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

Should medically judged fat people pay higher medical costs?

  • Yes

    Votes: 31 42.5%
  • No

    Votes: 42 57.5%

  • Total voters
    73
I was simultaniously diagnosed with a thyroid problem and T2 diabetes. Once I got my diabetes under control, my thyroid problem went away also.

I was hoping that would be the case for me but my thyroid issue was diagnosed when I was 16. I've been too thin most of my life.

My diabetes is slowly starting to come under control. I'm still taking Metformin twice a day but they added Lantus insulin last month, and now I'm on 30 units of that each night. My sugars are down from the 200s+ to low-mid 100s. I am thrilled!
 
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.

PLOS Medicine: Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

According to that, non smokers of normal weight have the highest lifetime medical care costs due to the fact that they live longer on average than either obese people or smokers. I can see how that would be, but on the other hand, since they live longer, they also pay into the system for a longer time.

I suppose the case could be made that the way to decrease the cost of Medicare would be to encourage people to smoke and over eat. That strategy could reduce the costs of pensions and Social Security as well in the same way.

Is that a strategy you'd advocate?
 
I was hoping that would be the case for me but my thyroid issue was diagnosed when I was 16. I've been too thin most of my life.

My diabetes is slowly starting to come under control. I'm still taking Metformin twice a day but they added Lantus insulin last month, and now I'm on 30 units of that each night. My sugars are down from the 200s+ to low-mid 100s. I am thrilled!


Thin T2 diabetics. Not much of an issue in the US - but its actually pretty common in Europe. Less so these days.

Ive always thought that the most rational therapy for thinner diabetics might be Actos - its an interesting drug in term of mechanism, and will actually have patients literally increase their subcutaneous fat at the expense of their visceral fat.

Again, another drug that actually can directly cause weight gain and obesity, yet is treating a medical condition... which is why we shouldnt base insurance rates on obesity.
 
According to that, non smokers of normal weight have the highest lifetime medical care costs due to the fact that they live longer on average than either obese people or smokers. I can see how that would be, but on the other hand, since they live longer, they also pay into the system for a longer time.

I suppose the case could be made that the way to decrease the cost of Medicare would be to encourage people to smoke and over eat. That strategy could reduce the costs of pensions and Social Security as well in the same way.

Is that a strategy you'd advocate?


Of course not. I'm just pointing out the vagaries of trying to see if things are cost-effective. From a societal view thats concerned only with cost (and dont think that view doesnt exist...cough..teaparty.. cough.) the perfect lifestyle is for someone to be completely healthy and productive up until the point where they retire, and then drop dead of a sudden MI or untreatable cancer.

Ideally, you want to have the healthiest possible population for the longest time possible, and thats why preventative care, which plays a significant role in the ACA, will hopefully have the effect of both driving down long term health care costs AND maintain a healthier population for the least amount of money possible.
 
According to that, non smokers of normal weight have the highest lifetime medical care costs due to the fact that they live longer on average than either obese people or smokers. I can see how that would be, but on the other hand, since they live longer, they also pay into the system for a longer time.

I suppose the case could be made that the way to decrease the cost of Medicare would be to encourage people to smoke and over eat. That strategy could reduce the costs of pensions and Social Security as well in the same way.

Is that a strategy you'd advocate?

How about if we just charge everyone the same and stay out of their personal lives? :mrgreen: Then, none of this is an issue at all except for the whiners who whine because they have to pay a couple of extra dollars a month on their premiums.
 
How about if we just charge everyone the same and stay out of their personal lives? :mrgreen: Then, none of this is an issue at all except for the whiners who whine because they have to pay a couple of extra dollars a month on their premiums.

Thats exactly what I would like to do.

Except that I would have a sin tax on sugar and possibly some other health threatening food sources, and use the revenue from those sin taxes in the insurance pool, so that those who over eat unhealthy food pay for their own increased risk.

It's just the most simple solution.
 
Thats exactly what I would like to do.

Except that I would have a sin tax on sugar and possibly some other health threatening food sources, and use the revenue from those sin taxes in the insurance pool, so that those who over eat unhealthy food pay for their own increased risk.

It's just the most simple solution.

Not me. I'd prefer to just educate people and let them make their own choices. Besides, with the government mismanagement of taxpayer monies, you never know WHERE the money is going to go. AND I want the government to stay out of people's lives and choices.
 
Thats exactly what I would like to do.

Except that I would have a sin tax on sugar and possibly some other health threatening food sources, and use the revenue from those sin taxes in the insurance pool, so that those who over eat unhealthy food pay for their own increased risk.

It's just the most simple solution.

I dont know about a sin tax. That seems to be a little arbitrary... why tax sugar and not, say trans-fats? Or if you do both, do you tax artificial sweeteners?

It seems like a better solution might be NOT to subsidize the primary producer of sugar... corn (as in high fructose corn syrup, or dextrose, or corn sugar).

Take off those subsidies, or maybe transfer them to truck farm vegetable producers, and that may make sense.
 
