Anyone worried about Obamacare? - Mothering Forums

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#1 of 48 Old 01-15-2013, 09:00 AM - Thread Starter
 
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Not trying to start a heated debate here. I am just curious what others think.

 

Here is why I am worried. 1) Taxes. How high are they going to rise to help fund Obamacare? 2) Doctors who take it. I'm worried that doctors en masse are not going to accept Obamacare insurance, either to protest or because of poor reimbursements, and refuse to see patients with it. They already have that freedom to do so with Medicaid. I can see this happening... more people will be insured, but still won't have access to care because there could be a large amount of doctors who don't take it. That's not solving a problem. 3) Long waits for appointments/surgery, etc. 4) The mandate itself. We are being forced to have health insurance by either keeping what you have already, having to buy it privately through, say, BCBS, or get on the government plans. If we don't do that, we get penalized, which is essentially going to be a tax. More taxes. That sucks. 5) More employers dropping healthcare insurance for their employees because it will be too expensive. This leads me to #6... 6) Rates are going to skyrocket.

 

Thoughts?


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#2 of 48 Old 01-15-2013, 12:39 PM
 
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I'm in Canada, so it's not going to affect me either way, but from my perspective, one thing that gets way underestimated is the affect universal health care will have on other areas. When your society treats you like your life has worth, you become a different person than in a society where people don't take care of each other. Access to health care for everyone will reduce crime rates, and improve education outcomes... taxes may go up, but the US will be a much safer place to live.


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#3 of 48 Old 01-15-2013, 02:42 PM - Thread Starter
 
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When your society treats you like your life has worth, you become a different person than in a society where people don't take care of each other. Access to health care for everyone will reduce crime rates, and improve education outcomes... taxes may go up, but the US will be a much safer place to live.

This would be a nice by-product. Time will tell I guess. One of the things I am worried about the most is what if doctors in the US don't want to take Obamacare insurance and therefore, refuse to see those patients, making them inaccessible for those people. Will that make things better or worse or the same? I think it will make things much worse because if doctors refuse to see all the new patients in the system where will they go? What will they do? Everyone is now insured, but no one wants to treat them. So, still, no one is getting care. This scares me. As far as society goes, this could cause a big breakdown of society here, which would have the opposite effect of what you're saying.


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#4 of 48 Old 01-15-2013, 05:36 PM
 
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I don't understand.  Why wouldn't doctors take them?  Is it posted for sure that they're going to pay less than other insurance companies do?  There will always be new doctors, doctors relocating, doctors semi-retired who would be willing to take new patients.  I imagine they'd get pretty good business if as you predicted many doctors wouldn't take obamacare.
 


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#5 of 48 Old 01-15-2013, 06:04 PM
 
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i am trying to understand obamacare.

 

i have read the website and i still dont get it.

 

what exactly is it?

 

is it big for businesses or is it big for the patients? how is it different from what exists now?

 

is there a FAQs page. i would find that very helpful.


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#6 of 48 Old 01-15-2013, 06:49 PM - Thread Starter
 
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Here's a start... http://obamacarefacts.com/   http://www.healthcare.gov/law/index.html  http://www.familydoctormag.com/doctors-office/194-doctors-debate-universal-health-care-pros-and-cons-from-the-experts.html

 

There is so much out there.

 

Currently, there is no universal heathcare in this country. Obamacare aka the Affordable Healthcare Act is a provision that requires all US citizens to have access to affordable healthcare. By next year, everyone has to have it or else you will get penalized aka taxed. Each year you don't comply, the tax (penalty) goes up. Obamacare makes it easier for people who otherwise can't afford it or have preexisting medical conditions to obtain affordable, quality healthcare. I haven't read the entire Act, neither have our politicians. They signed it without fully knowing what's in it. There are a few good things about it, but to me, the overall picture is not good.


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#7 of 48 Old 01-15-2013, 07:03 PM - Thread Starter
 
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I don't understand.  Why wouldn't doctors take them? 
 

Because of lower reimbursements for starters. Medicaid is like that. Right now, doctors are not obligated to accept Medicaid patients, therefore, making them inaccessible to Medicaid patients. I worked for an orthopaedic surgery practice that did not accept Medicaid. They would treat them in the ER if our practice was on call, but sent them somewhere else because the doctors private practice did not take that insurance. Another reason would be that they won't take Obamacare in protest because they don't want anything to do with it. As far as I know, at this point in time there is nothing mandating doctors to accept it.

 

 

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Is it posted for sure that they're going to pay less than other insurance companies do?

Don't know, but if it is anything like Medicare/Medicaid, the reimbursements will be lower than private health insurance, as has been the case for a long time.

