Health Care Thoughts: Carrot and Stick
by Tom aka Rusty Rustbelt
Health Care Thoughts: Carrot and Stick
The Obama administration has issued regulations allowing employers to use both incentives and penalties in wellness programs.
There is some controversy here, such as:
employer plans setting and enforcing blood pressure and cholesterol standards
punishing smokers (less controversial perhaps) – is this punishing addicts?
there are many age and racial determinants in health, and civil rights advocates worry about back door age and race discrimination
There are limits and requirements on employers and the incentives/penalties. Employer cannot enforce penalties without offering wellness programs and services (smoking cessation tied to a smokers penalty). Nothing in the rules negates any ADA standards.
Really complicated. HT: New York Times 5/30/2013
Employers always had the power to penalize employees for lifestyle choices and have done so in the past. Some employers have gone as far as not hiring people who smoke. Employers have had random drug testing which if tested positive could result in the employee losing their job. The PPACA allows for 150% of the lowest cost employee to be charged for smokers.
well, i guess i don’t like it.
but i don’t have an answer. unless the people are willing to pay for their own health insurance… through the government… and then put limits on what the government can “impose.”
i don’t think you can, easily at any rate, restrict what an employer can impose if the employer is paying for the insurance.
but it sure seems likely that the government itself would be hard to limit.
it may seem “reasonable” for those of us who do not smoke to want those who do to pay more for their insurance… instead of ‘us’ paying more for their likely higher costs. but allowing an employer or the government to force us into some “wellness program” (which is very likely to be pseudo psientific hooey) is getting very close, in my opinion, to Maoist reeducation centers.
Maybe it is best to just regard tobacco addiction as a “pre existing condition” and try to limit its use by old fashioned persuasion.
i may turn into a libertarian yet.
The Democrats who wrote ACA thought it needed to be codified in order for more employer to use these tactics.
The Repubs had a chance to contribute and they did what? To a person in both the House and the Senate, they chose instead to be the road block because of a “black” president and Grover Norquist. Quite frankly, they could have had far more in this bill which would have gone far more poorly for the insured. Obama would hve rolled for them.
” is getting very close, in my opinion, to Maoist reeducation centers.”
This is definitely pseudohistorical hooey, Dale. Go read about the cruelty and butchery of Mao’s cultural revolution. Your comparison is obscene.
you are overreacting. i guess i read the same history you read.
and i guess i didn’t think anyone would think i was comparing the “cruelty and butchery” to the “wellness programs.”
but i was comparing reeducation centers to , well, reeducation centers.
i am not interested in have the state OR my employer telling me what i have to do on my own time. and as a victim of mandatory first aid classes presented on my employers time, i didn’t like that either.
try not to think i am any stupider than you have to.
“try not to think i am any stupider than you have to.”
I do try, Dale. I promise to continue to. Meanwhile, perhaps you could try not writing any stupider than you have to. M’kay?
I am not sure why you feel a need to be nasty to me. Maybe you didn’t understand what i said.
In a set, A, there exist some elements, x, that have property p.
In another set B, there exist some elements, y, that also have property p.
Some y also have property q.
Therefore some elements of A, x, share a property, p, with some elements of B, y.
But Joel says this is obscene. Because, he reasons, since some y have property q, claiming that some x share p with some y means that x have property q.
I will leave it to those who don’t mind sounding stupid to Joel to explain what’s wrong with his logic.
It is, by the way, the same “logic” that says “all Negros are…xx” or “all commies are traitors…” something that we patiently tried to teach Joel in school was not good thinking. He never understood the point, but he learned to repeat a lot of what he heard, so he thinks he is educated.
well, of course he IS educated. but that doesn’t mean what he thinks it means.
he seems to think that “re-education” camps would be just fine as long as it could be done without cruelty and butchery.
“he seems to think that “re-education” camps would be just fine as long as it could be done without cruelty and butchery.”
No, Dale, I don’t. And you can’t find an atom of evidence on this thread to support this absurd assertion. Your grasp of the English language appears to be as poor as your grasp of 20th century Chinese history. Your use of the straw man argument is cheap and immature.
I understand, from having read many of your comments over the years, that you have a very high regard for your own opinions and an unfortunate inability to brook disagreement. This results in what otherwise might be a valid point disappearing behind a smokescreen of bafflegab and bloviation, and your unquenchable need to invent positions for others so you can best your straw men. It is a sign of intellectual poverty on your part, Dale.
glad to see you came back. my comment on reeducation centers was not something i took as seriously as you did. my comments on your logical fallacy were meant partly to reeducate you, and partly, of course, because your nastiness annoyed me. it was uncalled for. i suspected you had misread “try not to think i am stupider than you have to” as “try not to be stupider than you have to be.” but i can’t be sure. you certainly seem to have a need to be nasty to me that overwhelms your ability to read what is there as opposed to what you think is there.
i have a high regard for some of my opinions, less for others. and i brook disagreement just fine, but not persistent stupidity. unfortunately for both of us that is a judgement call that i have to make on my own, and neither of us is in a position to claim ultimate authority as to which is which.
i have reasonable confidence that in the present case a “fair reader” would agree with me that your comments are not reasonable in either sense of the word.
to try again to be specific..
the history of china has nothing to do with the point i was making about reeducation camps. i was specifically comparing “wellness programs” to other, more famous, programs to change people’s behavior. i don’t like them. and they are inherently cruel even if they don’t put bamboo sticks under your fingernails, or prop your eyelids open. i endured enough of those as an employee to have very definite opinions about them.
the fact that you come back to my supposed lack of knowledge of the history of china tells me you didn’t get the point at all. seeming to continue to believe that a comparison with any part of the chinese experience necessarily implies a comparison with every part of it.
this is illogical on purely formal grounds, as i tried to show. it is a very common form of illogic. one of the purposes of “education” as well as normal development is to learn to separate “things” into finer “components” so that you don’t have to move your whole arm when you only want to move a single finger. it makes tying your shoes easier.
if i persist it is not because I “hate to be wrong,” but because as an old teacher i hate for my students to be wrong.
i think you told us once that you had a fairly high degree of education. it would be too bad if all your education taught you was to throw out the words blogsters use in place of sticks and stones. but your “arguments” don’t amount to more than name calling. i think that’s because your “basic” argument is empty and name calling is all you have. but if you were indeed once a well-educated person, that would be tragic and a waste.