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COVID-19 Thread [V2.0]

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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 10:49 AM Post
Posts: 9123
OldSchoolSnapper said:
young guns said:
FVBrewerFan said:
Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

In a way I can't articulate, this sounds just so wrong to me.


It already exists. Lots of employers use health screenings and offer reduced premiums if you pass them. Mine has one but it is pretty easy to pass, you can fail 2/5 criteria and still get the full $700 credit. So you can fail BMI and waistline and still get the full premium. If you fail 3/5, you get a $350 credit. You can fail them all and still get some credit just for doing the screen.

All other forms of insurance are billed on risk. That there's a social sensitivity toward categorizing obesity as high risk is just silly; obesity is incredibly high risk and it's reasonable for the insurance company to bill it higher. It's important to point out that this is obesity, not merely being overweight or out of shape. I don't see a ethical dilemma about insurance being more costly for someone at a 30 BMI.

With that said, obesity really isn't a MAJOR health risk until later in life. There's not a high risk of death in the current calendar year for an obese 30 year old so the usual year-to-year employer plans don't put a lot of emphasis on it. The complications from it explode once you cross into the late 40s, 50s and 60s, though.

The point of contention seems to be that some think obesity should fall under the same category as something like a tobacco surcharge and others seem to think it should be treated as something like Type 2 diabetes, a pre-existing condition more or less beyond your control.

It's probably somewhere in between.


Right, I said it's already being done on the incentive side- just not the penalty side of things yet. It would be relatively easy, as obese has a definition and parameters. Difference between obese and overweight. I don't see a problem with it, as it's a choice just like smoking. I'm not real familiar with life insurance, but I know it's standard to have higher rates for smokers. So having higher health insurance rates for obese people isn't much a stretch. It's nt forcing anyone to change their lifestyle. You just pay more, that's all.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 11:11 AM Post
Posts: 5485
Location: Madison, WI
Interesting topic I've never gone down the wormhole on before. Good info and takes by all and my reaction is it does seem insurance would be something new to try, nothing else has worked the last 30 years. I also don't see a problem with kind of singling out this issue, to me it's the same as singling out smokers which no one has a problem with.

On this overall obesity/overweight topic Bill Burr has had some good bits on it over the years. If you want some laughs this weekend, which everyone needs these days, go down a Bill Burr trail on Netflix. Top of my head I'd think this topic was more in one of the more recent ones.


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Online  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 12:16 PM Post
Posts: 172
FVBrewerFan said:
Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

There are a number of issues with this.
1) It functions like a regressive tax, a tax on poverty. Obesity strongly correlates with economic level.
2) The burden of such of policy would be disproportionally felt by minority communities.
3) It disincentives people from seeing health care providers. Gain 10lbs over the last year? Maybe you skip this year's Dr appointment so you don't have to weigh in.
4) It gives your employer access to your health information (assuming you're talking about employee health insurance). There are a ton of reasons why your employer should not have your health info which I don't think I need to detail, but one additional problem is that it forces all employers to maintain HIPPA complaint record keeping, which is no small task.
5) It seems unlikely to actually work to me. I'm no expert in obesity, but anecdotally the few obese people I've chatted with about their weight badly wanted to lose weight. Their issue was not solely motivation.


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Online  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 12:20 PM Post
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Machu Peach said:
5) It seems unlikely to actually work to me. I'm no expert in obesity, but anecdotally the few obese people I've chatted with about their weight badly wanted to lose weight. Their issue was not solely motivation.


Right, and this is a big one. Like lots of these sorts of issues it gets whittled down a black and white thing where half the population starts believing obese people want to be obese because they get free stuff or something and just love the value insurance while eating whatever they want. Epidemic is the correct word to describe obesity in the USA.

Most people want to help themselves. They often lack the knowledge, access or understanding of how to do so. If you're obese by 8 you are fighting an immensely difficult battle to ever snap out of that.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 2:32 PM Post
Posts: 9123
I don't think hardly anyone believes obese people want to be obese to get free stuff and love "the value insurance" (Not even sure what that means.) Everyone has knowledge of how to do so- eat less.

