Do most Americans even WANT more "wellness and prevention" in their health care?

[CTyankee]

Maybe I'm just a little jaded at this point in my life, but when I hear "wellness and prevention" being touted as a big part of our overall reform of the health care system and to control costs, I wonder if that is REALLY what most Americans are concerned about. There's a lot of lip service to the general principles of wellness and prevention, but I've seen too many people who really just want to continue their bad habits (smoking, drinking, overeating) and then have a doctor "fix" it.

Please don't misunderstand. Here, I am NOT talking about people who have conditions that are beyond their control. They need help and decent care. I just don't see lots of people changing their bad habits (I've had my share and from my own experience a "kick in the pants" was the only way I changed!)

Besides, can somebody tell me how prevention and wellness will work? Will you be penalized under the new health care if you DON'T lose weight, for instance?

[global1]

1. I Don't Think One Should Be Penalized If They Don't Lose Weight Or Quit Smoking.......

however, I think there should be an incentive if one does. Perhaps the premium would start out a one level for all and then if one quits smoking or gets down to a certain weight - the premium would be reduced.

I'm thinking like what they did in auto insurance. If you have a car with an alarm, or if you don't have an accident for 3 years or if you are not a smoker - you get a better premium.

Just a thought. This makes for an interesting discussion topic because wellness and prevention in my mind should play a big role in this plan. We should be encouraged to eat better, drink and smoke less, practice safe habits like wearing a helmet when riding a bicycle or motorcycle, etc.

But I'm sure a lot of people will have a bug up their ass if this is somehow legislated. Freedom - you know.

I think the FDA regulating cigarettes is part of it. Restaurants and fast food places should be made to serve more healthy meals. We should include physical fitness classes back into schools - to get our children started on this path.

[Proud Liberal Dem]

4. Good idea

My insurance coverage (and I use that term VERY loosely) gives us a $400 reduction on our deductible for not smoking. But you're right: reward good habits/prevention but don't penalize bad ones either.
:thumbsup:

[abluelady]

2. I Have a Real Problem With This

I can't help but see it as Republicans interfering with our personal lives. Of course it doesn't cost them money to meddle so they are out there loud and clear. And what about "good" habits. How many of my friends who are exercise nuts have to have their knees replaced because of all the damage that has been done. If medical care is to be a right, these questions should be moot. The question is, will it ever be a right?

[CTyankee]

3. I don't see how "good" habits can really be enforced on people.

What I have seen over the years, is a sea change in Americans' minds about smoking. If they can change other health habits the way they did smoking, I'm all for it. I know when I quit my main reason at the time was my vanity: a smoker smells terrible and smoking ages you. I don't really care, actually, what made me quit but I'm glad it worked!

[wileedog]

6. "How many of my friends who are exercise nuts have to have their knees replaced"

A thousand times less than the amount of overweight people who cost the system millions because they develop diabetes.

90% of health care costs are incurred by the 10% of the people in the highest risk category - i.e. those who have developed a chronic condition. SOme of these are obviously out of a person's control, but many, many others are extremely preventable with even small lifestyle changes.

Investing in wellness and prevention should be a natural decision as part of health care reform. Not necessary as legislation (You must jog! Jog!), but certainly with incentives like premium discounts for good behaviors.

[global1]

9. Why Would You Attribute This To The Repugs?......

Wellness and prevention is non-partisan. I would welcome anyone who supported wellness and prevention and associated educational programs to support.

I don't mind paying more taxes to help people become healthier. I do get upset though with people that will take advantage of my good nature and continue their bad habits to continually cost the system more money.

An obese person has a number of associated problems that will put a burden on the system. Diabetes, respiratory problems, cardiac problems, orthopedic problems. Most of these moderate or disappear when a person gets down to a reasonable weight.

What about smokers - all kinds of respiratory problems, cancer, etc.

Educating people about this and helping them lose weight or quit smoking can only be better for all of us.

This is not a Repug plot. Get over it.

[abluelady]

16. I Have Never Heard a Dem

say that a smoker/drinker, etc., should have health care as a result of my tax dollars. And I hear it constantly from Republicans I come in contact with.