 

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There will always be new doctors, doctors relocating, doctors semi-retired who would be willing to take new patients. I imagine they'd get pretty good business if as you predicted many doctors wouldn't take obamacare.

I think Obamacare may have the opposite effect. They are predicting a shortage.

 

Obamacare does not remove private insurance carriers from the market who pay better than the government programs. So, alot of doctors may look at this and say, hey, I'd rather just see patients with private health insurance since they pay better. Why should I see these lower reimbursements and work double. Sounds bad, and it is, but this just may happen. People who get stuck with the subsidized insurance may get screwed because they can't find anyone to care for them... still. The problem will still exist.

 

The more I read, the more I worry about how this all is going to be a big mess. I personally feel like if they are going to mandate having healthcare insurance, expand Medicaid and create subsidized heatlh insurance (through the government), they should just get rid of private carriers altogether and go single-payer.

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#8 of 48 Old 01-17-2013, 12:16 PM
 
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Obamacare has already risen rates of insurance.  Quite obviously someone has to pay for you when you have a preexisting condition and your share (your premium) isn't enough to cover the services you use.  It isn't like there is just this unlimited account over at BCBS.  I don't see how on earth this could be labeled as "Affordable".  My DH and I are self employed.  We quite health insurance when for our family of 5 (this was a couple years ago) our monthly premiums with BCBS went up to $1000.  I am sure since then it has reisen at least 30% since every 6 mo BCBS raises rates 9%.  We are uninsured.  No government bill is going to change that.  We do however have a waiver since we are part of a Christian health sharing ministry.  So- it isn't as black and white as you assume OP.

 

As for doctors opting out- I wish more would.  We go to a doctor an hour and a half away who doesn't accept ANY insurance.  He has all the business he can handle.  We get wonderful service at a fraction the cost of what the local clinics charge and all without them sending in a social worker to tell us about all the benefits of "Obamacare" and medicaid.  

 

A young person who is looking to make a difference in society and make some cash should think twice before becoming a doctor in the US.  They will have very limited freedom in how they treat patience and receive less money for less service and more red tape.  

 

Mummoth- not to pick a fight- but that is not very good logic in the real world.  We place no more value on life now than we did before- the same as the Canadians.  When a society doesn't value the unborn everyone suffers.  It will only get worse as there are shortages of medical professionals and money to pay for health services- who will get cut then?  How does this make things safer or affect education?  It doesn't.  


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#9 of 48 Old 01-17-2013, 12:54 PM - Thread Starter
 
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Originally Posted by iowaorganic View Post

Obamacare has already risen rates of insurance.  .  

 

 

Yes, you're right, rates have risen. I've been periodically getting quotes over the last several months and there has been a change, they are going up. We are uninsured too. This "Affordable" healthcare act is putting billions of dollars into the pockets of the CEO's of the private health insurance carriers. They will have about 35 million (an estimate) more clients because of this. I wish we could find a doctor, like you, who does not take any insurance, all while lowering rates to make it affordable for people to pay out of pocket.

 

 

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Quite obviously someone has to pay for you when you have a preexisting condition and your share (your premium) isn't enough to cover the services you use. It isn't like there is just this unlimited account over at BCBS. I don't see how on earth this could be labeled as "Affordable". 

Nothing about Obamacare is affordable, especially since our taxes will have to pay for it. So, healthy individuals will be paying for less healthy individuals. You know, people who voluntarily are unhealthy... smokers, people who are obese, don't eat well, alcoholics, drug users. Everyone knows those people have secondary health problems because of their lifestyle choices... very expensive, chronic health problems.

 

 

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A young person who is looking to make a difference in society and make some cash should think twice before becoming a doctor in the US. They will have very limited freedom in how they treat patience and receive less money for less service and more red tape. 

 

This is too bad. I think if more doctors didn't take any insurance, and lowered the rates so people could afford to pay out of pocket, that would be much better. Like, what you do currently iowaorganic. The people who don't have insurance, but self-pay are unfortunately now going to be penalized/taxed for not having insurance under Obamacare. No freedom in that. As far as I know, doctors don't have to accept Obamacare, but the patients have to have it or some kind of insurance. If more doctors opt out of accepting Obamacare, all those newly insured people are going to be shit-out-of-luck to get care. Then, where will we be? I'm not talking about BCBS or United Healthcare here. I'm talking about these new government subsidized insurances that will be offered next year since many states are not accepting federal aid to expand Medicaid and also because many people simply can't afford, say, BCBS. There are a lot of us middle people who don't qualify for Medicaid, but can't afford private insurance. So, we are going to get screwed back, forth and sideways.