Motivation is a big part of it, just like quitting smoking. I'm not implying in any way it's easy. That's why it's worth trying different ways to motivate people. I wouldn't expect this to work on everyone, maybe it helps 10 or 15% of people. That's a big number.

HIPAA isn't an issue, it's just another factor being used for health insurance. Employer already has access to medical conditions, age, smoking, etc. I also don't think it's a disincentive to see a doctor. In fact, it would be an incentive, because you would have to go once a year to maintain your insurance.

I also wouldn't consider it a regressive tax. Obesity is an epidemic that extends to all races and economic status. When you use actuarial data, the numbers are the numbers. It's why insurance costs more for smokers, even though that affects low income and minorities more.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 3:48 PM Post
Posts: 2800
I think a bigger issue with tying insurance rates to obesity is that unlike other risk categories a significant part of the causation is not individual choice. Certainly there is a significant genetic component to the obesity, and based on the systematic increase over the years there are likely environmental factors outside an individuals control as well. It's far from clear as a case (nutrition research is challenging), but I'd look to target some things like food ingredients, sugar and high fructose corn syrup are both potential items that for example could be made less desirable with a tax to shift behaviors.


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Online  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 4:09 PM Post
Posts: 172
FVBrewerFan said:
I wouldn't expect this to work on everyone, maybe it helps 10 or 15% of people.
Where are you getting this number? Seems like wishcasting.

FVBrewerFan said:
HIPAA isn't an issue, it's just another factor being used for health insurance. Employer already has access to medical conditions, age, smoking, etc.
This is absolutely false. Your employer has no access to your medical records or insurance claims without your written permission (outside of specific legal situations). Also, the record keeping requirements of HIPPA are very serious.

FVBrewerFan said:
I also don't think it's a disincentive to see a doctor. In fact, it would be an incentive, because you would have to go once a year to maintain your insurance.
This means you're mandating a Dr visit and mandating a specific weight.

FVBrewerFan said:
I also wouldn't consider it a regressive tax. Obesity is an epidemic that extends to all races and economic status. When you use actuarial data, the numbers are the numbers.
Obesity in high income countries is negatively correlated with socioeconomic status. This will impact more low income people than high income people, that makes it regressive.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298576/

FVBrewerFan said:
It's why insurance costs more for smokers, even though that affects low income and minorities more.
Smoking does negatively correlate with income but I believe you are wrong that minorities smoke more. I believe that whites are slightly more likely to be smokers.

Either way, I'm generally against policies that have a disparate impact, particularly when things outside a person's control, such as genetics, clearly play a role.


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Online  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 7:38 PM Post
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FVBrewerFan said:
I don't think hardly anyone believes obese people want to be obese to get free stuff and love "the value insurance" (Not even sure what that means.) Everyone has knowledge of how to do so- eat less.


Value insurance was a term I made up to imply you can be as unhealthy as you want and your insurance is subsidized by healthy people.

I disagree completely with what you say here though. With every issue, Welfare, unemployment, whatever, a large segment of the population is convinced that every person on it loves it and is a mooch. A large segment of the population thinks fat people are all lazy. If you think "hardly anyone" believes that you then you need to talk to more people.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 25, 2020, 8:42 PM Post
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When I go in for the health screening for my wife's insurance the nurse that weighs me is obese and sounds like she smokes a pack a day. I shake my head at the fact that if she doesn't get the wellness credit, which she probably does because the parameters are a joke, her poor health is supposedly only costing the insurance company $300 more than mine.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 27, 2020, 8:53 AM Post
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I tend to think that the US has a structural problem with obesity. Agricultural subsidies and other pressures have made junk food cheap and plentiful. How cheap and plentiful is soda?

The US has knocked down smoking to a large extent. We don't have the political will to knock down obesity.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 27, 2020, 9:39 AM Post
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Depends on what you define as "junk food".

I've heard the argument for years that poorer people are more likely to be obese because junk food/fast food is cheap. That is patently false.

