Obesity

The Boss's Fat Tax

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The Washington Times reports that Clarian Health, an Indiana hospital chain, has started charging obese employees and smokers more for their health insurance coverage—$30 and $5 more, respectively, per paycheck. As in the case of companies that refuse to hire smokers (or fire them when they test positive for nicotine), I think decisions like these should be left to individual employers, who cannot force people to work for them and, by the same token, should not be forced to hire people on terms unilaterally imposed by one party. Still, I understand the complaints about increasingly nosy bosses who seek to pressure or punish workers into changing their off-the-clock behavior even when it has nothing to do with job performance. This phenomenon is another reason to rethink the tax policies that perpetuate the artificial link between employment and health insurance, just as the government's efforts to discourage risky habits that might cost taxpayers money are another reason to be leery of a state-run health care system. Given that the government can use force to get its way, while businesses have to compete with each other for employees, which sort of intrusiveness is more alarming?

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  1. Given that the government can use force to get its way, while businesses have to compete with each other for employees, which sort of intrusiveness is more alarming?

    Yeah, really. I notice that none of those advocacy groups that complains about children being brainwashed by advertisements don’t seem to mind most of the country’s children kept for 12 years in state schools, either. Talk about double standards…

  2. The answer is simple. Stop making the company that you work for the arbiter of what type of health insurance you have. Then they won’t give a damn what you do in your free time.

  3. I tried, but I can’t get worked up about obese people and smokers paying more for health insurance.

  4. Great business model: encourage employee honesty and boost morale by penalizing the fat people.

    Defunct businesses, as a general rule, have very low healthcare costs.

  5. Requirements for Employment in the future ( and this is the Janitor’s Spot)

    Background:
    – No Criminal Record
    – No Bad Credit Record
    – No Point on Driver’s Licence
    – No Tax Liens or Bankrupsy

    Health:
    – No Smoking … Ever
    – No Drinking … Ever
    – Cholesterol under 175
    – Blood sugar under 95
    – No Family History of any known Human Diseases

    Education:
    – Bachelor’s Degree from an accredited schools with NO LESS than a 3.75 GPA

    Skill Set:
    I guess we’ll take anyone that passes the requirements above.

  6. I’m happy to see that fat people pay $30 extra a month and smoker’s only $5. I guess this means that fat people are more unhealthy than smokers. As such, I think any municipality that bans smoking in restaurants should reverse the policy. And I mean reverse the policy. Food will now be banned, and cigarettes will be the only thing on the menu. Smoke to your health!

  7. Still, I understand the complaints about increasingly nosy bosses who seek to pressure or punish workers into changing their off-the-clock behavior even when it has nothing to do with job performance.

    Mr. Sullum loses libertarian points here for “understanding” a complaint that should simply be answered with “If you don’t like it, quit.”

  8. I tried, but I can’t get worked up about obese people and smokers paying more for health insurance.

    Me too, for the smoking part at least. As a smoker, an extra $5 bucks a paycheck is little more than one extra pack per fortnight.

    Since I buy about 14 packs in the same given period, no big deal.

    The problem arises when we try to define how obese you have to be to get charged the $30. What does it take? A little beer belly? A muffin top?

  9. OK, charging smokers more makes sense. But if they’re going to charge obese workers more, why not charge workers with cancer more? I’m hardly one to suggest that your average lard-ass has anything but his own lack of self control to blame for his/her weight, but there are certainly people who have medical conditions which cause obesity which they have no control over.

    And does obesity raise costs 6 X more than smoking? Why are obese workers charged more than smokers? I’d think it was the other way around.

  10. Fat people, smokers, and the depressed, are disastrous for the bottom line. I don’t think it is unreasonable to rid the company of such people. People can’t have all their cake and eat it to. Drink, smoke, fuck, be depressed. I will advocate that teh government not punish you, but I’m not punishing myself by paying for your vices.

  11. *too

  12. Mr. Sullum loses libertarian points here for “understanding” a complaint that should simply be answered with “If you don’t like it, quit.”