Of course not. I'm just pointing out the vagaries of trying to see if things are cost-effective. From a societal view thats concerned only with cost (and dont think that view doesnt exist...cough..teaparty.. cough.) the perfect lifestyle is for someone to be completely healthy and productive up until the point where they retire, and then drop dead of a sudden MI or untreatable cancer.

Ideally, you want to have the healthiest possible population for the longest time possible, and thats why preventative care, which plays a significant role in the ACA, will hopefully have the effect of both driving down long term health care costs AND maintain a healthier population for the least amount of money possible.

Exactly, and encouraging a healthy lifestyle is one way to promote the healthiest possible population for the longest time possible.
 
The worst part (and most obvious from within this thread) is the lack of shame and denial by fat Americans. I know it's a real phenomena because I work with grown men and women of all ages and demographics who are a good 40 pounds overweight. When 70% of your workforce is 40 or more pounds overweight what it creates is an "Obesity Fascism" of sorts. Nobody is allowed to really talk about it or even talk about weight because 7 out of 10 employees are medically fat. It's pathetic. They even pretend they're in shape sometimes out of that despicable little consumerist dogma of "individualism" when there's absolutely nothing "individualist" about eating Twinkies from a major corporation every day then passing the tab of your medical bills to everybody else.
 
I say yes for a simple reason: You take more natural resources for ill reasons then you should pay more medical bills for the same ill reasons.
 
The worst part (and most obvious from within this thread) is the lack of shame and denial by fat Americans. I know it's a real phenomena because I work with grown men and women of all ages and demographics who are a good 40 pounds overweight. When 70% of your workforce is 40 or more pounds overweight what it creates is an "Obesity Fascism" of sorts. Nobody is allowed to really talk about it or even talk about weight because 7 out of 10 employees are medically fat. It's pathetic. They even pretend they're in shape sometimes out of that despicable little consumerist dogma of "individualism" when there's absolutely nothing "individualist" about eating Twinkies from a major corporation every day then passing the tab of your medical bills to everybody else.

It swings both ways, though. I'm pretty sure they didn't make a size "00" when I was growing up.

These days, for *whatever* reason, an "average" body type is a rarity.

Or, we've all been brainwashed to the point where no one can accurately describe "average" to begin with. :2razz:
 
It swings both ways, though. I'm pretty sure they didn't make a size "00" when I was growing up.

These days, for *whatever* reason, an "average" body type is a rarity.

Or, we've all been brainwashed to the point where no one can accurately describe "average" to begin with. :2razz:


I'm just sick of hearing fat 30 and 40 year old's walk around claiming "Individual Liberty" while being fat. It's sick and completely contradictory.

It's not individualism if you're weighing down collectively your societies healthcare system by being fat, which you are. These people are simply idiots. I honestly believe that's what most of American conservatism is, simply misguided fat people trying to find a valid excuse for letting themselves go completely.
 
It swings both ways, though. I'm pretty sure they didn't make a size "00" when I was growing up.

These days, for *whatever* reason, an "average" body type is a rarity.

Or, we've all been brainwashed to the point where no one can accurately describe "average" to begin with. :2razz:

If you look at the people playing in the world cup, they mostly have an average body type. So do the members of active cycling clubs, water polo teams, basketball players, avid hikers, long distance runners, and anyone with an active lifestyle.

The human body was not designed to be sedentary.
 
I'm just sick of hearing fat 30 and 40 year old's walk around claiming "Individual Liberty" while being fat. It's sick and completely contradictory.

It's not individualism if you're weighing down collectively your societies healthcare system by being fat, which you are. These people are simply idiots. I honestly believe that's what most of American conservatism is, simply misguided fat people trying to find a valid excuse for letting themselves go completely.

But it is not a valid excuse, its a rationalization.
 
I suspect that part of the reason that so many people are fat an out of shape is that they don't realize how easy or fullfilling it is to be not fat and out of shape. All it takes is a modification of their diet, and a half hour of exercise or so a day, four or five days a week.

Or maybe they don't believe that they can do it, maybe they just think that being in shape is only for "lucky people", just like they think that making a decent living is only for people who are lucky.
 
I suspect that part of the reason that so many people are fat an out of shape is that they don't realize how easy or fullfilling it is to be not fat and out of shape. All it takes is a modification of their diet, and a half hour of exercise or so a day, four or five days a week.

Or maybe they don't believe that they can do it, maybe they just think that being in shape is only for "lucky people", just like they think that making a decent living is only for people who are lucky.

Maybe it depends on how long they have been overweight. I'm betting the older you are, the more difficult it is to lose the weight. Slower metabolism, etc. I read somewhere (not sure how true it is) that women over 40 have to exercise for at least an hour a day just to maintain their current weight.
 
Maybe it depends on how long they have been overweight. I'm betting the older you are, the more difficult it is to lose the weight. Slower metabolism, etc. I read somewhere (not sure how true it is) that women over 40 have to exercise for at least an hour a day just to maintain their current weight.