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#10 of 48 Old 01-20-2013, 01:48 PM
 
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I'm kind of confused about the way your talking about Obamacare.  It's not a form of insurance coverage.  It's not like you'll be able to choose from United Healthcare, Blue Cross/Blue Shield and Obamacare.  You will still have whichever insurance you currently have and the medical offices that take your insurance now will probably keep accepting it then. I believe the income eligibility will be raised for medicaid so more people will be on that, but that's the only form of government-run health care coverage that the bill has.


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#11 of 48 Old 01-20-2013, 02:59 PM
 
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If all Americans are forced to have insurance, and most comply rather than pay the penalty, the cost per person will ultimately drop. This is the premise the entire program is based on. Healthy people will be forced to get insurance even if they never use it. They will in turn help fund the insureds who are ill. Additionally, the high societal cost of people not being able to afford routine, preventive care will be eliminated.

For me, with my DH,s job and therefore insurance, at risk every year because of contraction at his job, it is. A HUGE boon. When he had no insurance we made too much to qualify for state insurance, and we had to pay 1400 a month to insure our family with COBRA, our only insurance option because we made just a little too much for cheap state insurance.

I can't tell how glad I am that this is in place. With my DHs job fluctuations we can manage budget cuts, but having no insurance for us and the kids, and potentially losing everything because of an illness (which happened to me in my 20s) was terrifying. My jb offers no insurance, but we can live on it if we don't have to also pay an arm and a leg for insurance.
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#12 of 48 Old 01-20-2013, 05:26 PM
 
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If all Americans are forced to have insurance, and most comply rather than pay the penalty, the cost per person will ultimately drop. This is the premise the entire program is based on. Healthy people will be forced to get insurance even if they never use it. They will in turn help fund the insureds who are ill. Additionally, the high societal cost of people not being able to afford routine, preventive care will be eliminated.

The rules of supply & demand do not apply when the government gets involved. IF what you said was true, then taxes would be less becuase there are more people to take money from.  If that were true, things like tolls on turnpikes & bridges would go down because more people use them.  How many times have you seen taxes go down?  How many times have you seen rates on bridges & toll roads go down?  I'm sure there are more examples.

 

Also, requiring that people have the insurance but not requiring that it be accepted everywhere isn't a guarantee of getting treatment that works for you (not that I think that is the way to go either).  An example is me & dh: we paid for dental insurance for the last year or so.  The dentist I go to does not accept any insurance.  Conventional treatment has gotten me no where but going to him, I've had improvements.  So, if we *had* to have dental insurance, we'd be paying for something we can't actually use for my care.  Pretty sucky proposition.

 

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#13 of 48 Old 01-20-2013, 06:09 PM - Thread Starter
 
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No, Obamacare is not necessarily a BCBS type plan. It is just a moniker for the Affordable Healthcare Act. This states that we all have to have some form of insurance by 2014, otherwise, we get penalized in the form of a tax. I lived in Massachusetts from Fall 2010 until just this past April. There it is called Romneycare. Basically if you can't afford BCBS (using this as an example) on your own... because your employer does not offer health insurance, then you have to go through an exchange called Commonwealth Care. You go on their website, plug in all your info, income status, etc and you get matched with a certain type of insurance... subsidized according to your income. When tax time comes around, you get a 1099 just for health insurance, which you need to plug into your state insurance stuff to prove you have it. There are 3-4 tiers of it and they all have different names, different coverages, different fees. Of note, not all doctors are on these plans and I had a heck of a time trying to find a pediatrician for our kids. I'm worried about this now that it will be on the federal level. Are our taxes going to go up? Probably. Those who are able to keep what they have, will their rates skyrocket? Probably. Will it be hard to find doctors who take this new insurance? Probably. As far as Medicaid goes, I'm not sure what is going to happen there. Not all states have accepted federal funds to pay for expanding their Medicaid programs... like Georgia, where I currently live. They are leaving things up to the federal government to handle and I'm worried about how this will affect my family. My kids are insured, me and DH are not. We need to see doctors, but can't afford to self-pay so we are waiting to see what happens. We'll get an Obamacare plan, but how hard will it be to find someone to treat us? Since the last time I posted, my DH had a job interview. Everything sounded great until the subject of benefits came up. This prospective employer will not offer health insurance to full-time employees because of Obamacare... because it may be too expensive for him to pay for, because his taxes may go up, and it may just be simpler for him to not offer health insurance and deal with all the red tape. This is not the first time I have heard of this. You will see that this is going to happen a lot, especially with small businesses. They won't be able to handle the expense. So, there will be more people than expected to get Obamacare and the fed govt won't be ready for it.


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#14 of 48 Old 01-20-2013, 07:21 PM
 
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I have family in Massachusetts and the health care act has been a big financial hit to them because it's not actually affordable and the plan they ended up with was very much substandard -- just the bare minimum to avoid the tax. So if Obamacare ends up going in that direction -- and it does sound very similar, from the little I understand of it -- it could be a huge financial disaster for some families.

