and finally dies of.. Lung Cancer.. too.
    That reminds me of a landmark cost effectiveness analysis done in the New England Journal of Medicine in about 1993, It clearly showed that stopping tobacco use would lead to much higher health care costs in the US, because with all the money you save in cardiovascular and respiratory diseases, you saved because smokers tended to die before Medicare age of functionally uncurable non-small cell lung cancer, which wasnt treatable back then - meaning a very quick, very cheap death with a tremendous amount of savings to the Medicare system.

    I bring that paper out every time someone gives me a lecture on how this intervention or that intervention will save money.
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  6. #446
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by Threegoofs View Post
    I think thats a bad assumption.

    Do Obese people use more health services? I'm not sure about that.

    I see lots of emaciated people with pretty severe health problems. In fact, if you look at long term health figures, being overweight generally leads to greater health and less medical expenditure than being underweight. So do we charge the underweight too? Should models be surcharged for insurance?

    The question is...how do you know someone is obese thru bad lifestyle or thru bad genes or thru disease? Some patients have thyroid issues that lead to obesity. Some people have need for medications that can cause obesity (antipsychotics, for example). Some patients probably have gut flora that is wrong and leads to obesity - this is a pretty promising angle in modern obesity science.

    Obesity tends to skew toward the more healthy people, to be honest, except for T2 Diabetes - and frankly, most of the type 2 diabetes patients cannot reduce their weight - they would not be "medically judged" to be able to lose weight. Its really hard to do that when you have a massive amount of insulin in your system from diabetes, which is an anabolic hormone, and the treatment for it is.. give more of this hormone that makes you gain weight.

    Heart failure paitents are often obese.. but I've diuresed 40 lbs of water off some of those.. so I'm not sure we can classify them as "medically judged" obese.
    It is intuitive that obese and overweight people will cost more for health care, but perhaps that isn't true at all, so I typed the question into my search engine and came up with this from Time Online:

    Between 2001 and 2006, average health care expenditure for normal weight people increased from $2,607 to $3,315—a 27% gain.
    For overweight people, the average cost rose from $2,792 to $3,636—an increase of 30%.
    And for obese people, the average amount paid increased from $3,458 to $5,148—a gain of 49%.
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  7. #447
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by imagep View Post
    You dont think that it would be considered invasive to have to take drug tests for your insurance company? And doesn't that add to the cost of healthcare? And how would someone who exercises in their home verify that they exercised?
    No because its voluntary. Everyone is free to pass on any or all of the rebates if they want. Plus, your hospital/doctor knows pretty much everything medical about you anyway.

    I understand its hard sometimes to think differently when something has been done one way for so long but Smeagolcare does not involve health insurance and by extention, health insurance companies. Under Smeagolcare its a direct membership with the hospital similar to joining a gym for a flat monthly fee. Your insurance company will not know your drug test results because you won't have nor will you need health insurance. That's aspect alone will emilinate a middle man and reduce costs. Not needing to provide drug rehab services to patients is less expensive than drug tests.

    I'm not sure about verifying working out at home. With going to a gym there's a check in/check out procedure and even some equipment has docking stations where you can plug in your smart phone to monitor your own work out stats. I know with some smart phone apps you can send your heart rate, etc. to the phone. Technology can work it out I'm sure.
    Last edited by Smeagol; 07-03-14 at 09:05 AM.
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by Dittohead not! View Post
    It is intuitive that obese and overweight people will cost more for health care, but perhaps that isn't true at all, so I typed the question into my search engine and came up with this from Time Online:
    Yes- but you have to control for the fact that some medical conditions actually CAUSE obesity, which confounds that calculation.

    Overall, obesity seems to be less of a driver of medical costs than one might think.

    http://journals.plos.org/plosmedicin...l.pmed.0050029
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  9. #449
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by Threegoofs View Post
    I think thats a bad assumption.

    Do Obese people use more health services? I'm not sure about that.

    I see lots of emaciated people with pretty severe health problems. In fact, if you look at long term health figures, being overweight generally leads to greater health and less medical expenditure than being underweight. So do we charge the underweight too? Should models be surcharged for insurance?

    The question is...how do you know someone is obese thru bad lifestyle or thru bad genes or thru disease? Some patients have thyroid issues that lead to obesity. Some people have need for medications that can cause obesity (antipsychotics, for example). Some patients probably have gut flora that is wrong and leads to obesity - this is a pretty promising angle in modern obesity science.

    Obesity tends to skew toward the more healthy people, to be honest, except for T2 Diabetes - and frankly, most of the type 2 diabetes patients cannot reduce their weight - they would not be "medically judged" to be able to lose weight. Its really hard to do that when you have a massive amount of insulin in your system from diabetes, which is an anabolic hormone, and the treatment for it is.. give more of this hormone that makes you gain weight.

    Heart failure paitents are often obese.. but I've diuresed 40 lbs of water off some of those.. so I'm not sure we can classify them as "medically judged" obese.
    I started Lantus last month for my T2 diabetes. One of the side affects is that it brings on weight gain. In my case that isn't a big deal as my thyroid problems have kept me defined as "underweight" for almost my entire life, but most people aren't like me.

  10. #450
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    Re: Should medically judged fat people pay higher medical costs? [W:87]

    Quote Originally Posted by tres borrachos View Post
    I started Lantus last month for my T2 diabetes. One of the side affects is that it brings on weight gain. In my case that isn't a big deal as my thyroid problems have kept me defined as "underweight" for almost my entire life, but most people aren't like me.
    I was simultaniously diagnosed with a thyroid problem and T2 diabetes. Once I got my diabetes under control, my thyroid problem went away also.
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