Deny Healthcare To Intentionally Destructive Lifestyles?

[Pugmire]

In USA, many opponents of nationalized healthcare say it’s a bad idea because alcoholics, smokers, obese people etc. will drive up demand and thus decrease the quality and increase the price (taxes) of healthcare for everyone. But if we apply the same logic that life insurance companies use to provide coverage, we see these problems are circumvented by a vetting process. People who are at high risk of death or who seemingly do not want to live are not approved.

So an easy way to keep costs down and quality up is to simply deny service to those who lead intentionally destructive lifestyles. A doctor could put patients who choose to maintain unhealthy habits (smoking, overeating to extremes, etc.) on a probationary period, and if no improvement is made within the allotted time, refer them to a private doctor. Can’t afford the private doctor? Shouldn’t have spent all your money on Big Macs and/or Marlboros and you wouldn’t need a private doctor anyway.

Of course the specifics of how to implement related policy would need to be very carefully thought out but I think the basic idea is sound, and hammering out ideas is what discussions are for anyway. So, yay or nay?

[Bezombia]

The problem is eventually you'll get to the point where "intentionally destructive lifestyle" comes to include such things as "driving high-emissions vehicles," "eating vegan," or "voting independent".

[Bogdanov Vishniac]

Terrible idea. Making doctors become the calorie police is a waste of time and money for everyone. Far better idea would be to provide free smoking cessation aides and subsidize gyms/physical therapy and subsidize healthy food like vegetables so more people can access and afford to make positive lifestyle changes.

[Neutraligon]

Who gets to decide what is intentionally destructive?

[Pugmire]

The problem is eventually you'll get to the point where "intentionally destructive lifestyle" comes to include such things as "driving high-emissions vehicles," "eating vegan," or "voting independent".

So basically, "we shouldn't legislate anything because eventually somebody will subvert the original intention"? Seems like an anarchist sentiment.

[Luziyca]

Who gets to decide what is intentionally destructive?

Exactly. I don't want the Tories to deny healthcare to those who criticize the government.

[Bezombia]

The problem is eventually you'll get to the point where "intentionally destructive lifestyle" comes to include such things as "driving high-emissions vehicles," "eating vegan," or "voting independent".

So basically, "we shouldn't legislate anything because eventually somebody will subvert the original intention"? Seems like an anarchist sentiment.

Thanks for shoving words in my mouth. I'm saying that it's dangerous to turn the state into an authority on morals, rather than just preventing harm.

[Pugmire]

So basically, "we shouldn't legislate anything because eventually somebody will subvert the original intention"? Seems like an anarchist sentiment.

Thanks for shoving words in my mouth. I'm saying that it's dangerous to turn the state into an authority on morals, rather than just preventing harm.

Legislation is entirely a moral issue, governments exist solely to protect the rights of citizens. However, since there is no objective measure of what is a "right" it lies upon society to decide how it wants to be governed and what "rights" are in a democracy. It's impossible for legislation to be anything but morality.

[Neutraligon]

Thanks for shoving words in my mouth. I'm saying that it's dangerous to turn the state into an authority on morals, rather than just preventing harm.

Legislation is entirely a moral issue, governments exist solely to protect the rights of citizens. However, since there is no objective measure of what is a "right" it lies upon society to decide how it wants to be governed and what "rights" are in a democracy. It's impossible for legislation to be anything but morality.

Incorrect legislation is not a moral issue. We give rights even when morally many would be against those rights (such as abortion or ssm or the death penalty).

[Bezombia]

Thanks for shoving words in my mouth. I'm saying that it's dangerous to turn the state into an authority on morals, rather than just preventing harm.

Legislation is entirely a moral issue, governments exist solely to protect the rights of citizens. However, since there is no objective measure of what is a "right" it lies upon society to decide how it wants to be governed and what "rights" are in a democracy. It's impossible for legislation to be anything but morality.

No. The purpose of government is, first and foremost, to protect its citizens. Sometimes this means protecting its citizens from other citizens - this is why we have jails, to name an example.
It is not, nor will it ever be, the purpose of the government to protect a citizen from themselves. Again, it all comes back to purpose.
The purpose of healthcare is to keep people healthy, no? How are you going to keep people healthy by denying healthcare to people who need it the most? That isn't protecting anyone. That isn't helping anyone.

[Reploid Productions]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

Alcoholics have a disease, a physiological addiction that often has co-morbid psychological issues underpinning it. People with eating disorders have a disorder, an illness that requires treatment to overcome. People who smoke have a disease, again, a physiological addiction that probably has a psychological component. People who have to work 80 hours a week just to scrape by aren't going to have the time or the energy to exercise or the time to prepare and eat healthy meals. People who are fighting with psychological issues such as depression and can't afford treatment or proper medication will self-medicate with nicotine or alcohol. People who can barely afford to keep a roof over their heads are stuck eating crappy food that's been processed to hell and back rather than healthy options, because they can't afford it.