At the same time, I welcome some kind of change in our healthcare system. Right now, between premiums, copays, coinsurance, and prescriptions, we are paying over $1200 a month for healthcare. That's nearly half DH's salary!! Add in a mortgage (in an area badly affected by the housing market crash) and we literally have zero dollars left for food, electric, etc. So clearly something needs to change, I can't be the only one in such a crappy situation. I'm just not sure how Obamacare will work, whether it will actually help families like my own, whether we'll be able to get the care we need... One thing I'm particularly worried about is the potential intrusion into medical care -- regulations that will require certain cheaper medications to be tried first, rules requiring mental health professionals to prove their patients are progressing via standardized tests, things of that nature.
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Originally Posted by erinmattsmom88 View Post

Nothing about Obamacare is affordable, especially since our taxes will have to pay for it. So, healthy individuals will be paying for less healthy individuals. You know, people who voluntarily are unhealthy... smokers, people who are obese, don't eat well, alcoholics, drug users. Everyone knows those people have secondary health problems because of their lifestyle choices... very expensive, chronic health problems.
I know this is a bit OT but I just need to point out... that most of those things you mentioned I would consider to be secondary health problems in & of themselves. How many happy, healthy, well-adjusted people do you know who choose to start drinking, overeating, etc.? More often there is some kind of undiagnosed/under-recognized issue going on -- diabetes leading someone to crave sugar & gain weight, people with anxiety issues or depression self-medicating with drugs/alcohol, etc. I think a lot of those lifestyle choices are much more of a response to untreated physical or mental issues. If we treated the underlying issues then these people might be more able to make better lifestyle choices.

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#15 of 48 Old 01-20-2013, 09:05 PM
 
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I do think anytime something is in question (especially regulations that may be expensive) there is a shock to the private sector.  You can see that in any type of regulation, any industry - people don't know what the costs will be, or how to handle it best, or what loopholes they might employ.  So I can understand the trepidation, but I don't think it's unusual.

 

I have no idea if Obamacare will actually provide the kind of routine, cheap, preventative care to enough people to fulfill the promise of "a stitch in time saves nine."  I do respect that age-old bit of wisdom, and I think our current system of people putting off medical care that they can't afford (being uninsured) often leads to expensive hospitalizations in the long run - which drive up care costs and insurance rates for everyone when they can't pay.  BCBS doesn't have money growing on trees, but neither do hospitals.  I do think we are already paying those costs.

 

I don't know if this is the solution, but I haven't heard a solid counter offer.  As someone with chronic health problems not of my own creation, I have always had to have some form of health insurance or be quite willing to face bankruptcy, basically - even if it's paying tons of money for COBRA.  I don't know what my family would do without it.  So, I'd like to offer that not all chronic health problems are due to lifestyle choices - and agree with crunchy_mommy that alot of those on that list are probably secondary issues, truly.  Mental health coverage being a primary concern - what would our country look like if that was more widely available?

 

Even with excellent insurance, the costs can be prohibitively high (at least 50 bucks or more a session plus any medications).  Also, costs in generally have been on a crazy trajectory in years leading up to this legislation.  I understand the fear that Obamacare might make it still worse - but at my last employer, insurance costs were going up by 40% every year (hundreds of employees - a handful had babies each year).  This doesn't make sense, and it certainly isn't sustainable - for anyone involved. shrug.gif


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#16 of 48 Old 01-21-2013, 05:11 AM - Thread Starter
 
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I totally agree that chronic illness is not always a result of poor lifestyle choices. I was just using that as an example. Many people are born with juvenile-onset diabetes, many cardiac patients have poor genes that predispose them to cardiac issues. I get that.

 

Here is an article I came across just this morning on foxnews.com. Disclaimer... I usually don't by into what they have to say, but this article is pretty decent in explaining what's happening. I think the percentages they use are way under reality, however.  http://www.foxnews.com/politics/2013/01/21/premiums-set-to-rise-this-year-in-run-up-to-obamacare-tax-on-insurance-industry/


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#17 of 48 Old 01-21-2013, 05:12 AM - Thread Starter
 
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Oh, and yes, I agree that something HAS to be done to overhaul the system. It's already bad, but about to get worse.

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#18 of 48 Old 01-21-2013, 05:16 AM - Thread Starter
 
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I have family in Massachusetts and the health care act has been a big financial hit to them because it's not actually affordable and the plan they ended up with was very much substandard -- just the bare minimum to avoid the tax. So if Obamacare ends up going in that direction -- and it does sound very similar, from the little I understand of it -- it could be a huge financial disaster for some families.

 

Yep, I saw this firsthand. I'm afraid Obamacare will go in this direction... not just in one state, but the entire country. If it does go like this, people are not going to be happy.
 


