Does/will/would Obamacare change anything related to coverage or costs based on behavior like smoking, wearing seat belts, riding a motorcycle without a helmet, etc. ?
I’d like that information too but for an opposite reason to yours probably. I wonder how much these factors weigh in on the cost of private insurance: you don’t hear too much these days about companies charging more for those activities, and if so it is a very minuscule part of the fees they charge.
So if they don’t do it and the government health care won’t do it either, then technically the answer is no, even if it would be more efficient to do so.
About a year ago, I contacted HR about our group plan (for which we had never answered any health questions or undergone a physical exam to enroll in), and asked if I could get a discount on my premiums by passing a drug test (which could include nicotine), a physical exam, or physical fitness evaluation. The answer was a big fat NO.
The danger is - where does it stop? Canada AFAIK no province makes any issues with behaviour vs health care. OK, people who make Jackass videos or do stuntman tricks for fun where there’s a really good chance they’ll get hurt… maybe they should be penalized. Then there’s the questionable acivity - whould we penalize someone who skateboards? Skis? Hang glides? Flys private (small) aircraft? Where does it stop?
As for lifestyle, then what? Smokers? Charge extra or reduce coverage for fat people? Heck, ther are more deaths from heart disease than smoking; have the fat police take time off from showing calories on NYC menu boards to chase down people who overeat? How about if it’s not lifestyle, but genetics? Your family is prone to heart disease or hgh blood pressure, so we’re going to charge you etra…?
The only place it comes into play, and I believe you have the same issue already in the USA - would be that for example, you will not get priority for a lung transplant if you do not stop smoking (assuming you still can with your condition) or similar behaviour for other organs (liver-drinking?). The physicians want to know that they are not just wasting a health donor organ that someone else would put to better use.
I hear you. IIRC (but maybe I’m mixing up health vs life ) smoking is a pretty standard question. If that is the case it already has started…I’m wondering why it hasn’t or even whether it can go further.
The Genetic Information Nondiscrimination Act of 2008 prohibits the use of genetic information by health insurers or employers. Health insurers may not deny coverage or charge a higher premium based soley on genetic predisposition.
Other insurers, like life insurers or long term disabiltiy insurers are allowed to use genetic information when making underwriting decisions.
My employer provided Health Insurance used to nearly double your premium if you smoked. Of course, that was before the AHA passed, too. Our new provider does not.
Personally, I have no problem with private insurance companies charging higher premiums for smokers, or not wearing seat-belts or helmets. If I had my druthers, I’d get rid of mandatory seat-belt and helmet laws, but allow insurance companies the option of not paying out should you get in an accident and were not wearing a seat-belt or helmet.
So if I don’t have you tested, can I raise your rates based on your family history?
Family medical history is considered genetic information under GINA and insurers are prohibited from using it in underwriting.
side-note: I read somewhere credible(23andMe.com, a genetic testing company, but can’t seem to find it now..) that this law has yet to be tested in court. So although you’re technically protected, we won’t know until someone gets thru a lawsuit.
How was this adjudicated in real life? Was it simply a question on a questionnaire or did they base it off of a nicotine test? If you were paying the smoker rate and one day you call HR and claim that you “quit” and can they drop you down to the nonsmoker rate, how did it work? Did you go in the next day for a drug test and if you passed, bam, or did you have to stay off for X days/weeks/months/years before you could be reclassified?
I know some people feel everything is about economics but I don’t believe that’s true.
I doubt there’s anyone who’s thought to themselves, “Thank God for Obamacare. It’s made dying of lung cancer affordable to somebody like me so I can finally take up smoking.”
I agree with this on the microscale, but on the macro-scale I suspect effects can be seen due to unconscious actions of the masses.
Perhaps a GQ answer to this would be compare rates of overly risky behavior between the U.S and the U.K. They are somewhat similar in demographics, and socioeconomic status. Although I suspect that a variable that may need to be controlled with be education level.
But you’re not going to die of lung cancer until sometime in the indefinite future, whereas you have to pay your insurance premiums today.
I’m with Cigna and this year they did this thing where basically they said “we’re going to raise your rates $20/month unless you participate in the so-called health screening”.
You go to the screening and give them all kind of personal measurements and body fluids, and then you have to sign an “agreement” that you will see a doctor within 60 days about any health risks (or what? I don’t know, but I’m sure it it will be brought up if I file a claim for a stroke in the future)).
So yeah, the days of your insurance company poking its nose into your personal life and telling you what to do? That already exists. Private companies are on that slippery slope. Death panels exist. The only difference with government healthcare is, would you like these decisions made by elected officials in your district, or by some insurance company executive who can afford an extra boat payment if he finds a new way not to pay out claims?
(reported for forum change)
I agree with Little Nemo in some respect. The choice to engage in risky behaviour is seldom based on the financial implications of the outcome. Though there may be some factor, the pain, discomfort and lethality potential far outweigh the question of whether someone can afford it or not.
If there is some stretch of a GQ answer, you could also compare behaviours within cohorts where the controlling factor is health insurance. As education, employment and wealth are closely tied to having insurance (and the type of insurance), those factors would need to be controlled for. Or look at people’s behaviours within a company that changed or dropped policies. When insurance covered less, did people change their behaviour?
With regard to behaviour, however, note that UHC or the weak Obamacare that was passed should tend to lower overall costs. Though UHC does have the problems associated with the appearance of unlimited resources, the availability of sound medical care will encourage the behaviour of seeing a doctor before it is an emergency. If routine exams are covered, and people have the option to see a doctor when symptoms first arise, preventative and early treatment will lower a person’s overall use of health resources. Additional productive years will increase the tax base. Alleviating suffering is an intrinsic good.
Guys. Obamacare is modeled on other countries, where effects like these have been feared, debated, studied, and found out to be manageable.
The link above is a wiki on socialized medicine. If there is info on the GQ I don’t see it.
Here’s the OP again … Does/will/would Obamacare change anything related to coverage or costs based on behavior like smoking, wearing seat belts, riding a motorcycle without a helmet, etc. ?
I believe its been established that smoking is currently used and no one has suggested that Obamacare would change that.
Having a health screening and following the guidance has also been mentioned but not exactly what I’m looking for.
Using genetics is/has been apparently forbidden.
I’d welcome a move to GD if a debate on whether it should be might also illicit some facts on whether it is allowed to be.
The equivalent service in other countries - no. In a society that wants to provide health care to all citizens, whats the purpose of adding bureaucracy to categorize your clients? In the end, they all get the same health care. Think of it like Medicare in the USA - if you qualify, you qualify. Adding a layer of office staff to figure out if you qualify as A or B - why?? In the end you get the same care. And what - if it turns out you lied or backslided (?) on your nonsmoking, they still have to treat you.
The purpose of conditions is for a commercial enterprise to find excuses to deny you coverage or charge more. In fact, AFAK most Canadian provincial health cares have no extra charges; it’s paid out of taxes.
What Canada does, for example - they jack up the taxes on cigarettes. A pack here costs substantially more than in the USA. Taxes on liquor are similarly quite high.
(According to a tobacco company study, smoking actually saves the system money; people who die early of lung cancer or heart problems save the system a huge amount of money which is usually spent on various chronic problems of the elderly. Not exactly the result they were looking for in the study…)
Why do you assume that would happen with government healthcare? it certainly hasn’t happened in Canada, which has had a national medicare system for going on 50 years. can you show were it has happened in other countries with a form of universal health care?