Giving Medi-cal for people who don't try to improve their health?

starzJune 8, 2008

I used to work in a clinic where the majority were on Medi-cal, obese, and wouldn't comply with the diet needed to heal their wounds.

I am now self employed and to get coverage it would cost about $900/month for me and my family.

Do you think it would be fair if we gave people a discount on health insurance if they:

were in their normal, healthy weight, didn't drink, smoke, do drugs, and did exercise?

I mean, we had one guy who was an obese diabetic and called himself "the million dollor foot man" because medi-cal paid over a million on his foot. The doctor said if he lost weight, followed his diet, and kept his blood sugars under control, he would have never had this in the first place. Sadly, he wasn't interested in improving his health. He was more interested in talking about his coin collection.

It just makes me wonder if we should at least give some discounts or low cost health insurance if people are working HARD at staying healthy.

I understand some with mental problems or certain rare diseases may not fall under this category, but the majority CAN prevent many illnesses by diet and exercise alone.

What do you think?

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I think it's a bad idea. I think many overweight people are often judged incorrectly... sort of how you are judging them.

I also think you may be opening yourself up to some lawsuits... How would you choose who would get a discounts? Some may argue drinking a little wine is benficial to health, etc.. What would you do with pregnant women or overweight mothers who just gave birth, or chronically and mentally ill people? And, you mention RARE chronic illnesses???.. I think even UNrare chronic illnesses can cause or lead to weight gain. Diabetes is a chronic illness so would the man in your example be an exception and get the discount anyway? Do you know what diabetic neuropathy is? And, a lot of very popular medicines people take actually cause them to gain weight too.

You'd just be opening up a can of worms. About the only thing you may be able to offer would be a discount for smokers... although there may even be some laws about, I don't know what would keep people from lying.

And, I know this isn't what your post is about but you really, really should be thankful for your good health and being able to eat right and exercise. Many people are not blessed with good health or good genes. Please don't judge every overweight person thinking that ... if only they ate better or exercised... You really don't know what they are going through until you walk a mile in their shoes... and, no, I am not overweight myself so I'm not coming from that camp... but I've had enough health issues to know some things aren't as black and white as some may believe.

    Bookmark   June 8, 2008 at 9:10PM
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Amen, Carla! Every person has a different case. It isn't black and white, and you would be hard pressed to decide each person's fate.

    Bookmark   June 9, 2008 at 7:54PM
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One of my mother's friends (now deceased) had a medical condition that caused her to gain weight. I don't know what it's called. All I remember is that she needed two chairs to sit on because her butt was too big. My mom told me then that she had this illness that caused her to gain weight and that it wouldn't stop. Just before she died, however, she lost a lot of weight. The total opposite of what she was living! She was such a lovely woman! It didn't matter what she did, she couldn't lose weight. I think it had something to do with her hormones or something.

    Bookmark   June 16, 2008 at 7:51AM
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Can you imagine charging less for people that say they don't drink coffee, beer, soda pop and always flossed after every meal? Of course not. But all those things are supposed to contribute to better health according to some people. Think of all the watch dogs that we would have to hire to keep check on bad health habits. Would people lie just to get a discount?

Or maybe, we could decide that some don't take enough vitamins, or get enough sun, or get too much sun. Should we insist that everyone on government health programs always wear sun block when they go outside? That's ridiculous, isn't it!

This is one thing where the tax payer has to pay for everyone, regardless. Otherwise, we really do open a BIG can of worms when we start regulating health habits.

The bottom line is that a lot of a person's personal behavior should be, just that......Personal.

I know what you are saying about poor health habits, but in this case, insisting that someone do the correct thing would be a real problem. It would open the door for too much regulation. Being overweight isn't the only problem.

    Bookmark   June 16, 2008 at 8:14AM
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You have to ask too, which came first the weight or the disease that disabled them and they became overweight. Y never know only assume and that can get you into trouble.

    Bookmark   June 16, 2008 at 1:16PM
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"I mean, we had one guy who was an obese diabetic and called himself "the million dollor foot man" because medi-cal paid over a million on his foot. The doctor said if he lost weight, followed his diet, and kept his blood sugars under control, he would have never had this in the first place. Sadly, he wasn't interested in improving his health. He was more interested in talking about his coin collection."