[Doctor_J]

11. Hey - that's right from Limpballs' show

"How many of my friends who are exercise nuts have to have their knees replaced because of all the damage that has been done."

Rusty made this exact point a month ago. Claiming that obese drug addicts like him are less of a drain than healthy people.

Earth to abl - come back from Hate Radio Land. It's nicer in reality

[abluelady]

14. Wow, I've NEVER listened to Rush

I just have a real problem with the judging of another person's health. I'm certainly not defending Rush, who I believe is a number one moron from what I've read, but I don't think the majority of people who live unhealthily planned to live that way. Call me naive, but I believe we all want the best for ourselves, but we're not all capable of getting there. I also don't believe that those who are unhealthy because of "poor" choices are worth any less than anyone else.

[Mr. Blonde]

13. I don't know

"How many of my friends who are exercise nuts have to have their knees replaced because of all the damage that has been done."

How many have? I know in the right shoes my knees feel a lot better when I work out than when I don't, and I have been very hard on my knees as wrestling involves a lot of torque on the knees. In general all of life is better when I work out.

The idea that an active lifestyle is bad is so completely foreign to me that you will have to enlighten me on this.

I don't know how a law to be active would be enforced, but the fact that people exercising would make the load on the health care system lighter seems like pretty easy math.

My idea would be to work on city infrastructure to include more bike paths everywhere to make that kind of commuting easier and less terrifying.

[abluelady]

15. I Don't Mean to Say An Active Lifestyle is Bad

I think shit happens to any and everyone--even those who try to live an active life. I don't know your age, but I know many active people who have had health issues because of their activity--weekend warriors! I also know a few men who got off the treadmill or came back from a jog and dropped dead from a heart attack. Sure there is risk and sure there are known factors to try to keep us healthy, but I'm more of a believer in your genes. I firmly believe that every human being has the same worth. As I said in another post, I don't believe anyone wants to live an unhealthy life. I've never heard a child say, "I want to grow up to be a obese, alcoholic, who smokes three packs a day." I also don't believe everybody has the resources to live a healthy lifestyle. I've said before, what if Jonas Salk was an obese smoker. Look what we, as a nation, gained from him. I believe every human being is worthy of universal health care. And I will try never to judge anyone's life style to decide they don't deserve the same health care I want.

[truedelphi]

26. Like you, I sort of feel that this is a distraction.

We need health care as a right, and somehow the discussionahs become "WHy don't you epople get healthy yourself!"

[lunatica]

5. Maybe we shouldn't think in terms of being penalized for everything

I can see where smokers will welcome the opportunity and effective help to quit smoking. Or alcoholics welcome the help to stop drinking. No one wants to be overweight or addicted to drugs or anything else. Teaching birth control in schools again will cut down on unwanted pregnancies and on abortions.

Preventive care is vital, and in my opinion welcomed.

[Oregone]

7. "can somebody tell me how prevention and wellness will work?"

No idea how it works in this plan.

As an example of how it could work, would be based on what British Columbia does. They created their own separate Ministry of Healthy Living and Sport. They organize events, travel and educate, sponsor programs, etc. They put a lot of focus with their groups to visit and address children, teaching about the benefits of exercise and sports. They generally just try and educate and get everyone excited about fitness. The ultimate goal of course is to promote prevention and wellness.

[LiberalFighter]

8. I haven't seen any other country that has prevention and wellness as part of their health care.

What their health care does provide is health care before they it becomes a major problem. How many Americans put off seeing the doctor because they don't have health care or for other reasons? And when they finally do seek medical help they go to emergency because it has gone beyond the scope of simple medication or other preventative care.

How many Americans go bankrupt because of this?

The Japanese system provides for a comprehensive medical evaluation when they turn 40.

[global1]

10. If One Sees Their Doctor On A Regular Basis Because They Now Can.....

hopefully the Docs - in an effort to keep people healthier - would encourage good habits - like good nutrition, no-smoking, physical exercise, etc. That's exactly how one prevents things from becoming major problems. I think that any health care reform should include yearly check-ups or at least some sort of regular check-ups.

Many males - myself included - don't go to a Doc until something becomes really serious. If we were expected as part of the plan to keep premiums to a minimum - to go for regular check-ups - I would be all for it.