That's possible.

I will be 50 on my next birthday, but I have managed to lose close to 50 lbs in the last two and a half years. That's a little less than a half lb a week, but I haven't exactly starved myself doing it, and I certainly don't spend hours in the gym every day. Matter of fact, up until about a month ago, I just exercised at home.
 
I'm just sick of hearing fat 30 and 40 year old's walk around claiming "Individual Liberty" while being fat. It's sick and completely contradictory.

It's not individualism if you're weighing down collectively your societies healthcare system by being fat, which you are. These people are simply idiots. I honestly believe that's what most of American conservatism is, simply misguided fat people trying to find a valid excuse for letting themselves go completely.

Well the collective crap is the problem. Not all people share the same body type but a collectivist thinker can't wrap his/her head around that one. But hey you want collectivism then make it fair. They went after smokers and made them pay more so add the fat people. Why not those who use legal drugs that compromise their health? Better charge them more too. How about adding those with lousy driving records that look like an accident waiting to happen? Yep they should pay more. What about people who sit at a damn computer all day as study after study show this puts people at all kinds of health risks? Better add their sorry asses too.
 
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Well the collective crap is the problem. Not all people share the same body type but a collectivist thinker can't wrap his/her head around that one. But hey you want collectivism then make it fair. They went after smokers and made them pay more so add the fat people. Why not those who use legal drugs that compromise their health? Better charge them more too. How about adding those with lousy driving records that look like an accident waiting to happen? Yep they should pay more. What about people who sit at a damn computer all day as study after study show this puts people at all kinds of health risks? Better add their sorry asses too.


Fatness is easy though. It's easy for any medical professional to diagnose you as medically fat. It is not "up in the air whether you're medically fat". You either are or you aren't.


It's also the culture of fatness that revolts me. It's important that a society can say someone's fat. Fat people not being able to be called fat is a bad thing for those people. It's bad for their children. It's bad for their friends. All because nobody can speak honestly with them. I would even argue that one reason we have so much PC nonsense in America is because most adult Americans are fat. If we can't as a society even admit to being fat asses, what hope can we admit to anything else?
 
That's possible.

I will be 50 on my next birthday, but I have managed to lose close to 50 lbs in the last two and a half years. That's a little less than a half lb a week, but I haven't exactly starved myself doing it, and I certainly don't spend hours in the gym every day. Matter of fact, up until about a month ago, I just exercised at home.

Congratulations on your weight loss. :) You aren't supposed to starve yourself, just to eat in moderation.

I wasn't saying it isn't possible with hard work and motivation; I just think it is more difficult as a person ages and his or her metabolism is slower.
 
Fatness is easy though. It's easy for any medical professional to diagnose you as medically fat. It is not "up in the air whether you're medically fat". You either are or you aren't.


It's also the culture of fatness that revolts me. It's important that a society can say someone's fat. Fat people not being able to be called fat is a bad thing for those people. It's bad for their children. It's bad for their friends. All because nobody can speak honestly with them. I would even argue that one reason we have so much PC nonsense in America is because most adult Americans are fat. If we can't as a society even admit to being fat asses, what hope can we admit to anything else?

Yeah well there are different levels of "fat" too. :lol: Some people are just chubby whereas others are ginormous!
 
Well the collective crap is the problem. Not all people share the same body type but a collectivist thinker can't wrap his/her head around that one. But hey you want collectivism then make it fair. They went after smokers and made them pay more so add the fat people. Why not those who use legal drugs that compromise their health? Better charge them more too. How about adding those with lousy driving records that look like an accident waiting to happen? Yep they should pay more. What about people who sit at a damn computer all day as study after study show this puts people at all kinds of health risks? Better add their sorry asses too.

This is my point exactly. Where does it end? There are all kinds of things that people might do that are going to be unhealthy or risky.
 
Fatness is easy though. It's easy for any medical professional to diagnose you as medically fat. It is not "up in the air whether you're medically fat". You either are or you aren't.


It's also the culture of fatness that revolts me. It's important that a society can say someone's fat. Fat people not being able to be called fat is a bad thing for those people. It's bad for their children. It's bad for their friends. All because nobody can speak honestly with them. I would even argue that one reason we have so much PC nonsense in America is because most adult Americans are fat. If we can't as a society even admit to being fat asses, what hope can we admit to anything else?

Basically you are saying that if the results of their unhealthy choices are obvious, then they should be targeted to pay more and if you can hide your bad habits because there is no real physical evidence on the outside you shouldn't have to pay more. Because you find fatness to be revolting isn't a good enough excuse to target them over increase medical premiums without holding everyone else to the same standards. There isn't one of us who is void of a habit that may result in poor health. Hate is a pretty strong emotion that many are prone to and it can cause hypertension and heart disease. Maybe those who hate should pay higher premiums.
 
Fatness is easy though. It's easy for any medical professional to diagnose you as medically fat. It is not "up in the air whether you're medically fat". You either are or you aren't...

What is the medical standard metric for determining that?
 
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