    I, for one, agree with that. Of course, businesses that succeed generally foster a positive attitude among their employees. Health insurance costs are a big problem for many businesses. Low employee morale and high turnover are much bigger problems.

  13. But wait, aren’t homosexuals more likely to get AIDS? Shouldn’t we charge them more too?

    Aren’t blacks more prone to hypertension? Let’s charge them more too!

    sarcasm off

    But seriously, as long as it’s private employers they can discriminate as they please.

  14. Mr. Sullum also writes:

    This phenomenon is another reason to rethink the tax policies that perpetuate the artificial link between employment and health insurance

    I agree with him on the tax issue as I think we’d all be better off not being so dependent on employment for health insurance.

    But it still means that insurance companies will charge more for certain undesirable traits. So from the individual’s point of view the problem is hardly solved.

  15. Given that the government can use force to get its way, while businesses have to compete with each other for employees, which sort of intrusiveness is more alarming?,/i>

    There are about two dozen industrialized countries with modern, universal health care and/or health coverage. Do you have any examples of any of them charging higher taxes/health care fees to citizens who are fat or who smoke?

    I’ve never heard of any doing so. Why do you think that might be?

    I don’t think libertarians have a very good understanding of the different incentive structures that exist in public service vs. private industry.

  16. Still, I understand the complaints about increasingly nosy bosses who seek to pressure or punish workers into changing their off-the-clock behavior even when it has nothing to do with job performance.

    As note by Dan T., Sullum really dropped the ball here.

    Employers care about profits. An employee’s job performance affects the employer’s profits. Similarly, health care costs affect the employer’s profits. And this is completely disregarding the correlation between health and job peformance (assuming there is any).

  17. joe,

    be sure to close your tags

  18. Mr. Sullum loses libertarian points here for “understanding” a complaint that should simply be answered with “If you don’t like it, quit.”

    ……………

    But it still means that insurance companies will charge more for certain undesirable traits. So from the individual’s point of view the problem is hardly solved.

    I agree with the first statement in that employers should be able to set whatever terms for their business they think will make it most successful. If people don’t like those terms, they don’t have to work for that employer.

    As for the second statement, I agree that the individual’s problem is not particularly fixed, but I don’t see why that’s such a problem. If the insurance company correctly identifies obese people as a greater risk, they shouldn’t be forced to not charge that person for their risk. Ideally, it would give the person incentive to lose weight or make other life adjustments to reduce their risk to the health insurance provider, and subsequently reduce their premiums.

  19. As for the second statement, I agree that the individual’s problem is not particularly fixed, but I don’t see why that’s such a problem. If the insurance company correctly identifies obese people as a greater risk, they shouldn’t be forced to not charge that person for their risk. Ideally, it would give the person incentive to lose weight or make other life adjustments to reduce their risk to the health insurance provider, and subsequently reduce their premiums.

    True, but what it also might lead to is a situation where the people who most need health insurance are least likely to be able to afford it. Forget “lifestyle” issues like smoking or obesity for a moment – we’re probably not too far from a time when insurance companies will be able to determine all sorts of risk factors from your genetic code and/or family history.

  20. I’m all in favor of decoupling health insurance from employment, but let’s not pretend that it would change the situation of fat people or smokers or whoever being charged more. If anything, it would probably make those practices even more common (in the absence of regulations to the contrary, of course). Without the risk pooling of employer-provided insurance, people would have to buy as individuals, and thus receive price quotes as individuals.

    There is much to be said in favor of decoupling health insurance from employment, but there will be downsides. Some of those downsides could be avoided with regulations, but then you’d have to trade one downside for another.

  21. Life is a Pre-existing Condition

    Many of us can’t help inheriting Heart disease, diabetes, cancer, etc.

  22. Fat people, smokers, and the depressed, are disastrous for the bottom line. I don’t think it is unreasonable to rid the company of such people. People can’t have all their cake and eat it to. Drink, smoke, fuck, be depressed. I will advocate that teh government not punish you, but I’m not punishing myself by paying for your vices.

    I’m going to go out on a limb here and say that depression isn’t a vice.