A 1/4 lb cheeseburger at a fast food restaurant will cost at least $3. Ignoring the cheese, bun, and ketchup/mustard, that's $12/lb for 70% lean beef; with the cheese/bun, let's say $10/lb (but that's also ignoring how much of the 30% fat that gets cooked off). A value meal with fries & a soda, at least $5; I don't know how much the fries weigh, but it's not a pound; let's say that the value meal comes to $10-12/lb of food. The "value menu" double cheeseburgers are at least $1.69; they use 1/10th of a lb patties, so for two patties it's 20% of a pound or at least $8.50/lb.

I buy chicken breasts at the grocery store for $3-$4/lb. A one-lb bag of peeled & ready to eat carrots is $1.50-$2/lb. Apples are $2/lb. Bananas are $0.69/lb. Sweet potatoes are $1/lb; baking/russet potatoes more like $0.69/lb. Beets are $1/lb. Brussel sprouts are $2/lb. Zucchini is $1-$1.50/lb. 85% lean ground beef is $4/lb. A 15oz jar of peanut butter is $2.50-$3. And a gallon of water is $1 (a 2-liter of soda is at least $1.79).

Fast food is not cheap - it's expensive. Fast food is easy.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 27, 2020, 10:03 AM Post
Posts: 14078
Machu Peach said:
FVBrewerFan said:
Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

There are a number of issues with this.
1) It functions like a regressive tax, a tax on poverty. Obesity strongly correlates with economic level.
2) The burden of such of policy would be disproportionally felt by minority communities.
3) It disincentives people from seeing health care providers. Gain 10lbs over the last year? Maybe you skip this year's Dr appointment so you don't have to weigh in.
4) It gives your employer access to your health information (assuming you're talking about employee health insurance). There are a ton of reasons why your employer should not have your health info which I don't think I need to detail, but one additional problem is that it forces all employers to maintain HIPPA complaint record keeping, which is no small task.
5) It seems unlikely to actually work to me. I'm no expert in obesity, but anecdotally the few obese people I've chatted with about their weight badly wanted to lose weight. Their issue was not solely motivation.


My first thought was the people making claims are typically older and much so once you get close to retirement age. If we started trying to skew premiums towards those higher risk groups you would create an even bigger problem with older people being able to afford healthcare. People should just think of higher premiums at a younger age as prepayment for their later years. Skewing those payments towards later years would require people to acknowledge that and plan for it...I don't have confidence in people doing that.

Additionally, everything you stated I tend to agree with. I think all you would do is create a bigger need for government assistance with healthcare and I don't think that is benefitting the people needing it or anyone else.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 27, 2020, 10:23 AM Post
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Hours after encouraging Denver residents to avoid Thanksgiving travel, the city's mayor office confirmed he is flying to Mississippi to spend the holiday with his daughter and wife, according to his office.

...

Earlier this month, California Gov. Gavin Newsom received backlash after he and his wife attended a birthday party at the French Laundry restaurant with a dozen others from several different households despite state health guidelines recommending against such gatherings amid a surge in Covid-19 infections.

...

New York Gov. Andrew Cuomo canceled his plans after facing criticism for planning to have a holiday meal with his 86-year-old mother and two of his daughters amid escalating numbers of Covid-19 cases.
The governor had previously warned New Yorkers who plan on holding Thanksgiving celebrations as usual that it was dangerous given that the virus can spread in large indoor gatherings.

https://www.cnn.com/2020/11/25/us/denver-mayor-thanksgiving-plans-trnd/index.html


What is the saying? Rules for thee but not for me.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 27, 2020, 12:11 PM Post
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re: obesity

Generally speaking, people have a very hard time making what they know to be the correct decision when the consequences are far out in the future. This has been shown time and time again - credit card debt, excessive drinking, not saving for retirement, overeating, too much sun, etc. Thinking/acting in the moment served us well as hunter-gatherers and we haven't evolved past that.

"Dustin Pedroia doesn't have the strength or bat speed to hit major-league pitching consistently, and he has no power......He probably has a future as a backup infielder if he can stop rolling over to third base and shortstop." Keith Law, 2006


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 27, 2020, 4:10 PM Post
Posts: 2271
I’m on my wife’s employer-sponsored plan because it’s slightly better than the one offered by my company. Employees who score an 85 or better on their annual health risk assessment pay a lower rate than those who score below 85. That’s a pretty good incentive to avoid bad choices. After regulary scoring in the high 80s / low 90s, I came in at 85 on the dot this year. Can you imagine the grief I’d catch from my wife if my snacking made her paycheck go down? I’ll be more careful this year.