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#19 of 48 Old 01-21-2013, 05:22 AM
 
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My 88 year old grandmother fell and broke her hip. Medicare won't pay. She has supplementary insurace but the bill will still be large (it may wipe her out financially). The hospital said that when the 11 billion (?) was shifted from Medicare to help fund Obamacare that Medicare cut what it will cover for patients. So, we are seeing the effects of this. I live in a medical  community (w. a medical college) and the opinion here is that a majority of doctors will take an early retirement rather than comply w. Obamacare. Also, they foresee fewer entering into the medical profession because the students won't earn enough income to pay for med school and malpractice insurance. So, fewer doctors/ specialists. My husband is Canadian/American. He says that they have "sin" taxes that help fund the insurance. I am not a smoker/ drinker so I am not sure if they have implemented this in the US. If so, I have not heard about it but that would make sense.

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#20 of 48 Old 01-21-2013, 06:24 AM - Thread Starter
 
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I'm sorry to hear about your grandmother. This whole thing will affect everyone. Yes, I have read also that doctors are looking to take an early retirement and less people will not want to choose medicine for their chosen profession. It's really scary.

 

I think "sin" taxes would be a pretty good way to go. Like, increase taxes on cigarettes, alcohol, twinkies, doritos... you know, stuff like that. Since we are going the way of socialized healthcare, I think this would be pretty fair... and I'm a libertarian-leaning independent!!!


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#21 of 48 Old 01-21-2013, 11:36 AM
 
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I'm sorry to hear about your grandmother. This whole thing will affect everyone. Yes, I have read also that doctors are looking to take an early retirement and less people will not want to choose medicine for their chosen profession. It's really scary.

 

I think "sin" taxes would be a pretty good way to go. Like, increase taxes on cigarettes, alcohol, twinkies, doritos... you know, stuff like that. Since we are going the way of socialized healthcare, I think this would be pretty fair... and I'm a libertarian-leaning independent!!!

There is no fair in socialized anything.  IT's about being equal.  I don't think there should be sin taxes any more than any other tax.  Why should someone like me, who takes care of themselves, pay more because some people don't & use those things as their medicine? Also, some people use that stuff as their actual food because they don't have access to real food (read, inner city kids, the ones who used to come to my fifth grade class while eating doritos, which was breakfast).  Plus, who gets to decide if doritos, twinkies, crackers, milk, beef, grain, etc. deserves the sin tax?  Just another system that is going to prolong the collective pain & fail in the future.

 

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#22 of 48 Old 01-21-2013, 11:52 AM - Thread Starter
 
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I don't want more taxes, just like anyone else, but maybe in this manner, the people, another example here, who eat poorly, become obese then develop diabetes, heart disease, etc should be held accountable for the choices they make and help pay up. Again, I know that these diseases occur in other ways... genetics, gender, luck of the draw... risk factors that one can't control. But, for those who smoke, eat poorly, don't exercise, and then have a heart attack or open heart surgery because their risk factors are due to choices they make, they should be held accountable for it. Just an idea.

 

Who should decide if doritos or twinkies should be taxed higher? Perhaps the people who have the experience and education to break down the nutrient content of those items and if they don't achieve a certain threshold of nutrition, then they should fall under a category that adds more taxes to their purchase. I don't know. I don't have an answer. I don't want to have to pay for other people's healthcare anymore than you do. So, what do we do? Obamacare is going to happen. Boo. If you aren't eating that stuff, say, or are a smoker, then a sin tax on those items wouldn't apply to you.


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#23 of 48 Old 01-21-2013, 01:54 PM
 
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I'm inclined to agree - we do need to work on solving problems like food deserts - but a large part of the reason those nutritionally-poor foods are so cheap in the first place is due to subsidies. shrug.gif  I'm not tax happy either, but I did think that, say, the recent tax on tanning beds was a no brainer.


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#24 of 48 Old 01-21-2013, 03:26 PM
 
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The "sin" tax my husband specifically mentioned was on alcohol and tobacco products. You paid the tax when you purchased the items. So, if you don't use them, you would not pay the tax. The tax on these are higher because they are known to cause health problems. It has been a while since hubby lived in Canada, can anyone from there elaborate?

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#25 of 48 Old 01-21-2013, 03:39 PM
 
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I don't want more taxes, just like anyone else, but maybe in this manner, the people, another example here, who eat poorly, become obese then develop diabetes, heart disease, etc should be held accountable for the choices they make and help pay up. Again, I know that these diseases occur in other ways... genetics, gender, luck of the draw... risk factors that one can't control. But, for those who smoke, eat poorly, don't exercise, and then have a heart attack or open heart surgery because their risk factors are due to choices they make, they should be held accountable for it. Just an idea.
I read a study not long ago about multivitamins increasing the risk of breast cancer. Should we hold people accountable for making the choice to take a daily vitamin if they come down with breast cancer?

