Under an Arizona Plan, Smokers and the Obese Would Pay Medicaid Fee

[boppers]

Source: NYT

"Arizona, like many other states, says it is no longer able to finance its Medicaid program adequately. As part of a plan to cut costs, the state has proposed imposing a $50 fee on childless adults on Medicaid who are either obese or who smoke. In Arizona, almost half of all Medicaid recipients smoke; while the number of obese people is unclear, about one in four Arizonans is overweight, according to the Centers for Disease Control and Prevention. The state’s plan must ultimately be approved by the federal government. Monica Coury, spokeswoman for Arizona’s Medicaid program, discusses."

Read more: http://www.nytimes.com/2011/05/31/us/31questions.html?nl=todaysheadlines&emc=tha24

---

Popcorn time.

[individual rights]

1. I think it is a good idea to encourage people to adopt healthier lifestyles.

[Tx4obama]

5. Encouraging people to be healthy is NOT the same thing as discriminating against them...

and fining people is WRONG.

Hey let's fine ALL the people that use cell phones - why should taxpayers have to pay for their care after they get brain cancer!
:sarcasm:

See, once one group is targeted then there is a slippery slope and ALL people are targets.

[individual rights]

9. Smoking and an unhealthy diet drive up the costs of health care.

If it can be proven that cell phones cause cancer, I would favor a $50 fee for those who refuse to use ear pieces.

[provis99]

14. so does driving a car.

Do you support taxing the health plans of people who drive?

[individual rights]

18. That one is already covered...

Insurance costs are higher for less safe cars.

[provis99]

19. no, we need to charge more for ALL cars.

and heck, the more you drive, the fatter you get, and the more at risk for an accident. Daily commuters should be paying health fees through the roof.

[Tx4obama]

24. Yes, I agree.

Sitting in traffic while commuting to work every day raises the risk of lung cancer due to breathing in air pollution.
ALL drivers should pay an additional fee for health care.

Also, people that partake in sports as a 'hobby': skiing (broken bones), jogging (knee injuries), football/baseball (head injuries), etc.

And, people that eat french fries, butter, sugar, etc. should have to pay extra too. Eat the wrong foods drive up the cost of health care do to heart disease and diabetes.

And and, people that are excessive 'texters' should have to pay an extra fee. TONS of folks are going to need carpel tendon surgery in the future.


If they are going to come after childless obese/smokers then we pretty damn make sure that they target EVERYONE for each and every thing that they do that can cause a medical problem! :)

[saras]

30. It has been - just another issue where America doesn't pay attention

And fees discriminate in favor of the wealthy, so what you're saying is you have no problem with our country changing so that the poor no longer have access to cell phones.

The WHO on cell phones and cancer:
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x4868311

[Courtesy Flush]

13. That's like saying don't charge teens more for auto insurance.

Except the teens get labeled as irresponsible even if they're not. That's not the same as charging more for people who engage in riskier behaviors.

[WatsonT]

43. I assume you are opposed to all "sin" taxes then?

Like those on alcohol and tobacco and the proposed ones for sugary foods?

[SoapBox]

2. For the "obese"...which flabby T.HATERbagger gets to set the limits?

Talk about your over-reaching government!

[BulletproofLandshark]

3. Arizona: Building bridges back to the 19th Century every day n/t

[Sparky 1]

11. ^^^^^ ***** 5-star answer

[LiberalFighter]

4. Just childless?

Why not all obese or smokers at $25?

[boppers]

6. Wow, I missed that on first read.

Maybe having children *makes* people obese/smokers, so it would be unfair? :eyes:

[MaineDem]

12. That doesn't seem legal.

A tax for NOT contributing to over-population, etc???

[Robb]

34. That's actually the only bit that is backed by data. Childless Medicare recipients

...generally cost less than those whith children, especially in the last five years of life: http://aspe.hhs.gov/daltcp/reports/2006/childless.htm

[shanti]

7. ummm

smoke what? :smoke:

[JustABozoOnThisBus]

31. Smoke ANYTHING, you damn hippie!

And get the hell out of Arizona!

:hi:

And get a haircut!

[shanti]

41. hee!

:hi:

[jtuck004]

8. There are lot of risks out there, and it is silly to limit these to just those they can see.

They should build a database of hereditary characteristics, require anyone who gets coverage to offer a sample. Anyone who doesn't fit "the" profile, or who has specific markers, could be identified as a profit center increased risk.