This system has its limitations because if one’s health care is heavily subsidized by the government anyway, where is the incentive to improve their score?


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 28, 2020, 11:19 AM Post
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LouisEly said:
Depends on what you define as "junk food".

I've heard the argument for years that poorer people are more likely to be obese because junk food/fast food is cheap. That is patently false.

A 1/4 lb cheeseburger at a fast food restaurant will cost at least $3. Ignoring the cheese, bun, and ketchup/mustard, that's $12/lb for 70% lean beef; with the cheese/bun, let's say $10/lb (but that's also ignoring how much of the 30% fat that gets cooked off). A value meal with fries & a soda, at least $5; I don't know how much the fries weigh, but it's not a pound; let's say that the value meal comes to $10-12/lb of food. The "value menu" double cheeseburgers are at least $1.69; they use 1/10th of a lb patties, so for two patties it's 20% of a pound or at least $8.50/lb.

I buy chicken breasts at the grocery store for $3-$4/lb. A one-lb bag of peeled & ready to eat carrots is $1.50-$2/lb. Apples are $2/lb. Bananas are $0.69/lb. Sweet potatoes are $1/lb; baking/russet potatoes more like $0.69/lb. Beets are $1/lb. Brussel sprouts are $2/lb. Zucchini is $1-$1.50/lb. 85% lean ground beef is $4/lb. A 15oz jar of peanut butter is $2.50-$3. And a gallon of water is $1 (a 2-liter of soda is at least $1.79).

Fast food is not cheap - it's expensive. Fast food is easy.


It's not the cost of food that is the problem, it is the cost of time.

"I wasted so much time in my life hating Juventus or A.C. Milan that I should have spent hating the Cardinals." ~kalle8

Twitter: @MKEHiker
Website: http://www.mkehiker.com


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 28, 2020, 6:25 PM Post
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I'm curious. I see a lot of people saying they won't get the vaccine right away and want to make sure it is safe first...

Has there ever been a vaccine in the USA that was deemed unsafe after doses were given out? Has there ever been a vaccine that was known to cause health issues years down the road?

"I'm sick of runnin' from these wimps!" Ajax - The WARRIORS


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Online  Re: COVID-19 Thread [V2.0]
Posted: November 29, 2020, 12:10 PM Post
Posts: 172
RotaShield, a rotavirus vaccine, was associated with intussusception in something like 1 of out 10,0000 children under the age of 12 months. It was used for 9ish months in the late 90s before being withdrawn from the market, though there's some level of debate about if the increased intussusception was real or a statistical blip.

The oral poliovirus vaccine is no longer used in the US in favor of inactivated poliovirus vaccine in part due to safety reasons ...but that's more of a risk/reward and route-of-transmission thing than a this-vaccine-is-unsafe thing. Oral poliovirus vaccine is still used by many counties because it makes more sense for their specific situation.

The most famous vaccine with issues was a swine flu vaccine in 1976 that lead to an increase in Guillain-Barre Syndrome in something like 1 out of 100,000 people. I think about 400 people ended up with GBS. It's still not particularly well understood why it occurred.

There also have been issues with specific lots of vaccines, most famously the Cutter Lab Incident in 1955.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 30, 2020, 7:01 AM Post
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Pfizer is currently distributing it's vaccine while it waits for approval. The vaccine is currently arriving in the U.S. and being stored in Pleasant Prairie, WI.

Moderna plans to officially ask for final approval today.


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Offline  Re: COVID-19 Thread [V2.0]
Posted: November 30, 2020, 12:03 PM Post
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I'm operating under the assumption that proof of vaccination is going to be required for air travel, international travel, and possibly sporting events and concerts. So I'll be first in line when it is available. Also hoping to book some cheap flights on the 737-Max while people are still afraid of it.


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