Health care law changing behavior

[Scott_Lafrance]

How many got exams before the law took effect?

As for “lowering costs” who paid for those 24 million “free” exams?

I was gonna say, they should stop calling it free, because it isn’t. The person getting the exam doesn’t pay for it, someone else does. So, we have a government that forces people to pay for other people’s services. And we thought slavery was abolished.

 

[seekerz]

Just to add to this, that in a world where a kid can still die of simple diarrhea or an infected cut, there is something positively immoral about people eating themselves into various types of organ failure, the cost of which could support a whole village for a year.

What 40 year old on dialysis from uncontrolled diabetes that has been hastened along by his unwillingness to place reasonable curbs on his appetite, could ever justify such behavior in the name of personal freedom? I’m not implying that everyone with uncontrolled diabetes or on dialysis put themselves there on purpose, but the numbers of people as described in my example are ballooning. People literally eating themselves into a hospital bed by refusing to adhere to recommended advice that amounts to nothing more than commonsense self-restraint, while some kids can’t get access to a routine dental check. How is that okay on any level?

 

[SamH]

Just to add to this, that in a world where a kid can still die of simple diarrhea or an infected cut, there is something positively immoral about people eating themselves into various types of organ failure, the cost of which could support a whole village for a year.

That’s why the US should end welfare as we know it. The greatest health threat to the poor in this country is obesity.

 

[Ridgerunner]

There is a middle-ground (I’m growing to live the middle more everyday) between state-mandated ‘behavior change’ - not that behavior change works very well as an approach to health - and unfettered obesity. It’s called empowerment - given the opportunity to both acquire knowledge of health preservation AND the opportunity to provide (name removed by moderator)ut to the discussions and the policies that flow from them - most individuals and communities can come to sensible solutions that approximate to their values without placing undue strain on limited health resources.

I reject the notion that freedom is limited to living one’s life in blissful, irresponsible ignorance of the consequences to self or to society as a whole.

Empowerment, indeed. Disempowerment would be more like it.

What person who smokes does not know of the health risks? What obese person does not know about the health risks? What persons in either category are truly ignorant of the ways to change their habits of life?

Telling an obese person that he/she needs to lose weight does nothing. I recently read an interesting article by an NP who did a survey, and it appears the nagging approach by both the media and healthcare people simply leads to resistance, particularly when moralizing is added to the brew.

So, then, if we just can’t live with the thought that someone is obese, what do we do about it? Pound them some more so they become more resistant? Do we deprive them of healthcare even if the condition for which care is sought has nothing to do with obesity? Or do we simply shoot them out of hand?

Unfortunately, deprivation of heathcare is becoming the “treatment of choice”, and government programs now encourage that treatment.

What might possibly be answers? I don’t know. Maybe there are none, and maybe we shouldn’t make a religion of imposing the “answers” those who have never experienced it so readily prescribe. The NP abovementioned, at least, had another suggestion, but it would be devilishly hard to do in a “one size fits all” politically based solution. Her suggestion was additional training to professionals in ways to become more “holistic” in medical practice, including real insight into the real causes of obesity, distinctions between “obesity” that’s unhealthful and that which is not, better education in metabolic “burn rates” and psychological training so that the patient’s overall health is a partnership between the patient and the provider. She also suggested that certain types of resistance are intractable at any given moment in time, and the patient should be left alone about it and not penalized in the professional setting. Unfortunately, the likelihood of that happening is virtually nil because it requires too much provider time and is 180 degrees contrary to what’s going on. Furthermore, it requires insight and compassion on the part of the provider, which is mightily discouraged in the current “cookie cutter” medical model movement.

 

[Scott_Lafrance]

Just to add to this, that in a world where a kid can still die of simple diarrhea or an infected cut, there is something positively immoral about people eating themselves into various types of organ failure, the cost of which could support a whole village for a year.