  23. Oh Randolph…of course depression is a vice.

  24. FWIW, I see the benefits of risk pooling, and I see the benefits of negotiating insurance prices as a bloc rather than as individuals (market power), but I’m not sure employment is the best way to pool risk and negotiate premiums. I don’t claim any insight as to a better way to do it, but I’m agnostic on the notion that employment is the best way.

  25. True, but what it also might lead to is a situation where the people who most need health insurance are least likely to be able to afford it. Forget “lifestyle” issues like smoking or obesity for a moment – we’re probably not too far from a time when insurance companies will be able to determine all sorts of risk factors from your genetic code and/or family history.

    While I can sympathize with that, I don’t see an obvious solution other than the extremely unpleasant thought of genetic selection, whereby those who are best fitted to our human environment survive and reproduce, and those who are not die off. This is in contrast to the possibility of subsidizing genetic inefficiency (free health care for all and gov funded med research), but even just thinking about this without expressing any kind of opinion about it makes me queasy, so I’m going to stop now.

  26. uh, how is an emotional condition a vice? How about unrealistic optimism – vice?

  27. I don’t have a problem with this as long as people can as pointed out above, charge practicing homosexuals a higher rate for their documented higher risk of STDs and AIDS and black people for their documented higher risk of hypertension and diabetes and so fourth. The problem is that the only groups that are going to be charged extra are going to be the groups who are social pariahs among the liberal Victorians like smokers and fat people while other more protected groups will never be forced to pay based on risks. If it wrong to charge a black man extra becuase of his genetic predisposition to diabetes, it ought to be wrong to make someone pay extra because they have a genetic pre-dispostion to obesity, which some people do. Same goes with smoking. Yes, people choose to smoke, but people also choose to do things like have multiple male homosexual partners and have sex with prostitutes. If one group has to pay why not all groups? If not, how is this just picking on unfavored groups rather than really making people absorb the true costs of their genetics and behaviors?

  28. While I can sympathize with that, I don’t see an obvious solution other than the extremely unpleasant thought of genetic selection, whereby those who are best fitted to our human environment survive and reproduce, and those who are not die off. This is in contrast to the possibility of subsidizing genetic inefficiency (free health care for all and gov funded med research), but even just thinking about this without expressing any kind of opinion about it makes me queasy, so I’m going to stop now.

  29. One last point, you can only risk pool if you don’t know what each individual risk is. If you can figure out through genetics and behavior who has the big risks and cut those people out, then you really are not pooling much risk anymore. The whole principle of insurance is that I don’t fully know my risks, therefore I pay in case I something bad happens. If we know for sure that an individual is very unlikly to get sick and another is very likly to, you really are not risk pooling anymore.

  30. Let’s try again:

    While I can sympathize with that, I don’t see an obvious solution other than the extremely unpleasant thought of genetic selection, whereby those who are best fitted to our human environment survive and reproduce, and those who are not die off. This is in contrast to the possibility of subsidizing genetic inefficiency (free health care for all and gov funded med research), but even just thinking about this without expressing any kind of opinion about it makes me queasy, so I’m going to stop now.

    IMO, it’s pretty clear that some sort of national health care system is the only way to address this problem, which is probably one of the reasons why everybody else in the modern world has adopted one.

  31. No Dan T. You just tell insurance companies and employers they can’t charge extra based on genetics. They then have to pass the costs on to everyone else. That is fine by me, because I would rather pay the extra on the off chance that I am diagnosed geneticly defective by some future but now unavailable genetic test.

  32. Fair point, John. Maybe I should call it cost-pooling. Which is what employer-provided insurance is in an era where your propensity for an illness can be measured.

    I don’t claim any easy answers here, but let’s not pretend that severing the link between employment and insurance will end this practice. We can debate whether it’s desirable to end this practice or extend it, we can debate how best to circumvent it (if at all), but individual purchasing of insurance will assuredly lead to more of this, whether it’s a good or bad thing.

  33. No Dan T. You just tell insurance companies and employers they can’t charge extra based on genetics.

    They’d find another way around it John, I assure you. Nothing’s as easy as simply passing a ban on something… surely everyone here is aware of that.

