Should we apply the same sort of "stupid X law" to people who drink alcohol or drive motorcycles or play rugby? This is one of the moral hazards of a socialized medical system. When the rest of society is paying for your medical care it becomes tempting to save money be dictating exactly how you're allowed to live your life.
Obesity is a serious public health problem but we won't fix it by calling people stupid or charging them extra.
Yes I think that makes sense, to an extent. Maybe not specifically those because they are too hard to measure. But it would be a great way to have people put skin in the game. As a taxpayer paying for others’ healthcare I’d love if they were incentivized to live healthier lives to reduce costs
There are people genetically predisposed to gain weight or have heart disease. Cancer can be Russian roulette, as is your immune system picking up random autoimmune disorders. Accidents happen.
There are too many stakeholders with too many backgrounds and conditions for anything like your proposed system to work. Everyone would be angry.
> There are people genetically predisposed to gain weight
And this genetic mutation somehow happened in the last 50-100 years or so? Obese people have always existed. Obese poor people are fairly new. The root cause is diet, not genetics.
>Should we apply the same sort of "stupid X law" to people who drink alcohol or drive motorcycles or play rugby?
Yes, precisely. Keep chopping down at these factors until all that's practically left is private healthcare -- that's a feature not a bug. It's enough that I have to pay the bill to scrape the blood off the street when a motorcycle is crashed, not interested in paying someone elses motorcycle related health premiums on top of that (I've gotten enough motorcycle injuries while carrying my own private healthcare :) )
>This is one of the moral hazards of a socialized medical system.
As you say with public healthcare the effect (you say temptation) is to socialize your health related losses while privatizing the gains you reap.
I'm not sure how the heck you jumped from "drive motorcycles" to "drive cars".
Driving cars would be minor and apply to almost everyone, so it would mostly cancel out and be negligible. Really it would be a slight discount for taking transit, and that seems... fine to me.
And those other ones aren't even notable risk factors.
Not people who live in dense cities with good subway systems and a walkable infrastructure. Driving is one of the most dangerous things humans do. The argument that all health care should be private– the perspective this comment addressed– would not make such a consolation simply because it's common.
> Not people who live in dense cities with good subway systems and a walkable infrastructure.
Yeah, so almost everyone.
> Driving is one of the most dangerous things humans do. The argument that all health care should be private– the perspective this comment addressed– would not make such a consolation simply because it's common.
Car deaths are about 1% of deaths. Heart disease and cancer are each around 15x as likely.
Even if it's high on the danger scale, I don't think it would be a very big factor in health care costs.
The US is a big place but most people live in cities. Few car accidents are fatal.
CDC: Motor vehicle crashes are a leading cause of death in the U.S.1, with over 100 people dying every day. 2 More than 2.5 million drivers and passengers were treated in emergency departments as the result of being injured in motor vehicle traffic crashes in 2015.1 The economic impact is also notable: for crashes that occurred in 2017, the cost of medical care and productivity losses associated with occupant injuries and deaths from motor vehicle traffic crashes exceeded $75 Billion."
American Society of Civil Engineers infrastructure report card says only 45% of the US population has no access to public transit.
> Motor vehicle crashes are a leading cause of death in the U.S.1, with over 100 people dying every day.
Motor vehicle crashes are slightly outside the top ten causes of death. Those 100+ deaths are coming out of about 9300 total deaths.
> The economic impact is also notable: for crashes that occurred in 2017, the cost of medical care and productivity losses associated with occupant injuries and deaths from motor vehicle traffic crashes exceeded $75 Billion.
Productivity losses are outside the scope of medical costs, but even if we include those dollars that's $75B out of $4100B in health care spending.
So I stand by my statement that it's a pretty small impact.
> American Society of Civil Engineers infrastructure report card says only 45% of the US population has no access to public transit.
And most of the other 55% still need cars.
You said "good subway systems and a walkable infrastructure" and that's what I responded to. We can go ahead and remove the word "subway", but the fraction of people with access to good public transit systems is pretty small.
Obesity is a serious public health problem but we won't fix it by calling people stupid or charging them extra.