Healthcare: Are we responsible for all illnesses we acquire?

[supernova]

Poll question: Healthcare: Are we responsible for all illnesses we acquire?

There have been some surprisingly interesting conversations about healthcare here at DU, especially when it comes to the topic of risk assessment and management. This comes into play when you talk about how much people would be expected to pay into such a system.

I'm interested in knowing how much you think is under any one individual's control.

Of course, I have my thoughts on this topic, but I'll share those later.

So vote away and share any comments you have on this subject, especially if you feel more than one option applies. A shame we don't have multiple choice. If you think I missed an option, please list it.

I'm all ears... er eyes. :-)

edit: Spelling and added mental health options.

[ProfessorGAC]

1. I Have MS

Which lifestyle choice causes MS? Answer: None. If you're going to get it, you're going to get it.

No, i'm not responsible for my illness.
The Professor

[Tandalayo_Scheisskopf]

2. What about mental health issues?

Sure, some can be traced back to behaviors and some can be exacerbated by certain behaviors, but really, are they the fault of the people who have them?

A silly premise.

[supernova]

4. I think so

but I have been surprised.

And you're right. I forgot about mental health issues.

[soothsayer]

3. If you believe in karma, then I guess you are responsible for whatever you get

in some fashion or another.

[Beerboy]

5. I didn't vote in the poll, because I didn't see

an option that applies to the dirty filthy stinking smokers polluting with their cigarette butts/starting fires, polluting, then demanding everyone pay-their-way after they can't work anymore, due to their own fault.
Smokers are fucking leeches.

[supernova]

9. Option 1 is for you

[Beerboy]

15. It was somewhat weak and equivocating. n/t.

[supernova]

17. How so?

[Milo_Bloom]

11. Same argument can apply to a TON of things.

People who eat too much and develop obesity related conditions.

Hell, people who exercise TOO much are more likely to become delibitated from deteriorating joints and won't be able to work and then ask for us to pay for them.

The only additional argument against smokers is the "pollution", but that pollution pales in comparrison to someone who drives 40 miles to work each day.

[LeftishBrit]

16. Do you also think that AIDS is a punishment for sin?

It sounds like the same sort of argument!

I am anti-smoking, but I am pretty shocked by your argument.

[Lurking Dem]

6. I'm not sure

how applicable these poll questions are.

When discussing health care policy, one is discussing the aggregate. So, really, the first choice is absolutely false. The other 3 are all true but not necessarily helpful in terms of determining policy.

There are 3 factors (in a nutshell) that define the purpose of health care.

One is keeping the healthy population healthy. That includes things like vaccinations, other public health initiatives, check ups, prenatal care, etc.

The second is mitigating the consequences of modifiable risk factors. Smoking, obesity, inactivity, and other lifestyle choices that can, and do, effect health. Education programs, medications, diets, exercise and wellness programs are all part of this.

The third is adequate and competent care for those who are ill, whether chronically or acute.

Health care coverage should cover ALL these things no matter what. If you smoke and get lung cancer, it still needs to cover your cancer treatment and you should not be penalized for having smoked.

What should change is the rate for that coverage. People who modify their risk factors (or have few or none) should pay less for coverage than people who do not.

[supernova]

12. Agree w/ everything except

your last sentence. It's a lot like what I think in terms of taking care of everyone. And yes, I think prevention is a wonderful idea too.

I think your last sentence is what we have now in a private insurance environment, where the sicker pay more and in fact are dropped if they try to use any of their services.

[Lurking Dem]

24. But that's backwards.

I don't want to pay a doctor more for better care. WTF am I paying him at all for? Lousy care?

But if we don't have SOME kind of incentives for people to TRY and live in a healthier manner, we are going to be a financial hole so deep there will never be an kind of health care for anybody.

So if Joe Schmo quits smoking and starts walking 3 days a week, he should get a discount on whatever premium/payment system there is (no matter whose pocket it ends up being out of). If he STILL ends up with lung cancer because of the 20 years he smoked previously that shouldn't change anything. His rate shouldn't change and his care should be the same as anyone else in his situation.

If you think in terms of the aggregate, then x percentage of people modifying their lifestyle will reduce overall health care costs for the aggregate and people who smoke 3 packs a day and live on Taco Bell and McDonald's will raise costs for the aggregate.

So you have a set price, no pre-existing (the pool will be big enough that chronic ill costs are balanced by the disgustingly healthy), no dropping of patients, and a built in discount for a defined set of activities - wellness programs, smoking cessation, etc. - that mitigate the consequences of risk factors.

[sutz12]

7. I voted for 2, but 3 applies, also.

We can all try to maintain a healthier lifestyle, but shit happens, and then who you gonna call?

In my case, nobody. I'm one of the 45 million (or so) on the Republican health care plan--"Don't get sick."

[Milo_Bloom]

8. Isn't 2 and 3 essentially the same?

Both suggest you have some measure of control, but not full control.

[blondeatlast]

10. Can't answer because the issue is far more complicated than that.

That being said--let's see that everyone gets needs met (like being able to see a doctor before they are too sick or in too much pain) and then worry about it.

[Lilith Velkor]

13. No, we are responsible for telling victim-blaming assholes to shut the fuck up. n/t

[blondeatlast]

20. Damn, I wish to hell that were a choice in the poll. I abstained, but am writing in this one. nt

[Lilith Velkor]

22. Assholism is the biggest public health menace to this nation

We all must do our part. :patriot:

[supernova]

23. True dat

I wanted to see how deeply this perception is imbedded in our culture.

[Individualist]

14. Heredity is a factor in a number of diseases

Despite efforts to live a healthy lifestyle, that factor often cannot be overcome.

[supernova]

18. Yes, that's true

[LeftishBrit]

19. I put option 2; but really...

I agree with all except the first, and the last but one.

I think that lifestyle is one significant factor in health, but there are so many others; and I don't believe in judging and punishing patients on the basis of whether they are 'guilty' or 'innocent'. There's been too much of that already with regard to the specific topic of AIDS/HIV.

I believe in universal single-payer health-care, and don't think that people should be charged directly for healthcare according to lifestyle factors. However, I think it is appropriate to tax known unhealthy products (e.g. cigarettes and certain foods) at source, and perhaps to subsidize foods and products that are known to contribute positively to health.

[kineneb]

21. inherited mental health issues

are not under the control of the individual. I have depression issues which can be traced back at least to my great-grandmother. My goddaughter is bipolar and it was definitely inherited.

Genetic counseling might help, if it were heeded; however, there is a huge amount of denial regarding mental health problems.

Universal healthcare, as praticed in other countries includes a great deal of preventative care and education. Our current system waits until something breaks and then tries to fix it, hence it is also far more costly. Think- if one could be seen by a doctor more frequently (at no/low cost), any health problems would be spotted at an early stage.