  34. The problem with cost pooling is that some people are just screwed. For example, my mother suffered from cancer in her 30s and again fatally in her 50s. No way did she ever contribute enough money in her lifetime to pay for what she cost the insurance companies. Of course, the insurance companies do okay because for every person like my mother, there are people who are never sick in their lives and die in a car accident or drop dead of a heart attack one day. If it becomes cost sharing and you really can tell who people like my mother are, then those people are just screwed.

  35. They’d find another way around it John, I assure you. Nothing’s as easy as simply passing a ban on something… surely everyone here is aware of that.

    At the very least they’d simply deny coverage for those who don’t pass the gene test, which is really worse than charging them more.

    Unless you’re going to pass a law that says insurance companies must take everybody in addition to charging everybody the same, in which case you might as well just have a socialized service.

  36. Reinmoose-

    I’m not so sure that insurance companies would even bother finding a way around a ban on charging more for obese people. They’d probably just calculate their expected costs, add a markup for profit and for risk protection, and then pass on the cost. Insurance companies seem to be comfortable issuing just about any sort of policy as long as they’re able to attach a price that they are comfortable with.

    Then again, I could be wrong.

  37. Just to clarify: the smokers and fat people are NOT being charged more for health insurance. They’re simply having their pay docked.

  38. Ah Jennifer, lost income is just like a charge. It is the same thing. Were you trying to be funny? Sorry if you were and I am just being dense.

  39. Given that the government can use force to get its way, while businesses have to compete with each other for employees, which sort of intrusiveness is more alarming?

    Nationalized (socialized) healthcare is the answer. Because we want it that way.

    Employers who increasingly use the tactic of ‘tier pricing’ will increasingly come under the scrutiny of the government. At some point, a legislator or legislature will get involved and put a stop to this ‘tier’ pricing. Companies will complain that they’re now hamstrung, and can’t compete with foreign nationals whose governments subsidize healthcare. A call by corporations to be “unburdened” from this whole health insurance process will go out. The government, realizing that corporations can no longer “foot the bill” for employee health insurance will begin by subsidizing “qualifying” businesses per employee on healthcare costs– and or minimum wage requirements. Eventually this will morph into some kind of wide government voucher system for employers to pay for employee healthcare. Once this machinery is in place, a call will go out for a more centralized, even, and easier to understand system. Government will propose such a system where employers will be extricated from any health insurance coverage and the employees will no deal directly with a government insurance system– removing the middle man a.k.a. “employer” from the process altogether.

  40. thoreau –

    If they wouldn’t bother finding a way around it, you have to make the assumption that gene-based risk assessment isn’t something they’d even bother doing in the first place. That’s fine, but then it doesn’t make any sense to refute the point.

  41. Paul,

    That has already happened with retirees. It doesn’t matter how good your private healthcare insurance is, once you turn 62, you get dumped into medicare along with everyone else. The best you can do is buy suplimental insurance, but you are in medicare regardless.

  42. I think Jennifer’s point is that the insurance companies are not charging the employer more for the obese/smokers’ policies.

    Is the company just keeping the extra money?

  43. If we know for sure that an individual is very unlikly to get sick and another is very likly to, you really are not risk pooling anymore.

    In that case, the only remaining risk that you’re pooling is Chance. Which is basically how the rest of the insurance industry works.

  44. “I’m going to go out on a limb here and say that depression isn’t a vice.”

    Then you haven’t met my x-fianc?e’. She ate depression like candy.

  45. Is the company just keeping the extra money?

    No, it goes into the prize pool for the annual sales meeting.

  46. John-

    I think a least bad (notice I didn’t say “good”) approach to health insurance, one that keeps private mechanisms and (mostly) market pricing, while pooling costs, would be this:

    1) For a certain level of basic coverage (major diseases, all the serious and expensive stuff) insurance companies can only charge based on metropolitan area (or zip code, or some other geographical marker), to account for differences in price in different areas, as well as the characteristics of different populations. (Not too many Texans get pneumonia, and you won’t see as much heat stroke in Vermont.) And they can’t deny coverage to anybody who pays. Each company can still set its own prices, of course, and this would probably lead to different levels of service: With the cheap company your claims are processed by a guy in a call center located 12 time zones away, and he takes 5 months to send you the form letter saying that they need more info to process the claim. With the expensive company your claims are processed more efficiently than that.