What 40 year old on dialysis from uncontrolled diabetes that has been hastened along by his unwillingness to place reasonable curbs on his appetite, could ever justify such behavior in the name of personal freedom? I’m not implying that everyone with uncontrolled diabetes or on dialysis put themselves there on purpose, but the numbers of people as described in my example are ballooning. People literally eating themselves into a hospital bed by refusing to adhere to recommended advice that amounts to nothing more than commonsense self-restraint, while some kids can’t get access to a routine dental check. How is that okay on any level?

Personal freedom includes the power to destroy yourself, if you so choose. God gives us that right, why can’t other people.

I’ll tell you why. Because they are control freaks. They cannot stand that other people would dare to choose to do something different from what they would choose, so, the elect people to government (or run themselves) to make rules that forces everyone into conformity.

 

[SamH]

Personal freedom includes the power to destroy yourself, if you so choose. God gives us that right, why can’t other people.

I’ll tell you why. Because they are control freaks. They cannot stand that other people would dare to choose to do something different from what they would choose, so, the elect people to government (or run themselves) to make rules that forces everyone into conformity.

But the government will make sure that taxpayer money is spent on those with the greatest need.

freerepublic.com/focus/f-chat/2817166/posts

 

[Scott_Lafrance]

But the government will make sure that taxpayer money is spent on those with the greatest need.

freerepublic.com/focus/f-chat/2817166/posts

Ya right. Read my tag line. You cannot divorce government control from political control. The money will always be spent where it will buy the most votes.

 

[Trader]

I think you will find, soon, that those people who have unapproved lifestyle habits (except sexual promiscuity, of course) will be on the outside of the healthcare world, looking in. Well, also excepting those who enjoy political power or favor, of course.

Nevertheless, one does need to wonder at least a little about a society that purports to “change the behavior” of its citizens, particularly if the “change” does not clearly lead to any societal or even individual benefit and presents no clear and present danger to anyone. Do we, like the giddy early Bolsheviks somehow think we are going to abolish illness and death by fiat or overblown optimism based on anecdotal science? Yes, studying well people will definitively establish…that they’re well.

It is well known that members of contemplative religious orders enjoy remarkably good health and long lifespans. But does that mean that the government should therefore impose Carmelite-like behavior on everyone? A single cup of vegetable soup for Thanksgiving, perhaps. Or perhaps instead a bowl of boiled nettles. After all, the inhabitants of the Gulag lived on that, didn’t they, and their BMIs were wonderfully low. And if the inhabitants of the Gulag smoked manure in the absence of tobacco, well, there are no statistics kept of the hazards of the former, so perhaps that can be permitted.

It truly does astonish me that in a supposedly free society there are so many who so readily revert to what is essentially a secular Puritanism, and upon such uncertain premises. If we can’t be allowed to be overweight, then what can we be allowed with any certainty? To follow the dictates of the state, one supposes.

I am also pro-freedom. I do not support the proposals that would tax soft drinks for everyone because some people overdo it. I do not support a cigarette tax that approaches infinity. It will drive more tax evasion and make the tobacco trade a top business for organized crime. I do not support a government takeover of health insurance where a handful of the self-annointed elite decide which groups get favored treatment and which groups are assigned the duty to pay for it.

I support a market based system where individuals get decide which risks to take and bear the responsibility to pay for the choices they make. Those Carmelites deserve a lower rate on health insurance and private companies would fight for their business in a market based system, because it would be profitable.

Can you imagine a system of auto insurance where a person with a 1997 minivan and no tickets in 45 years would pay the same premium as my neighbor with the brand new $70,000 Corvette and a DWI conviction? Only goverment would be dumb enough to use that model for health insurance.

 

[Roselle]

Sadly the new health care law is making medicine more expensive. It is making the situation worse. Medicaid expenses are up nearly 30% further bankrupting states hurting for cash.