That you're even suggesting this as an effective cost-cutting measure shows pretty clearly that you have little grasp of the incredible tangle of inter-related issues that can contribute to these sorts of problems for people.

[Napkiraly]

In USA, many opponents of nationalized healthcare say it’s a bad idea because alcoholics, smokers, obese people etc. will drive up demand and thus decrease the quality and increase the price (taxes) of healthcare for everyone. But if we apply the same logic that life insurance companies use to provide coverage, we see these problems are circumvented by a vetting process. People who are at high risk of death or who seemingly do not want to live are not approved.

So an easy way to keep costs down and quality up is to simply deny service to those who lead intentionally destructive lifestyles. A doctor could put patients who choose to maintain unhealthy habits (smoking, overeating to extremes, etc.) on a probationary period, and if no improvement is made within the allotted time, refer them to a private doctor. Can’t afford the private doctor? Shouldn’t have spent all your money on Big Macs and/or Marlboros and you wouldn’t need a private doctor anyway.

Of course the specifics of how to implement related policy would need to be very carefully thought out but I think the basic idea is sound, and hammering out ideas is what discussions are for anyway. So, yay or nay?

I don't think you understand what nationalized universal healthcare means. Plus if you tax cigarettes at a certain rate, smokers will essentially pay for themselves as they do in the UK.

[Mysterious Stranger 2]

People don't typically set out to hurt themselves. Alcohol and tobacco are addictive- most people drink to excess and smoke because they're addicted to it, which is by its very nature a loss of free will. Besides which, a random chance at a de facto death penalty for smoking isn't something civilized societies are in the habit of doing.

[Azorean Lands]

Doesn't sound like a bad idea, I could see why behaviour that could be linked to a higher rate to diseases could lead to such a thing, or at least having to pay more taxes.
To the people in the thread complaining about it being subverted, that doesn't really make sense, legally something would have to be directly linked to a higher rate of X for it to have any consequences. I like this idea, the healthcare system spends millions that could have been used developing better care than trying to save people who over ate themselves to death.
I'd like to see how you feel if your kid gets bumped down the line because some guy is getting a lung surgery because he couldn't stop burning through packs of cigarettes. All these destructive lifestyle choices, be it obesity, smoking, doing drugs, homosexual intercourse, having unprotected sex, anal sex, lack of exercise, etc, should lead you to get denied of public healthcare.

[Northwest Slobovia]

The problem is eventually you'll get to the point where "intentionally destructive lifestyle" comes to include such things as "driving high-emissions vehicles," "eating vegan," or "voting independent".

So basically, "we shouldn't legislate anything because eventually somebody will subvert the original intention"? Seems like an anarchist sentiment.

No, "we shouldn't legislate poorly thought-out ideas that are subject to obvious forms of abuse". The question of who decides and how is always a problem with such subjective proposals.

You've also got a hell of black-or-white fallacy: insurance companies are very clear on relative risk and policy prices, and often would rather charge people according to their risk than refuse their business. At the highest end of risk, sure, they'll turn people down, but not just because of some minor risk, even "intentional" ones. Committing an "at-fault" traffic accident doesn't usually get people denied drivers' insurance, it just gets them higher rates.

[Esternial]

I'm sure you've exhausted every other possible avenue to reduce costs to come to this conclusion.

Otherwise you wouldn't suggest denying people healthcare, obviously.

[Luziyca]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

Alcoholics have a disease, a physiological addiction that often has co-morbid psychological issues underpinning it. People with eating disorders have a disorder, an illness that requires treatment to overcome. People who smoke have a disease, again, a physiological addiction that probably has a psychological component. People who have to work 80 hours a week just to scrape by aren't going to have the time or the energy to exercise or the time to prepare and eat healthy meals. People who are fighting with psychological issues such as depression and can't afford treatment or proper medication will self-medicate with nicotine or alcohol. People who can barely afford to keep a roof over their heads are stuck eating crappy food that's been processed to hell and back rather than healthy options, because they can't afford it.

That you're even suggesting this as an effective cost-cutting measure shows pretty clearly that you have little grasp of the incredible tangle of inter-related issues that can contribute to these sorts of problems for people.

The only way that post can be better is if you had your mod sig in it. You just nuked that proposal argument not from orbit, but from the other side of the universe, and then managed to obliterate all traces of the argument, and the surrounding area. For this, you get to go on the AQ.