    2) For anything else, they can charge as they want.

    This pools costs, protects those with serious illness, but keeps competition in play.

    3) To decouple insurance from employment without mandating it, just put in place some tax incentives comparable to what employers get for offering insurance, and also give a tax incentive to employers who give employees a bonus comparable to the average cost of basic insurance in the metro area.

    Not terribly elegant, but it would treat employer-provided and personally-purchased insurance similarly.

    4) For those who can’t afford insurance, instead of enrolling them in a massive bureaucratic program, give them a check (based on a means test) to purchase insurance. This gives them an incentive to shop around based on price, and keeps coverage a private sector matter rather than enrolling a bunch of people (including the elderly) in a giant bureaucracy.

    I don’t claim that this proposal would pass any libertarian purity test, but it would be a hell of a lot better than some of the proposals likely to come from Team Blue. And it would keep the private sector very much involved.

  47. My point was that the problems stemming from employer-provided health insurance are not the issue here; even employees who don’t get health insurance through the company are going to have their pay docked.

  48. The question I have is this. Why get insurance at all? And for that matter, why even go to the doctor? Why is everyone so terrified of dying? It’s a natural process.

  49. My company uses positive reinforcement. You get paid when you’re hired if you don’t smoke (no proof required, honor code). You can get the bonus if you sign up for the free smoking secession program. Also, they have annual suggested workouts and diets that you get. If you sign up and complete the program, cash bonus.

    I like that they reward good behavior rather than punish bad behavior. It also doesn’t judge someone as obese. If you sign up and do the exercise program, you get it for the effort. It’s a good morale booster and saves them money on the insurance.

  50. I believe there is some auto insurance law – perhaps it is state-by-state – which mandates that private insurers must insure some number of drivers who they would ordinarily refuse to cover. ie, Gold Chip Insurance Co, which only accepts customers over 40 and under 60 with no points on their record, is required to also insure some (probably) smallish number of drivers with rap sheets a mile long. They are free to charge these higher-risk drivers more money, but they are required to provide coverage for them.

    Perhaps something like this could work for sharing out the risk of high-risk individuals seeking private health insurance.

  51. No Dan T. You just tell insurance companies and employers they can’t charge extra based on genetics. They then have to pass the costs on to everyone else. That is fine by me, because I would rather pay the extra on the off chance that I am diagnosed geneticly defective by some future but now unavailable genetic test.

    And I’d like it if you didn’t wave a gun in my face because you’re afraid you might not be able to one day pay a medical bill. Evil of guns > your inconvenience. Insisting that the latter justifies the former is sheer narcissism.

    Besides, allowing the costs of such genetic conditions to be recognized by the market will increase the incentive of entrepeneurs to develop treatments for such conditions.

  52. Life is a Pre-existing Condition

    Many of us can’t help inheriting Heart disease, diabetes, cancer, etc.

    None of us can help inheriting mortality, except of course URKOBOLD.

    Hail!

  53. joe said: There are about two dozen industrialized countries with modern, universal health care and/or health coverage. Do you have any examples of any of them charging higher taxes/health care fees to citizens who are fat or who smoke?

    I’ve never heard of any doing so. Why do you think that might be?

    Because the politicians running these programs pander to people with unhealthy lifestyles so they can get reelected?

    Because it’s not the politician’s money being spent here, so why care about giving people incentives to keep the costs they’re imposing on others down?

  54. Can Reason start up a new website called FakeLibertarians.com (or LetsScrewOtherPeople.com), so all the people who came on this thread advocating for socialized medicine can have some place to post their statist prescriptions to problems caused by prior statist legislations?