“Medicaid Blows Up State Budgets”

blogs.the-american-interest.com/wrm/2011/11/30/medicaid-blows-up-state-budgets/

From Walter Russell Mead:

The unsustainable course of American health expenditure is placing growing pressure on state budgets from one end of the country to the other. The Washington Post has the story:
The Fiscal Survey of States says that even as states struggle with tepid revenue growth, they will be called on to spend more because of the economic distress caused by continued high unemployment…
Officials say the fiscal pressure that Medicaid puts on states is expected to increase when the federal health-care overhaul takes effect in 2014…
States are also struggling to meet the needs of local governments. Many states cut aid to localities during the recession, and many of them want it restored.
State spending on Medicaid increased, on average, a whopping 29 percent this year. That cost looks set to increase, and there is no money to pay for it. The new health care law that supporters argued would solve these problems appears to be making them worse.
This can’t go on forever, and it won’t.

 

[seekerz]

That’s why the US should end welfare as we know it. The greatest health threat to the poor in this country is obesity.

And welfare is what causes obesity? There is no obesity epidemic among people not on welfare? I see we’re back again to if you’re fat you can’t possibly be truly poor…which, I personally find highly offensive. No, I am referring not to social class but to the overfed, whatever their class.

 

[Scott_Lafrance]

And welfare is what causes obesity? There is no obesity epidemic among people not on welfare? I see we’re back again to if you’re fat you can’t possibly be truly poor…which, I personally find highly offensive. No, I am referring not to social class but to the overfed, whatever their class.

Yes. The type of diet subsidized by welfare (food stamps, WIC, etc…) is the leading contributor to Syndrome X and Type 2 Diabetes, of which obesity is a major part of those disease complexes.

 

[seekerz]

Sadly the new health care law is making medicine more expensive. It is making the situation worse. Medicaid expenses are up nearly 30% further bankrupting states hurting for cash.

“Medicaid Blows Up State Budgets”

blogs.the-american-interest.com/wrm/2011/11/30/medicaid-blows-up-state-budgets/

From Walter Russell Mead:

I see the headline, but not the connection. Honestly, it’s a bit confusing. One would think that if hospital admissions are down as two earlier posters reported, that Medicaid costs would be less - not more. So how exactly (I know health care is a complex area) does the new law increase Medicaid costs as it has so far been implemented?

 

[SamH]

I see the headline, but not the connection. Honestly, it’s a bit confusing. One would think that if hospital admissions are down as two earlier posters reported, that Medicaid costs would be less - not more. So how exactly (I know health care is a complex area) does the new law increase Medicaid costs as it has so far been implemented?

Who said hospital admissions were down?

 

[seekerz]

Empowerment, indeed. Disempowerment would be more like it.

What person who smokes does not know of the health risks? What obese person does not know about the health risks? What persons in either category are truly ignorant of the ways to change their habits of life?

Telling an obese person that he/she needs to lose weight does nothing. I recently read an interesting article by an NP who did a survey, and it appears the nagging approach by both the media and healthcare people simply leads to resistance, particularly when moralizing is added to the brew.

So, then, if we just can’t live with the thought that someone is obese, what do we do about it? Pound them some more so they become more resistant? Do we deprive them of healthcare even if the condition for which care is sought has nothing to do with obesity? Or do we simply shoot them out of hand?

Unfortunately, deprivation of heathcare is becoming the “treatment of choice”, and government programs now encourage that treatment.

What might possibly be answers? I don’t know. Maybe there are none, and maybe we shouldn’t make a religion of imposing the “answers” those who have never experienced it so readily prescribe. The NP abovementioned, at least, had another suggestion, but it would be devilishly hard to do in a “one size fits all” politically based solution. Her suggestion was additional training to professionals in ways to become more “holistic” in medical practice, including real insight into the real causes of obesity, distinctions between “obesity” that’s unhealthful and that which is not, better education in metabolic “burn rates” and psychological training so that the patient’s overall health is a partnership between the patient and the provider. She also suggested that certain types of resistance are intractable at any given moment in time, and the patient should be left alone about it and not penalized in the professional setting. Unfortunately, the likelihood of that happening is virtually nil because it requires too much provider time and is 180 degrees contrary to what’s going on. Furthermore, it requires insight and compassion on the part of the provider, which is mightily discouraged in the current “cookie cutter” medical model movement.

