Great opinion, I totally agree with many points. The cost/fines, the flying under the radar amendments (like the gun control one too)and yes, the lifestyle "incentives".

As a woman who went bankrupt for medical crisis due to a child's care, I would never be able to afford any insurance or a fine, I guess I'd end up in jail!

I think that this should be public vote, and I always have.

It's far more serious and lifelong affecting, than voting for President. I am not comfortable with a handful of immoral and corrupt politicians choosing my life's outcome.

What a mess, I didn't vote for Obama and I'm going to suffer the consequences of his smooth self-centered marketing campaign long after he's out of office if this crap passes.

Right on Philip, and I hate it because I think all of us should have access to health care but I'm opposed to mandatory health insurance and of course to it's companion, electronic medical records. As you say, if you have to be "healthy" to have have health insurance and you have to have health insurance, then all sort of health care is mandated, most of all treatment for "depression." It's scary how many people don't care about this.

If health insurance is such a good thing why does it have to be mandatory? (not necessarily a rhetorical question). Why not just pass all of the reforms, like prohibiting insurance companies from dropping you in the middle of treatment for cancer? If it's so great then people will buy it of their own accord.

At first glance, I liked the idea of discounts for 'healthy choices' (even though I smoke). The problem is, as you point out, who gets to decide what is a healthy choice? I can totally envision forced drugging being perceived as such. I really want some way for those with no coverage to have better access to care, and I would also like to stop getting robbed by my insurance company, but I worry about the real cost. The kind that can't be measured in dollars and cents. Maybe it is my bias as a traumatized person who went on to be abused by the medical establishment, but as much I admire Obama for certain things, the phrase 'help is on the way' scared the bejesus right outta me. 'Help' has not been helpful in my experience. It has been destructive. I would have been better off left for dead. I'm thinking about giving up a vice. Perhaps it will be voting (but that probably qualifies more as a folly than it does as a vice).

Concerning the "healthy lifestyles amendment", I'm concerned about what all would be considered a lifestyle issue. I think charging differential rates based on choices that are well proven to cause problems (smoking being the most obvious one) is a great idea. If it covers conditions (obesity, high blood pressure or cholesterol, mental health problems), then I oppose it.



I believe that we need to seriously encourage healthier lifestyle choices, and this seems like a good way to do so (except I oppose having health insurance tied in with employment).
But, there are choices (choosing to smoke, abuse drugs or alcohol, eat too much, and not get enough exercise), which are different from conditions. If a person is overweight, is the cause lifestyle or genetic, or maybe medication they are on?

I believe that encouraging a healthy lifestyle is not comparable to requiring medical treatment (with known and often serious side-effects) for conditions. (I do wonder if in the future, they will not only be comparable, but considered equivalent. But that is not for here and now.)

I'm totally with Anon on this... "help is on the way" is a scary, traumatizing phrase to me.

Hmm, this stuff seems like a backdoor way to still allow discrimination by health insurance companies. Like, the official line is we will now forbid h.i. companies from refusing to cover people with preexisting conditions. But then we'll favor people who are healthier in their lifestyles. Ta-da: reinforce the status quo by other means.

I guess the conclusion I'm coming to is that this only SEEMS "Nanny State"-ish. It's really pro-corporate.

I do believe in public-health measures such as mandatory seat-belt wearing because it's not only a choice, it's provable that not wearing one leads to more hospitalizations and deaths. Whereas you can't prove someone is, say, overweight because of unhealthy habits. Hmm...how are they going to deal with people who are obese because they take Zyprexa and the like?!

I'm a pinko in most of my political philosophy but mandatory health insurance and lifestyle discrimination send me into a Libertarian fit.

It's interesting to me that only individuals are being held accountable for these lifestyle issues. The major corporations that lard our food with pesticides and genetically engineered ingredients (and there's simply NO way our level of knowledge allows us to know the effect of GE foods on the human body) get only protection. And hey, how about all that hidden corn syrup, folks? Does anyone seriously think that unknowingly consuming the empty calories hidden in so many of our foods doesn't contribute to obesity.

I'm dead set against mandatory subsidy of insurance companies, which is all Medicare D and compulsory insurance are (is?).