Some studies recommend 30-60 minutes of moderately intense exercise every day. How many people are able to meet that goal? Do we hold people accountable for their poor choices if they only manage to exercise 20mins, 3 times a week?

Smoking used to be acceptable, it wasn't until... the 1950's I think? ...that smoking started to be linked to cancer, heart disease, etc. So there are many older people who likely started smoking in their teens/20's and became addicted before anyone knew how dangerous it was.
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Who should decide if doritos or twinkies should be taxed higher? Perhaps the people who have the experience and education to break down the nutrient content of those items and if they don't achieve a certain threshold of nutrition, then they should fall under a category that adds more taxes to their purchase. I don't know. I don't have an answer. I don't want to have to pay for other people's healthcare anymore than you do. So, what do we do? Obamacare is going to happen. Boo. If you aren't eating that stuff, say, or are a smoker, then a sin tax on those items wouldn't apply to you.
I think if you don't want to pay for other people's health care then maybe forego insurance completely? And pay out-of-pocket for everything so you aren't somehow subsidizing someone else's care.

I don't want more taxes but if I am going to pay taxes anyway, I'd much rather pay for someone to have open-heart surgery (no matter how horrible their diet or how many packs of cigarettes they smoked) than for wars, corporations, etc.

I would not support sin taxes on food, except if very clear guidelines were in place. It's too fine a line to walk because there are so many differing ideas regarding nutrition. I would probably support subsidies to make fresh fruit & veggies more affordable. I would support stricter guidelines around pesticide use, artificial colors/flavors, HFCS, etc. including bans like some countries have. But I don't know that you can go around taxing anything that isn't 100% healthy. When I was vegan I was convinced people who ate meat were damaging their health. Now I need to eat meat several times a week for health reasons. I would hate to have some policy-maker decide that meat should be more heavily taxed because they deem veg*ns to be healthier or because some studies show meat consumption increases heart attack risk.

For the record, I am a very healthy eater, I'm not remotely overweight, I've never smoked or used drugs/alcohol... but I have a lot of compassion for those who do, because I know it's not a choice made entirely out of free will. When people have the proper knowledge, support, money, opportunity, etc., they can make better choices. I don't believe in punishing people because they make poor choices in the midst of a bad situation. If we want to stop paying for heart surgery for someone who's obese & eats poorly & smokes, we need not only to treat all of that person's mental health issues (depression, anxiety) and physical health issues (thyroid problems, food intolerances, etc.), but also to make sure that person has a full knowledge of healthy eating, money to support a healthy diet, time in the day to exercise (which may mean reduced work hours, a less sedentary job, extra child care, a gym membership, etc.), ways to control the factors that lead them to smoke (including stress, social issues, advertising, etc.), and some treatment to help them break the addiction. It's not as simple as just holding them responsible for their medical expenses or throwing extra taxes at them.

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#26 of 48 Old 01-21-2013, 04:21 PM - Thread Starter
 
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I read a study not long ago about multivitamins increasing the risk of breast cancer. Should we hold people accountable for making the choice to take a daily vitamin if they come down with breast cancer?

I need to look this up, as I have not heard about this.

 

Saying that someone who made a decision to improve their health, then got sick anyway does not mean the same as someone who decides to smoke, which is a KNOWN risk factor of disease and then gets sick. Those are two totally different scenarios.

 

 

 

Quote:
Some studies recommend 30-60 minutes of moderately intense exercise every day. How many people are able to meet that goal? Do we hold people accountable for their poor choices if they only manage to exercise 20mins, 3 times a week?

 

You are starting to reach a bit. This is not a good example of what I am talking about. Any exercise is a good lifestyle choice and can improve one's health.

 

 

Quote:
I think if you don't want to pay for other people's health care then maybe forego insurance completely? And pay out-of-pocket for everything so you aren't somehow subsidizing someone else's care.

I'd love to, but we cannot do this unless we want to pay a penalty/tax thanks to Obamacare. Everything is different now.

 

 

Quote:
I don't want more taxes but if I am going to pay taxes anyway, I'd much rather pay for someone to have open-heart surgery (no matter how horrible their diet or how many packs of cigarettes they smoked) than for wars, corporations, etc.

 

That's your preference, and I agree about not wanting to pay for useless wars and bailing out banks, etc.

 

 

Quote:
I would not support sin taxes on food, except if very clear guidelines were in place. It's too fine a line to walk because there are so many differing ideas regarding nutrition. I would probably support subsidies to make fresh fruit & veggies more affordable. I would support stricter guidelines around pesticide use, artificial colors/flavors, HFCS, etc. including bans like some countries have. But I don't know that you can go around taxing anything that isn't 100% healthy.