The sad part here is that medical cost was over a million dollars. WHY??? That's just crazy!

    Bookmark   June 20, 2008 at 8:33AM
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I would feel 100% great about paying into a socialized medical system like they have in all the other developed countries of the world. I HATE that most of my health care dollars are only fattening the pockets of the CEOs of HMOs. If my money went directly to providing health care to people who need it instead of paying BCNC executives over $1 million/year, I would be completely happy with that, no matter what the people did otherwise.

    Bookmark   June 22, 2008 at 12:24PM
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There are so many factors that go into health - that obese diabetic probably had some genetic predispositions to both diabetes and obesity. A lot of healthy people work at it and a lot are just lucky by way of genetics or exposures. The guy who wouldn't take care of his health may have been suffering from low self-esteem or depression which would make him unmotivated to change.

I agree the health premiums for the self-employed are out of this world and unfair. If you aren't a big company you have no bargaining power with those big health insurance companies.

    Bookmark   June 29, 2008 at 10:29AM
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I dont think you can judge people just on being overweight. For about 5 years I had been unable to lose weight and had off the scale cholesterol results, my doctor kept assuming it was my diet at fault so for years I excercised, tried to eat right, couldnt lose weight, my cholesterol barely improved and my health deteriorated. I ended up with hormonal problems, liver problems, was having bad hypoglycaemic attacks every day (even though tests cleared me of any diabetic problems), I was apathetic and low on energy.

everyone just treated me like a fat lazy person, including my doctor, and it took a very clever specialist to finally diagnose me with diabetes and pcos, she got me on the right medications, sent me to a fanatastic dietician, I finally got my life back and I have been losing weight ever since.

when you have certain conditions like diabetes, your body very easily stores fat and you develop a number of other complications so you cant look at a diabetic and say "it's because they are fat", because their condition makes it hard to exercise (low energy) and in many cases their weight is probably caused by the diabetes and they struggle to lose weight.

some people may have been raised in situations where they simply dont know how to eat healthily, or they may not be able to afford to eat well, they may have conditions that just make them overweight, they could be prone to alcoholism , or addiction, you just dont know but if someone gets sick they deserve help no matter what to get them well again.

    Bookmark   July 12, 2008 at 7:49AM
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The problem with the man with the million dollar foot, is that where do you stop treating him? Before or after he loses the entire foot? Maybe just stop when he is partly healed if he doesn't start eating as Medicaid thinks he should.

That's the problem with certain chronic conditions like diabeties. There is no good stopping place in the treatment. Once started, it means going all the way until death.

My neighbor had a diabetic foot problem. They started whittling away at her toes, then it was part of the foot, then the rest of the foot, finally the leg. Then the other foot got a sore that would not heal. That too ended with the lost of the other leg. The entire thing took about 10 years until she finally died. And NO, she was not fat, she watched her diet, but she had an uncontrolable diabeties. I would imagine that all of her leg treatments including the amputations were well over one million. And the tax payers paid for it.

    Bookmark   July 12, 2008 at 9:03AM
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agnespuffin your post really struck a chord with me. My mother had type 1 diabetes and the exact same thing happened to her, and about 1 year after losing one leg she developed problems in her other foot which eventually led to a second amputation. prior to that she suffered from foot ulcers which would take on average about 18 months to 2 years to heal with constant treatment by the doctor and she wasnt overweight and did all the right things to control her diabetes, but over time, diabetes does take it's toll on the body.

starz, once youve watched someone go through these type of diabetic complications on a personal level you could never believe that someone would choose it, it really is too horrendous. If someone has a weight problem, regardless of if they have diabetes or not, there is a reason, it may be medical, psychological, cultural but there is always a reason I believe and if that reason isnt addressed, telling someone to "eat right" wont make a bit of difference, and any doctor who thinks a diabetic wont get foot problems if they maintian a healthy weight is talking rubbish.

    Bookmark   July 13, 2008 at 3:33AM
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