The only reason an insurance company would carve someone out and charge them more is marketing and profit. The rates for the rest of the people they cover HAS to include the risks from people whose risks might be higher, unless you can be SURE that your testing has eliminated all that risk. And it's a GREAT way to deny coverage without all those messy rejection letters...

Where is the data that supports cost-saving, as opposed to the superstitious belief that this group must must cost more - and without that there is no proof of cost-saving. It doesn't not automatically follow that if you have to spend a couple hundred thousand dollars for someone who dies from smoking in their 50's that they would cost more than the person who lives to 70 with the variety of common ailments that simply come with aging. Where's the data?

But this is certainly a good target for profit-mongering - it's like "Hey boss, I thought of a new product for more revenue, and it doesn't cost us anything".

I wonder if we would save more if we started subsidizing the growing of fruits and vegetables instead of beef and corn.

[boppers]

10. "Where is the data that supports cost-saving"?

Are you seriously suggesting that there is no data linking healthcare costs with smoking and/or obesity?

[mntleo2]

16. I would agree with this question ...

...here is some GOOD data as far as smokers for insurance companies: they die quicker and earlier.

As for the obese ...low income people are obese because of poor diet as obesity is a form of malnutrition. If you calculate food stamps per person, this allows around $1.19 per meal ~ and this includes a drink. Tell me what you can cook for that? As it is illegal to allow combining of food stamps unless you are a family receiving them and even then, for a family of three this means around $3.57 per meal, this means that in order to stretch your food dollar, it is important to include a lot of starches and fats in the meal so everyone is able to get full enough to function.

If we really wanted to make Medicaid to work well, we need a better diet and to supplement it better than $1.19 per meal. As for smoking, this is something a lot of poor people do ~ it is not illegal, it is not alcohol or street drugs and it is something that is a pleasure for those with little ~ particularly if they roll their own meaning they buy tobacco in bulk, which costs less than going to a movie and lasts all month.

Although upper classes do not smoke as much, alcoholism and drug abuse happen far more in the upper incomes and is just as bad of a health cost, sometimes worse. But they get away with it and are not incarcerated as much as the poor. So the most people misusing the System by far are the middle and upper classes, not the poor.

Finally low income people pay a WAY higher proportion of their income in taxes so upper income people do not have to and they do not use the Commons as much as upper income people do (including hospitals which are huge revenue takers as well as the roads, parks and the legal system).

Tobacco, which is one of the highest taxed commodities around, is something even tax haters LOVE to tax and raise them more and more every year in legislatures all over the country as well as the US Congress. Much of these tobacco taxes PAY for the health care system and Medicaid (for non-smokers as well). In other words, smokers already pay for their habit, while the upper class drunks and druggies do not and they use the health care system far more.



Just sayin' ...
Cat in Seattle

[jtuck004]

21. Do I need to type slower? You know that's not what I wrote.

What I said is that they have not shown it is cheaper, across all the people insured, to support someone for 20-30 years and into a nursing home than to pay someone else's cost of dying at least 10-15 years earlier, perhaps more. I also suggested that if this wasn't just the latest installment of "let's find a way to be mean to people with little income", that we would look at things that might really make a difference, like giving, say, locally grown fruits and vegetables the vendors of oil (subsidizing their food costs and transportation), corn, and beef get.

What if it is cheaper to shave money off the last few years of the healthy 70 year old's life, instead of preventing people with little income from buying insurance? They could get a Groupon for insurance after that, perhaps. (I would point out that there is data out there to back that up, but I won't. But if someone else wants to Google it themselves, be my guest). Under such a scenario they simply stop payments at 70 - it would save hundreds of millions of dollars spent on the last years of life.

'Cause this is about cost savings - not a knee-jerk beating up on "sinners" or people with little income, right?

There is no data to show that this route would save them MORE money than other approaches, it's all based on assumptions, not genuine comparisons. But what this DOES do is single out a part of the population, which is very likely of lower-income, and deny them care by making them choose between food and health.

How 'bout we get rid of polo players (those horse accidents are terrible), people who drive red cars, people who take their yachts out on the open ocean? Computer network geeks are going to have years of therapy on their backs to treat the curve that develops from configuring routers, network equipment, and the endless reading of documentation. There are all sorts of groups we could single out, and make a case that EACH of those incurs higher costs than other parts of the population.

And they all have one thing in common - most make more money than the people that are the object of this OP.

[kestrel91316]

15. Illegal discrimination: against the CHILDLESS. Fuck those bastards.

".....the state has proposed imposing a $50 fee on CHILDLESS adults on Medicaid who are either obese or who smoke...."