[Jennicut]

12. As a diabetic, I can say sometimes stuff just happens to you. Prevention only goes so far.

I wasn't obese or even overweight when I got it. No one in my family had it. I never had any other health problems. Even my doctor was baffled. Sometimes our bodies just do nutty things.

I don't see a problem with a wellness/prevention program that rewards "healthy behavior" but punishing it is a dumb idea.

[BlooInBloo]

17. Nope - all the experts are unanimous: there's no such thing as prevention...

All the bad things that happen to people are completely and utterly out of their control. People are the most powerless creatures EVAH at exerting any control whatsoever over themselves and their environment.

Sad, but true, according to the experts.

[Hekate]

18. Just think of it as "staying healthy as long as possible given the circumstances. I don't understand

... why so many people seem to think that smokers et al. deserve to get sick and die. It's to everyone's financial (not to mention karmic) advantage to keep offering addicts (whether to nicotine or heroin) the means to break their addiction -- which usually takes several tries for heroin and many more tries for nicotine. Same with alcohol. As for obesity -- everyone's favorite whipping boy -- it is a complex condition for which people also need help over the long term, not just a stern lecture once a year.

As for your "will you be penalized" question: Yes, you will be penalized under a for-profit system because your condition impacts the bottom line. In fact, you pretty much already are penalized. Under a rational not-for-profit national health care system I have every reason to trust that you would not be penalized, but by having access to health care you would be helped over your lifetime.

Hekate

[CTyankee]

31. Oh, I dunno. I didn't stop smoking until I got a kick in the butt. I just didn't want it that badly.

I'm real glad I did eventually try to give up smoking because I found that the "I'm addicted, there's no hope" to be a false assumption. I walked away from a 20 year pack a day habit and had no problems. Ya don't know if ya don't try! But I had incentive and I also really hated my self image as a smoker...so much is in your psyche, really...

[masuki bance]

19. I read somewher that smokers are less expensive overall,

they die earlier.

[Waiting For Everyman]

20. There's no wellness OR prevention in ChampVA, which is a federal program

for families of veterans. None, zero. If I have a serious illness or injury, I'm covered for that. Nothing for checkups, diagnostics, dental or vision. Nada.

Consequently, I haven't seen a doctor since 1982. No vision check, one dental appointment 10 years ago. Good thing I was strong enough to have lasted this long, through 25 years with a totally disabled husband. I have to depend on my "good genes" to get me through.

But I'm "insured". (And that's doing me a lot of good, isn't it? I've never used the coverage in all the years I've had it. But eventually, I'm gonna get something big enough to use it - probably something preventable.)

The feds should start first on that wellness and prevention idea with their OWN existing programs, wouldncha think?

[Scout]

21. i'm sick of it. stupid fucking "wellness programs" at work....

woo hoo, walk, drink water, earn points and get a pedometer! or how about a nifty water bottle you don't need!

[Cleita]

22. This always struck me as a conservative idea that is code for we don't

want to pay for medical care for smokers and other people who didn't take care of themselves. The fact is that a lot of people haven't had a choice about workplace pollution and even other environmental or genetic reasons that people can become sick from no matter how well they try to eat and exercise. And even those who weren't responsible about their health shouldn't be denied health care when they need it. Most people who feel that they can go to a doctor even though only exhibiting mild symptoms should be able to. It could be that some aspirin will take care of a hot spot or it could be a beginning cancer tumor. Early detection will do more to save medical costs than all the diet and exercise in the world. Unfortunately, we have a woman who comes from comfortable circumstances as our Secretary of Health, who obviously hasn't come down from her ivory tower yet to look at the real world.

Last night on Jon Stewart's show Kathleen Sebelius said in her best, smug, nasal voice, “Take your kids away from the video game and run them around the block”! Apparently this is her answer to the health care crisis.

How did Obama think that a middle class white woman from Middle America would have a clue about what happens to people who don’t have access to real health care; to working class people; to the elderly; to the unemployed and not able to work because of illness and disability? So what about the parents who just finished a double shift? Should they also run around the block? Should the crippled and handicapped run around the block? Will that take care of their health care problems? This woman disgusted me and she’s a Democrat! I thought we were done with the clueless in jobs of responsibility when we dumped the Bush administration. But as long as people like her are in charge, I have little hope of meaningful dialogue from that branch of government. Obama really needed Howard Dean in that position.