 

 

Yes, a very clear guideline would need to be in place. Just what, I don't know. I agree with what you are saying. It would be very hard to do something like this, but in the instance of an extremely poor diet or smoking, those seem to be pretty clear cut. As far as different ideas of nutrition, yes that can vary, but I'll tell you that I all too often see people in grocery stores buy just horrible, horrible food. I've seen families fill their cart with all different kinds of juice, not fruit juice, but that red, blue, purple stuff, and donuts, pork rinds, cakes, cookies, sugary cereals, hot pockets, soda. Just awful. There was not a vegetable or meat to be found. So, it's not a matter of taxing more for canned vegetables as opposed to fresh. How about taxing more on twinkies and that purple juice stuff that is totally void of nutrients. That would be easy to do.
 

 

Quote:

 I don't believe in punishing people because they make poor choices in the midst of a bad situation. If we want to stop paying for heart surgery for someone who's obese & eats poorly & smokes, we need not only to treat all of that person's mental health issues (depression, anxiety) and physical health issues (thyroid problems, food intolerances, etc.), but also to make sure that person has a full knowledge of healthy eating, money to support a healthy diet, time in the day to exercise (which may mean reduced work hours, a less sedentary job, extra child care, a gym membership, etc.), ways to control the factors that lead them to smoke (including stress, social issues, advertising, etc.), and some treatment to help them break the addiction. It's not as simple as just holding them responsible for their medical expenses or throwing extra taxes at them.

I kinda do believe in not punishing people, but holding them accountable. No one is saying to stop paying for open heart surgery, but if they are knowingly not helping themselves, they need to be responsible for their actions. Yes, usually people in these cases have other problems too, and they do need to be educated. I used to work in cardiac and pulmonary rehab as an exercise specialist. We taught them everything you outlined above and more. Some were willing participants, some were not. It was very frustrating to work with the folks who didn't care, because no matter what you did, they just kept on behaving as they did before the event that brought them to rehab. Maybe a hit to the pocketbook might change some of these folks. That may not even do it. Again, I don't have an answer. But maybe having a sin tax would help the situation.


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#27 of 48 Old 01-21-2013, 07:46 PM
 
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I kinda do believe in not punishing people, but holding them accountable. No one is saying to stop paying for open heart surgery, but if they are knowingly not helping themselves, they need to be responsible for their actions. Yes, usually people in these cases have other problems too, and they do need to be educated. I used to work in cardiac and pulmonary rehab as an exercise specialist. We taught them everything you outlined above and more. Some were willing participants, some were not. It was very frustrating to work with the folks who didn't care, because no matter what you did, they just kept on behaving as they did before the event that brought them to rehab. Maybe a hit to the pocketbook might change some of these folks. That may not even do it. Again, I don't have an answer. But maybe having a sin tax would help the situation.

 

My sister had a massive heart attack at some point a few years ago. (We don't actually know when she had it. She survived, and continued to function on a damaged heart for an unknown period of time.) The preliminary diagnosis of "there's something wrong with your heart - get to the hospital now" was made on her 40th birthday. Two weeks later (three years and three weeks ago), she had a valve replaced, another one repaired, and six separate bypasses. She still smokes, even though she lives in poverty, and cigarettes (due largely to "sin taxes") are over $8.00 a pack. I have mixed feelings about sin taxes, but I've never seen any evidence that they're going to curb the behaviour of the people who need those changes most.

 

I'd be nervous about "sin" or "health" taxes on food, as a rule. But, I think a good argument could be made for taxing candy, soda pop, and fruit drinks that don't even contain any juice. (There are probably a few others, but those are the things I can think of, off the top of my head, that offer no nutrition beyond carbs...simple ones, at that. I've seen a lot of arguments about the health impact of meat, dairy, organic vs. conventional, grains - whole or otherwise, fruit juice - real juice, etc. I've yet to see anybody make an argument for the nutritional value of candy - aside from maybe dark chocolate, soda, and fruit "drinks".) I'm not sure I'd agree with it, but I think a good argument could be made.

 

On the other hand, this kind of thing can result in some bizarre results at the cash register. We have the GST (Goods and Services Tax) in Canada. Food is exempt, but snacks aren't. As a result of the way this has been implemented, I can buy a six-pack of muffins, and pay no tax on them. In that quantity, they're considered to be a grocery item. If I only buy one, then it's a snack, and it's taxed. This applies to other products, as well, but I can't remember what they are. It's really odd.


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#28 of 48 Old 01-21-2013, 09:21 PM
 
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I cringe every time someone suggests taxing high fat foods and meats because they are unhealthy.  Grrr.  We eat a high fat low sugars diet on purpose, and no one in my family is anywhere near overweight--not even pudgy-- and we have consumed no health care treatments for YEARS.  I am not expecting our diet will be the cause of future health issues, either.