  55. I think that many businesses like having health insurance connected to employment because it helps reduce turnover. Many people fear losing their insurance when they lose or change jobs.

  56. Obvious that a lot of the posters here don’t worry about their genetic health or the possibility that they will get rejected from getting health insurance.

    Looking at the mess that the private market has made of the situation, I’m now totally for a national health service. Ok, I’ll let you skip out of it, not pay, and find whatever “private” health insurance you want. The catch is, if you ever want to go back on the national health service, you have to go through a battery of tests and show you are at least as in good health as the average nagged-by-the-NHS person on your age and sex. Capisce?

  57. Has anyone thought about the possibility that health care costs are so high because of blanket health care insurance? If auto insurance were set up the way health insurance is I bet an oil change would cost $1,000.

  58. I think the part people here are failing to recognize is that all these questions about what health care would be like if this or that system were implemented is that you’re assuminng the current backdrop of ridiculously high and escalating health care costs created by the current system stays under the new system. The “market solution” proponents view cutting the tie between employers and insured as a way to reduce costs by both competition and more prudent use of healthcare. My pie in the sky prediction is that if we moved in that direction and costs did in fact get more realistic, you’d have less posturing by insurance companies to more precisely calculate risks to allow them to charge more to cover the huge payouts. That way, if I’m an employer and I find an incredibly talented individual who also smokes while downing bearclaws on the way to work I can hire him or her without worring about him or her jacking up my premiums.

    In the limited thought I’ve given the subject I’m sure there are all sorts of complexities and nuances I’ve overlooked. And I’m also sure that the path from A to B wouldn’t be a merry skip….

  59. Do you have any examples of any of them charging higher taxes/health care fees to citizens who are fat or who smoke?

    Actually, back in the ’70s Canada boosted cigarette taxes and the specific justification was the perceived costs of healthcare associated with smoking. Of course all the money went into general revenue, but it certainly ends up as a surcharge for smokers.

    That was a very noisy example but almost everywhere I’ve lived health issues are always cited as justifications for ciggy taxes.

    And frankly, what other externalities besides respiratory and heart disease are associated with smoking to justify the high rates of tobacco tax here? Hmm, fire protection, maybe?

    Of course that was where the blatant hypocricy of the tobacco suit lay.

    If the money paid in tobacco taxes far exceeded any amount that the states of the feds were out for medicaid and medicare costs.

  60. If auto insurance were set up the way health insurance is I bet an oil change would cost $1,000.

    Bobster, your garage would bill the insurance company for a G-note but your insurance would cut a check for $287.63 in accordance with their negotiated agreement.

    And you’d still be on the hook for a $15.00 copay.

  61. Or, here’s a crazy idea, people could pay for their medical care, and if smoking costs them more that will be their choice.

  62. Oh, and if we get nationalized healthcare, the government will quickly begin making everything unhealthy illegal, on the basis other people shouldn’t have to support your unhealthiness.

    And then it’s just a matter of time till the closed-circuit TVs are ordering you to exercise every day.

    HEALTH IS YOUR DUTY.

  63. Oh, and on the genetics thing: Michael Jordan got better basketball-playing genes than I did, and we don’t seize his assets and redistribute them on that basis.

    Bad genes are bad luck, sometimes tragically, and good genes are good luck, sometimes miraculously. The coercive power of the state can’t change that, and shouldn’t try.

    The insurance coverage problem just illustrates how ridiculous the whole insurance system is. What is the purpose of insuurance? To smooth out the cost of your healthcare over time, or average your risk into society’s?

    We all die in the end anyway.

  64. Hi, my name is Ben. I am a fat, depressed, chain-smoker. I have chosen a profession with an industry wide turnover rate of 121% annually. I am a truck driver and can get a job anytime, anywhere. I choose not to pay 968 dollars a month for insurance. I spend the money on twinkies, camels and Popeyes fried chicken. Cholesterol under 180. BP always 120 over 78. Heart is great as of last year. Thank God for good genetics.