[Esternial]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

Alcoholics have a disease, a physiological addiction that often has co-morbid psychological issues underpinning it. People with eating disorders have a disorder, an illness that requires treatment to overcome. People who smoke have a disease, again, a physiological addiction that probably has a psychological component. People who have to work 80 hours a week just to scrape by aren't going to have the time or the energy to exercise or the time to prepare and eat healthy meals. People who are fighting with psychological issues such as depression and can't afford treatment or proper medication will self-medicate with nicotine or alcohol. People who can barely afford to keep a roof over their heads are stuck eating crappy food that's been processed to hell and back rather than healthy options, because they can't afford it.

That you're even suggesting this as an effective cost-cutting measure shows pretty clearly that you have little grasp of the incredible tangle of inter-related issues that can contribute to these sorts of problems for people.

The only way that post can be better is if you had your mod sig in it. You just nuked that proposal argument not from orbit, but from the other side of the universe, and then managed to obliterate all traces of the argument, and the surrounding area. For this, you get to go on the AQ.

It was alright I guess.

[Benuty]

Generalizing addiction, and obesity as wholly intentional is rather misleading.

[Azorean Lands]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

I feel like you present the solution in your very first paragraph, simply do not give emergency care either.
And your whole point becomes moot, step it kid.

[Mysterious Stranger 2]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

Alcoholics have a disease, a physiological addiction that often has co-morbid psychological issues underpinning it. People with eating disorders have a disorder, an illness that requires treatment to overcome. People who smoke have a disease, again, a physiological addiction that probably has a psychological component. People who have to work 80 hours a week just to scrape by aren't going to have the time or the energy to exercise or the time to prepare and eat healthy meals. People who are fighting with psychological issues such as depression and can't afford treatment or proper medication will self-medicate with nicotine or alcohol. People who can barely afford to keep a roof over their heads are stuck eating crappy food that's been processed to hell and back rather than healthy options, because they can't afford it.

That you're even suggesting this as an effective cost-cutting measure shows pretty clearly that you have little grasp of the incredible tangle of inter-related issues that can contribute to these sorts of problems for people.

Damn.
Well, we can all go home now.

[Ashkera]

This is all well and good until the fat people end up in the emergency rooms requiring surgery they can't afford because you didn't nip the problem in the bud decades ago, as they didn't want to go to the doctor and get kicked off the healthcare rolls for eating exactly what the commercials which saturate modern society told them to.

You can have this cost-cutting measure when unhealthy foods are massively taxed and/or banned, as is their advertising.

[Esternial]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

I feel like you present the solution in your very first paragraph, simply do not give emergency care either.
And your whole point becomes moot, step it kid.

Give this man a Nobel prize.

[Pugmire]

Nay, because in the vast majority of situations, people need healthcare and help to overcome "intentionally destructive" habits. And denying them that healthcare will just worsen emergency room crowding and costs, because as already shown in the US, when people can't afford preventative healthcare and such, they instead let a situation go until they have to go to the ER, which is obligated to help regardless of whether or not the patient can afford it, ultimately costing taxpayers far more than it would if affordable preventative treatment and such is available.

Alcoholics have a disease, a physiological addiction that often has co-morbid psychological issues underpinning it. People with eating disorders have a disorder, an illness that requires treatment to overcome. People who smoke have a disease, again, a physiological addiction that probably has a psychological component. People who have to work 80 hours a week just to scrape by aren't going to have the time or the energy to exercise or the time to prepare and eat healthy meals. People who are fighting with psychological issues such as depression and can't afford treatment or proper medication will self-medicate with nicotine or alcohol. People who can barely afford to keep a roof over their heads are stuck eating crappy food that's been processed to hell and back rather than healthy options, because they can't afford it.

That you're even suggesting this as an effective cost-cutting measure shows pretty clearly that you have little grasp of the incredible tangle of inter-related issues that can contribute to these sorts of problems for people.

The only way that post can be better is if you had your mod sig in it. You just nuked that proposal argument not from orbit, but from the other side of the universe, and then managed to obliterate all traces of the argument, and the surrounding area. For this, you get to go on the AQ.

Not really, considering the point was that healthcare exists for those who want to live, not those who will create a burden for everyone. Why finance the existence of people who will continue to make their own lives worse despite medical advice given to them in the probationary period? In this scenario they are told by a doctor to stop, and given some preliminary care.

And as mentioned they can always go to a private doctor. Being a butter golem or having unprotected gay sex with Rodrigo from the club because he is just fabulous are choices, and everyone shouldn't be forced to pay for the luxury of Uncle Tad to smoke Newports and drink 40s on the corner.

[Prussia-Steinbach]

No.

They pay taxes too. And it can't always be helped, either.