 

I don't know what the new laws will mean for us because we are self-employed and extremely low income.  I think we are too poor to be hit by any penalty?  Being without health insurance is the worst part of being self-employed.  It is very discouraging that even if we do somewhat better in income we are a world away from insuring ourselves.  Thus I feel hopeless that building our business ventures is even worth it even though they are both moderately viable. 

 

I wish I thought that this health care act would help us but I fear it will not.  I am glad that the effort has been made to overhaul this system. 

 

I can hardly believe it is legal to brainwash us all with advertising to eat bad foods, the profit goes to big companies, then we also pay for the health costs that result and the profits for that go to other big companies.  Think about soft drinks alone: so much advertising, a staple in most family refrigerators, standard alongside any average or fast food restaurant meal, and pretty much toxic.  Equally harmful is all of the marketing encouraging us to watch more TV and buy even more hand held gadgets to entertain yourself without moving any muscles except in your hands...   Why is it okay that our youth are saturated with consuming (passive) messages in advertising?  That stuff is powerful.  Most people seem to think they are somewhat immune to it... Many people don't care if they are or not. In the US it seems like most of our economy is built on "sin"-consuming with a heavy heavy dose of manipulation. 

 

Really, anything that encourages a sedentary lifestyle would be excellent for a sin tax.  Movies and television and video games should be taxed before cigarettes; they affect more people and more chronically and tobacco is already heavily taxed in many states.  Any entertainment controlled by buttons, accessed by machine, that can be done without leaving home is pretty bad news for health and could be included.  It's so tempting, so addictive, and so easy to watch television 4-5 nights a week with lots of sit-down work/school in between.  It's the norm for a lot of folks.  Games, computer time, movies, TV, etc.  How many kids move from schoolwork to homework to hours of these reward entertainments?  And how many adults have similar patterns? 


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#29 of 48 Old 01-21-2013, 11:20 PM
 
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"Sin" tax would be too complicated to manage.  I think unless people really want their country to fall apart, it's best to avoid those and treat all people equally, no matter what stupid choices they've made.  I know someone who is obese and has diabetes because he has mental illness and can't manage cooking and meal planning too well.  I'm not sure what caused his mental illness but he has a hard time finding a job because of that and thus has to eat very cheap food.  He was abused as a child.  Who do we blames and hold responsible?  And how do we make him pay since he is dirt broke?  The only "fair" thing would be to let these people die, problem solved, right? 

 

All countries with universal health care have higher tax rates.  And for most people it's not exactly "free".  Everyone who can afford premium is required to pay.  My family pay over $400 a month for insurance (government plus extended).  Those doctors who don't accept them will eventually have to.  This is my personal feeling but I always though doctors in US make way too much, and drugs are way too expensive.  Doctors and drug companies might have to make less profits, might be the end of the golden age for them, but it might not be a bad thing.  They probably don't work any harder than doctors in India, what makes them deserve so much more pay?  Just because it's US? 


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#30 of 48 Old 01-22-2013, 06:27 AM - Thread Starter
 
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I cringe every time someone suggests taxing high fat foods and meats because they are unhealthy. Grrr. We eat a high fat low sugars diet on purpose, and no one in my family is anywhere near overweight--not even pudgy-- and we have consumed no health care treatments for YEARS. I am not expecting our diet will be the cause of future health issues, either.

I don't mean to tax higher fat cuts of meat versus lean meats or canned vs fresh veggies. I'm talking the terrible stuff... candy, cheetos, soda, etc. stuff like that.

 

Yeah, trying to get health insurance, being self-employed, is really hard and really expensive. DH has been self-employed in the past, now he works as a subcontractor (essentially same thing) and his employer does not offer health insurance. He interviewed for a job last week, which is a W-2 position, they aren't offering health insurance either, and the guy specifically said he isn't offering it because of Obamacare. Buying health insurance as an individual is way more expensive than getting it through an employer. And, the coverage is not as good either. The middle man always gets hosed.

 

 

Quote:

Really, anything that encourages a sedentary lifestyle would be excellent for a sin tax. Movies and television and video games should be taxed before cigarettes; they affect more people and more chronically and tobacco is already heavily taxed in many states. Any entertainment controlled by buttons, accessed by machine, that can be done without leaving home is pretty bad news for health and could be included. It's so tempting, so addictive, and so easy to watch television 4-5 nights a week with lots of sit-down work/school in between. It's the norm for a lot of folks. Games, computer time, movies, TV, etc. How many kids move from schoolwork to homework to hours of these reward entertainments? And how many adults have similar patterns?

I agree.


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