    Fark the insurance companies. I will live right up till I die.
    I do agree that if they are gonna discriminate, they should do it across the board. Genetic testing. psych tests(MMPI). lots of tests for pre-existing conditions or a predisposition to diseases. make it a legal mandate that employers must test every applicant at the employer’s expense. If the employer gets to choose who gets coverage, they should pay the premium minus the difference for folks like me.

  65. I want it to be none of my business what you eat or whether you exercise or smoke. If I am forced into an insurance pool with you, I have to care. I am paying for your life choices.

    If you engage in risky behavior, you should pay higher premiums to prevent you from becoming a free rider.

  66. Isaac Bartram

    Bobster, your garage would bill the insurance company for a G-note but your insurance would cut a check for $287.63 in accordance with their negotiated agreement.

    And you’d still be on the hook for a $15.00 copay.

    Sweet. Only $287.63 for an oil change. (Plus my $15 copay of course.) Who can’t love socialized car insurance?

  67. Ah, but Ben, are you planning on becoming pregnant? That could be the kicker for an employer who is considering you, but is on the fence.

    I didn’t know Popeyes chicken was still around.

  68. Lot of Popeyes Chicken out here in the Midwest.

    About the only edible stuff I’ve found there is the red beans and rice.

  69. Oh, and I’d like to point out that if you want to swear at pregnant women at being in the health insurance pool and Driving Up Premiums, getting them OUT of the health insurance pool will either a) cost taxpayers more, because they’ll have to go to the emergency room when the time comes (which has always been more expensive) or b) they will be less inclined to have kids and may decide not to have them at all.

    Given that the only way we know so far of the reproduction of the next generation is by having women-get-pregnant-and-give-birth, you might want to consider the benefit to society in general about providing health insurance for certain groups of the population–such as pregnant women.

    (Sometimes I think that Libertarians want the US to totally die off within three generations, considering how they treat pregnancy, childraising, and employment protection for parents.)

  70. What do they charge for people with anorexia or bulemia?

  71. Every time I hear this I think of Henry Ford was vilified for firing smokers when, in fact, he was down right progressive. [looks around hoping Joe isn’t in the room]

  72. As someone who’s handled his company’s insurance policy I have to ask, what insurance company charges a higher rate for overweight people? I know that they have higher rates for smokers, age, and families, but I’ve never seen a rate increase for an individual based upon their weight. So what the fuck is the boss doing with that $30?

  73. I haven’t yet read the entire thread of responses, but my normal response to something like this is, “Get insurance outside of employment!” It’s cheap and an illness doesn’t keep you tied to an employer. Many would be surprised at how little the average person needs in the way of healthcare insurance.

    A high deductible policy will protect assets in the event of serious illness and make you think twice about seeing a doc for the common cold. Every state Blue Co. can provide coverage very cheaply.

  74. There are about two dozen industrialized countries with modern, universal health care and/or health coverage. Do you have any examples of any of them charging higher taxes/health care fees to citizens who are fat or who smoke?

    I’ve never heard of any doing so. Why do you think that might be?

    The UK is planning on assigning fat people and smokers a lower priority in waiting lists for medical services.

    Also, increased health care costs are used as justification for smoking bans, food bans, and other nannie state policies.

    So, while socialist governments might not directly tax fat people and smokers more, they are willing to deny fat people and smokers equal health care (remember, it is a government service, so this is the same as denying them equal police protection, or equal education), and are willing to use socialized medicine as justification for neo-Victorian prohibitionism.

  75. Ooops.. The first two paragraphs should be blockquoted.

  76. you might want to consider the benefit to society in general about providing health insurance for certain groups of the population–such as pregnant women.

    Oh god, give it a rest. I DO NOT CARE if you want to get pregnant, but I am damn sure tired of paying for the sticky little trolls, in terms of free goodies for them, in taxes and in my liberty in general.

    Let me ask this…the second after I die, why should I care if the world ends? I’m dead

    I note, grumpy, that you’re all about charging more for lifestyle choices up until your particular ox gets gored, then it’s “but think of society/children!”. Take your lead-lined gold cloak somewhere else, please.