The idea of empowerment is for solutions to be built from the bottom up, not top down. So, individuals and their communities could be tapped for their insights into the root causes of some of our medical problems and in turn could receive (name removed by moderator)ut from ‘experts’ regarding how to go about solving the issues that they have identified as priorities needing attention. So it’s not about telling people what they already know, it’s probing their thinking and their attitudes as to why for example, smoking is not a big deal for them. Is it a coping mechanism for overwhelming life stress, is it peer pressure or is it simply because they don’t envisage living long enough to develop lung cancer? Most people on reflection, can identify the reasons they engage in behavior - sometimes despite their desire to change…All empowerment is giving people the forum, the tools and the necessary knowledge to tackle problems which they identify as being central to their lives.

 

[bbarrick8383]

The idea of empowerment is for solutions to be built from the bottom up, not top down. So, individuals and their communities could be tapped for their insights into the root causes of some of our medical problems and in turn could receive (name removed by moderator)ut from ‘experts’ regarding how to go about solving the issues that they have identified as priorities needing attention. So it’s not about telling people what they already know, it’s probing their thinking and their attitudes as to why for example, smoking is not a big deal for them. Is it a coping mechanism for overwhelming life stress, is it peer pressure or is it simply because they don’t envisage living long enough to develop lung cancer? Most people on reflection, can identify the reasons they engage in behavior - sometimes despite their desire to change…All empowerment is giving people the forum, the tools and the necessary knowledge to tackle problems which they identify as being central to their lives.

I started to use tobacco as soon as I turned 18 because I could. I’d seen other kids younger than me doing it but never was allowed by my parents. A lot of people start in their early to mid teens just because their folks did it. I dipped snuff then started smoking and then told myself I was going to quit before I was 30. I’m 33 now and haven’t had tobacco since my late 20’s. It was a stress reliever, it was a bit frustrating at first. But I just told myself I wasn’t going to waste any more money on it. I never understood why some people need the gum or anything else to quit, after the first week it was pretty easy for me.

 

[Scott_Lafrance]

I started to use tobacco as soon as I turned 18 because I could. I’d seen other kids younger than me doing it but never was allowed by my parents. A lot of people start in their early to mid teens just because their folks did it. I dipped snuff then started smoking and then told myself I was going to quit before I was 30. I’m 33 now and haven’t had tobacco since my late 20’s. It was a stress reliever, it was a bit frustrating at first. But I just told myself I wasn’t going to waste any more money on it. I never understood why some people need the gum or anything else to quit, after the first week it was pretty easy for me.

Hey, I quit cold turkey myself. As far as I am concerned, it is the only real way to do it. Make up your mind and commit. I didn’t need a “plan”. My plan was simple, don’t smoke anymore. Not sure why people make it so complicated.

 

[seekerz]

Hey, I quit cold turkey myself. As far as I am concerned, it is the only real way to do it. Make up your mind and commit. I didn’t need a “plan”. My plan was simple, don’t smoke anymore. Not sure why people make it so complicated.

Because everyone is not you and empowerment is not simply about quitting; its about helping people identify and take action regarding the things that make them start smoking (or doing whatever else they see as a problem) in the first place.

 

[bbarrick8383]

Because everyone is not you and empowerment is not simply about quitting; its about helping people identify and take action regarding the things that make them start smoking (or doing whatever else they see as a problem) in the first place.

It doesn’t start out a problem though and most people would tell you to go fly a kite if you stopped and said “Hey, I’d like to talk to you about empowerment.”

They don’t want to listen until they start to fear that it will become a problem or it does become a problem. And there really isn’t a whole lot you can do about that.

For me, the fear of what may happen if I continued to do what I was doing beyond my 20’s was enough for me to quit.

 

[seekerz]

It doesn’t start out a problem though and most people would tell you to go fly a kite if you stopped and said “Hey, I’d like to talk to you about empowerment.”

Actually, that’s not quite the way it’s done…point is there is a solution that lies between the extremes of government being a nanny and people indulging/abusing themselves to death in epidemic fashion.

 

[Holly3278]

I don’t have too much of a problem with the health care law other than the fact that they are now going to require health insurance to cover contraceptives and sterilization. I also am worried that they will eventually make health insurance cover abortion.