[Uben]

17. When are we gonna tax the skinny alcoholics?

These people have been skating for years! Ha ha! Repubs must have done a study and found out dems are fatter and smoke more.
Personally, I'm in favor of a republican idiot tax. Around a 50% tax rate would be appropriate due to the extreme ignorance.

[RoccoR5955]

20. So by that logic...

People who ride motorcycles, people who climb trees, people, who work in mines, people who make hazardous chemicals, people who drill for oil, people who work at heights, people who don't brush their teeth, and others should also be fined.
Heck, why not just fine people for being plain stupid. It would fill the State's coffers in no time, as it's a known fact that the most abundant substance in the universe is stupidity. And this law is plain stupid.

Why not just raise the tax on the rich? Wouldn't that be easier to prove than prove that someone has smoked a legal substance at any time in their life?

[alp227]

22. they KNOW that banning such activities is unconstitutional,

so this is a discriminatory end-run.

Meanwhile, fiscally obese people still get tax breaks...

[PSPS]

23. This is contrary to the insurance model

You price insurance, which is what Medicaid is, based on the risk of the pool, not the individual. Otherwise, you have selective pricing, just like the private insurance racket does today.

There's nothing wrong with encouraging a healthier lifestyle, but you do this at the pool level, not the individual level.

This is just another nose under the tent to destroy the program.

[Robb]

33. This.

And it is typical GOP "amend the Constitution instead of solve the problem" hatchet thinking.

[24601]

25. Smoking is a choice - so is drinking & unprotected sex. Some obesity

however, has a genetic component rather than simply resulting from over-eating.

[jillan]

26. My daughter, who is on Medicaid, has a weight problem - but it's not because she eats too much

it's because she was born with a chromosome abnormality and she is predisposed to be overweight.
Just like many people with Downs tend to be heavy. It's not her fault.
She is 23, and doesn't have any kids so I imagine this will apply to her.

Just more heartless bullshit from the repukes.

[wordpix]

27. this is the stupidest thing I've ever heard of

These Medicare recipients need education, alternatives, and support groups, not a special fee.

The corporations like MacDonald's and Altria should chip in to help pay for programs.

[mr_smith007]

28. Smoking and Obesity huh...

well that pretty much describes every tea bag Republican in Arizona.

[buckrogers1965]

29. what is obese?

Is a perfectly healthy 300 pound Maori tribesman considered obese? How about an unhealthy white guy with 30 extra pounds all in his gut?

Underweight is even more unhealthy than overweight. Are skinny people going to be fined too?

[Thor_MN]

32. WTF!!! What does being childless have to do with health care costs?

I can see the arguement on smoking and obesity, they affect health. Don't necessarily agree, but I see the connection.

However, can someone explain to me why having children improves your health so much that it counters the nefative effects being overweight and smoking?

[KamaAina]

36. It's politically unpopular to take health care away from the kiddies

even the repukes try to stay clear of that, lest they face an electoral backlash.

So they content themselves with sticking it to the childless. :grr:

[Robb]

40. This part is mere statistics.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=102&topic_id=4868668&mesg_id=4869180

[ItNerd4life]

35. This is no different than taxing cigarettes, alcohol, sugar, etc.

I say go for it. Why should I have to pay more in taxes to help take care of people who won't even take care of themselves?

I will gladly help someone with cancer and other ailments because they drew the short straw. But if people choose
to be unhealthy, then let them pay for it.

[WatsonT]

37. It's weird how many people support extra taxes on cokes and other snack items

to force people to be more healthy, and then get outraged by this sort of law.
Seems like the flip side of the same coin.

[Evergreen Emerald]

38. Meth makes people very skinny n/t

[AndyTiedye]

39. They Would Probably Use Body Mass Index (BMI) to Determine Who is "Obese"

Body mass index makes no distinction between fat and muscle.
It would be grossly unfair o charge more on that basis.

Such a metric is good enough for the CDC because it is somewhat
accurate over large populations, but it is not good enough to
use as a basis to penalize individuals!

Poor people who do manual labor would be doubly likely to be
penalized, since they would be more muscular, so even a healthy
amount of body fat might get them tagged as "obese" if BMI
is the metric.

A more accurate test for obesity would likely cost more than $50.

[LetTimmySmoke]

42. I don't see a problem with this at all.

Do whatever you want, but you have to pay for it.

[WatsonT]

44. Someone somewhere proposed an estate tax to cover medicare/caid expenses

so you pay for what you've used after you no longer need the money.

I'm not sure if I support that but it's an interesting idea.