[TexasObserver]

23. I agree. Americans want health care when they're sick or hurting.

While wellness and prevention are good goals, most people want treatment for ails and injuries, not lectures on their eating and lifestyle habits.

If UK and Canada can do it for half of what we pay per person, there's no reason the US cannot do it.

[babylonsister]

24. I think both have to do with education at an early age. If I had

been told about the evils of smoking in my youth, and both my folks hadn't smoked (providing good role models), I'd have been less inclined to start smoking.

Same with food. Who knew 50 years ago pot roast, steaks, etc., weren't necessarily good for you?

Education could be the answer.

[PretzelWarrior]

25. of course they do. they just don't want "Wellness-lite" of the insurance companies

where you log onto a website that tells you to exercise.

They need real interactions with doctors giving them specific medical direction based on lab results saying they need to do "X" to alter life habit or they are in serious jeopardy of diabetes/heart disease/etc.

Also, think about if people are getting cancer screenings early and reducing advanced cancer cases. That alone will be a huge thing for us.

[CTyankee]

33. Or a nurse who calls you up and asks you a barrage of questions about your "lifestyle."

My health insurance carrier does that and I think it's annoying. You just know they're taking down everything you're saying and you wonder what they're gonna do with it, so you don't say anything. Who wants to be drilled about your waistline size, your weight, and what you are eating (altho I did find out that deli sandwich meat is full of sodium...).

[lunatica]

27. Sex education, health and personal hygene taught to children in grade school

like brushing your teeth and washing your hands as well as pre-birth health care are all preventive medicine. Teaching good nutrition to expectant mothers is preventive medicine. Teaching and promoting exercise for people of all ages is prevention.

Just saying...

[Uzybone]

35. well said

[old mark]

28. We - PA State employees were forced to take part in a "wellness"

program connected to our health insurance. I tturned out to be partly iritating comments about things everyone already knows - smoking is bad, exercise is good, and similar shit. The other part was a periodic chat on the phone with someone supposedly a nurse who would ask you questions about what you had done over the last month or so to improve your health. This information was reported to the insurance company who would sent you letters with yet more unwanted advice such as smoking is bad, exercise is good.
It became irritating and bordered on harrassment, it accomplished nothing positive, and it made a lot of employees angry. It was discontinued after a year or so.

mark

[lumberjack_jeff]

29. Most americans want to lower their healthcare costs.

Without improving wellness (whether the beneficiary wants it or not) cost containment will never be truly successful.

[TEXASYANKEE]

30. I guess I hear it differently.

For me "prevention" means affordable access to yearly mammograms, prostate exam, colonoscopy, things like that. I'm lucky in that my place of employment pays for these types of yearly exams. But someone with no insurance or access to an affordable clinic will not get these things. This type of early prevention can save A LOT of money, not to mention give the person a better chance of beating the illness.

I think this type of prevention should be affordable and available to all Americans.

[CTyankee]

36. that I agree with, of course. That is good. But even there you have folks who

resist the screenings...people don't go for colonoscopies very willingly. They have to be told they "get drugs" and then it's OK. My husband dreads his prostate exam and complains bitterly every year when he has one (he "rests" on the sofa afterwards...). I am not the biggest fan of mammograms; they hurt and there's nothing you can do about it. Even pap tests hurt, altho it is a quick thing, but they lie about it by saying it is "painless").

[solstice]

32. This coming from a President who put a Monsanto official in charge of the USDA is really, really

rich.

Obama's concerns for wellness don't seem to extend to what our industrially engineered food supply is doing to us since he rewarded one of its main perpretrators.

[Uzybone]

34. Wellness and prevention are key

Americans have very very bad habits and its a good thing that its brought to the fore.

[FrenchieCat]

37. To a great degree, there are many facets of health that we, as individuals,

control over our own lives.

To believe that this shouldn't be part of the debate mix of health care is ridiculous.

Here's my testimonial on the issue of my health and the importance it has had on my life as I have changed some of my bad habits, and picked up good ones:
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=258&topic_id=6832&mesg_id=6832