I'm also completely disgusted with the dropping of the public option from the health "care" bill. The Dems have gone through their dog-and-pony posturing in order to claim they "fought" for a public option. I'm not buying it for a minute.

Snarkily yours,
Sherry

I agree that discounts for "being healthy" is fraught with some issues regarding definition (such as "med compliance" being considered "healthy" God forbid). At the same time I do resent subsidizing those who are making poor choices like smoking, eating processed food, and not exercising. I spend a lot of time on my health; I consider it a social responsibility in fact. Our society is only as healthy as the individuals in it. I think there's a strong chance that more of us should be paying for our routine care (which would be an incentive to make better choices) and the government or private insurers should be there for the catastrophic and chronic stuff. That's what really needs to be covered. Dissing incentives to make healthy choices seems to be the least of the problems with health care reform. Aren't there bigger fish to fry?

healthy habit bonus: soon, this will spark outrage. Who are the most clean-living amongst us? It is those of us who, for religious/organized religion-following reasons, do not smoke or drink or have s exua l relationships outside of marriage. So, there will be a differential benefit for Mormons, Muslims, and the modest portion of Christians who actually practice what we preach. In Utah the Mormon lifestyle's influence upon health is so dramatic that Utah defies many health trends across the rest of the states. For a different demographic illustration, consider the health habits of the poor: not only do lower-income people have worse access to health care, the rates of unhealthy behaviors are dramatically different. Smoking rates have a smooth linear relation with education levels (more educated smoke less), and with income levels (more income = smoke less) until you get to the lowest SES levels: poor people, and / or people with few years of education REALLY smoke, relative to their higher-ranking SES neighbors. Same pattern for overweight/unhealthy diet/low exercise. Thus, any health behavior penalty will regressively hurt the poor. And favor the pious organized-religion followers. Is this the change we voted for?

Medsvstherapy is right that healthy lifestyle bonuses are regressive and hurt the poor more than the wealthy and educated. I still think healthy lifestyle is darn important and ought to be encouraged. Don't know how to do it, it's true.

You know "poor choices" and referencing diet, exercise and smoking?

Devil's advocate for a minute:

Let's take the government to task for allowing advertising for junk food, corporations for making money off of kids (hello McHappy meal)and school lunch programs and their fat content, and cheap ingredients.

It's pretty hard for the American lifestyle to change overnight! we are reaping the benefits of our "freedom" to choose, to having companies, own stock, etc.

At this point we are so screwed up there is no way this health reform can work.

America as it is now is what we have created. We are products of our environment that is for sure, and it looks like the environment isn't so great after all!

"I don't even want to get into how the amendment--and increasingly much of the bill itself--flies in the face of personal choice and American individualism."

I'm surprised you'd say that. Personal choice and individualism is why America has such a high rate of psych drug use - Direct To Consumer advertising (First Amendment!) and the idea that people can just decide that they're "mentally ill" because they saw an advert and demand treatment for it...

Ever been to Europe? I think you might like it. Big Pharma is a lot less Big over here.

These comments are making me just as angry as Ensign's proposed amendment (as described here - I haven't read it either). There. Is. No. Moral. Obligation. To. Be. Healthy.

I agree with Another Anon. I do my best to walk regularly; eat not only the right portions but avoid almost all pesticide-laden, genetically engineered and corn-syrup loaded convenience foods; use my seat belt; rarely drink; have never smoked--cigarettes. But I do none of this out of social obligation. That would really be putting way too much of a burden on me, frankly. I'd be way more likely to go in the other direction if I thought of it that way.

I do all this because I despise doctors and will do nearly anything to avoid them. I figured out a few years ago that there were about five or six things I could to to maintain my health so I could mostly avoid contact with the medical profession. I also FEEL better, plain and simple.

That's why I do all this. Other people have other reasons. But, please, don't tell me that I, who live in one of the most unhealthy societies on earth am supposed to transcend my culture and stay healthy for the rest of you. That just doesn't fly.

I live in a rural area, don't have a tv, have little interest in US culture, all of which makes maintaining my lifestyle a whole lot easier than it would be if I lived in the suburbs or city. Anyone who wants to join me--all for the common good, mind you--in my boring little life is more than welcome. I don't find it boring, but I'm betting most people in the US would.