  77. (Sometimes I think that Libertarians want the US to totally die off within three generations, considering how they treat pregnancy, childraising, and employment protection for parents.)

    Besides the fact that there’s no single way that libertarians treat pregnancy and/or childraising (besides thinking that the government rarely has any good reason to interfere with either), how did the U.S. ever survive so many generations without employment protection for parents?

  78. which sort of intrusiveness is more alarming?

    To the question at hand (and to steer the thread back on course), I am not sure it’s a particularly smart business move for companies to get so intrusive…for more on that, I think Tyler Cowen’s enlightening comments on perceived control (be it governmental or economic) are relevant. I’m hesitant to outright condemn activities like this, simply because I believe that it’s a form of social change and perhaps this is how society evolves; by businesses modifying their models to change behavior, much like the Industrial Revolution modified human behavior for the better.

    Where I am leery though is how much of this change by businesses is precipitated by the government’s propaganda work. That is, do these outrageous government studies that claim secondhand smoke is more dangerous than actually smoking or that one cigarette consumed is like, the END TIMES for a person, cause businesses to get jumpy about the government forcefully implementing the changes? If so, that means that business is changing out of fear, not out of market demands.

  79. Yes, Dan Troll. Nationalized healthcare is the way to go. I mean, who wouldn’t want the same government that created FEMA, Homeland Security, the War in Iraq, Social Security, etc. ad infinitum, to also provide universal healthcare. That would be just great.

    And BTW, all of you socialists touting the healthcare systems of other nations, why don’t you do a little research on the French system. It’s running a multi-billion dollar deficit even though everyone pays health premiums, deductibles, and co-pays. Great Britain and Canada are making moves to privatize portions of their system because of systemic failure. Of course facts don’t matter to those touting socialized medicine. They’ve created a right out of thin air and the sheeple are falling in line.

  80. Oh god, give it a rest. I DO NOT CARE if you want to get pregnant, but I am damn sure tired of paying for the sticky little trolls, in terms of free goodies for them, in taxes and in my liberty in general.

    And why should the rest of society care about the opinions of amazingly self-absorbed individuals such as yourself?

  81. Something tells me that the grumpy realist is commenting based on a negative experience he/she had.

    (Sometimes I think that Libertarians want the US to totally die off within three generations, considering how they treat pregnancy, childraising, and employment protection for parents.)

    LOL! You’re silly

  82. Ah, duh, cigarette taxes. Of course.

    TallDave, name a socialist country that has banned unhealthy behaviors. Go ahead.

  83. TallDave, name a socialist country that has banned unhealthy behaviors. Go ahead.

    UK and Canada.

  84. Sweden & Denmark?

  85. No, dhex, “socialist.” Not communist.

    More specifically, on subject, a country with a socialist health care system.

  86. Examples?

    England, Sweden, Denmark have banned smoking? Mandated 1984-style exercise routines?

  87. And why should the rest of society care about the opinions of amazingly self-absorbed individuals such as yourself?

    They shouldn’t… nor should they be asked to. That’s kinda the whole point.

    If you want to start an insurance company for pregnant women then go for it. But just because a woman is pregnant, doesn’t mean she deserves super special treatment and freebies at society’s expense. That duty should fall upon the woman and the father of the child, as it was their decision to have the baby in the first place.

  88. Actually, having children is very important for a society and so the case could be made that parents do deserve special considerations in exchange.

  89. …the case could be made that parents do deserve special considerations…

    Ok, so make it.

  90. I understand the complaints about increasingly nosy bosses who seek to pressure or punish workers into changing their off-the-clock behavior even when it has nothing to do with job performance.

    I so totally don’t give a shit about your “understanding.” Can’t you simply be honest and say something like, “those unappreciative pricks need to stop complaining about their employers and should instead feel likely that they have a job” ? Seriously, what good does your “understanding” do? You’re not my mother. Are you going to offer them a better job?

    I come here for the heartless libertarianism that laughs at the poor rubes for foolishly daring to wish their employers would make their lives a bit more pleasant. I don’t want this to be cloaked in some sort of faux “understanding.” I don’t want that– I want tough love!

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