Who'd a thunk it? Obamacare not repealed

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jacob
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Re: Who'd a thunk it? Obamacare not repealed

Post by jacob »

@7wb5 - As far as I understand, a "No Code" tattoo won't do it. Note, for practical purposes you'd want it on the chest anyway, not on the ass (wrong side/area anyway, duh!). EMTs need/require a printed/signed statement to be provided inside of 60 seconds to avoid performing heroic measures. So keep it in chest pocket at all times.

PS: Due to suffering from a severe staircase-wit, I haven't gotten any tattoos. However, I do intend to get a No Code tattoo on my chest when/if I turn 70 just in case it helps/some EMT is more concerned about doing right than doing legal. I did contemplate getting a log-scale tattooed on each index finger =(built in slide rule) but rejected the idea because it could leads to so scary conclusions when it came to exponential projections insofar my fingers don't grow at equal rates (left/right) or (front/back) henceforth #thirdorderconsequences #fourthorderconsequences My doubling rules might get all screwed up and thousands of readers/fankids(*) would suffer from it.

(*) That don't verify calculations.

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Ego
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Re: Who'd a thunk it? Obamacare not repealed

Post by Ego »

jacob wrote:
Wed Mar 29, 2017 3:30 pm
Note, for practical purposes you'd want it on the chest anyway, not on the ass (wrong side/area anyway, duh!).
Depends on the position the EMTs are most likely to discover the victim. 8-)

jacob
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Re: Who'd a thunk it? Obamacare not repealed

Post by jacob »

Note to self: When visiting CA, also carry instructions in rear pocket :lol:

Laura Ingalls
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Re: Who'd a thunk it? Obamacare not repealed

Post by Laura Ingalls »

[quote=IlliniDave

My dad was 75 and had 15+ years of retirement. He also made some crappy lifestyle choices notably smoking for 30 years.

We declared ourselves FI on the lean side with the understand that if we "failed" we would go back to"real" jobs. As opposed to the low stress low pay gigs we have now.

So far so good.

BRUTE
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Re: Who'd a thunk it? Obamacare not repealed

Post by BRUTE »

classical_Liberal wrote:
Wed Mar 29, 2017 1:45 pm
A universal payer or medicare/medicare we could create a "skin in the game" situation. Provide incentives for those who are unhealthy to improve health. Annual weigh-in's for obese or A1C incentives for diabetics, etc. We are already collecting the data at healthcare appointments for treatment.
this is actually part of the reason why brute favors individual, privatized health care, instead of single payer.

any sustainable health care system will need to create "skin in the game". in a private/individual system, this incentive is created by charging according to personal risk and behavior.

in a monolith single payer system, the only way to create skin in the game is fascism. yes, that's right. this is exactly what will lead humans to prohibit other humans from eating donuts, smoking, running marathons, eating red meat.. if everyone's health becomes a problem for every other human, suddenly, every humans has the right to intervene in everyone else's life.

so while brute's "drop'em like they're hot" approach to pre-existing conditions might seem cruel, the alternative is really the state locking fat humans in cells until they're not fat any more.

thus, brute considers himself on the moral high ground with libertarian health care.

shade-tree
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Re: Who'd a thunk it? Obamacare not repealed

Post by shade-tree »

On this forum, I always hear folks (including comments above) telling us to take care of ourselves, that virtually all serious health problems are caused by unhealthy lifestyle and that exercise and diet can prevent them. That's dangerous, magical thinking and a threat to your early retirement.

Healthy youngish people get expensive to treat diseases that aren't self caused/ lifestyle diseases. i.e. autoimmune diseases, cancer (only about 40 percent is caused by environment, external stuff they say). Don't think it can't happen to you, kids.

Lemon
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Re: Who'd a thunk it? Obamacare not repealed

Post by Lemon »

@ classical_Liberal Some private health insurance does that here already. Not sure if it works particularly well though this paper seems to show some benefit of cash transfers for smoking cessation and vaccination: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949711/ (disclosure - not done full literature search). Be the effect size is small and I suspect for getting people active/eating better even harder. Certainly not going to solve the problem on a population unless you are talking very big cash incentives.

Only other papers I have seen that show really good effects for the metabolic syndromes is to give people personal trainers for a few sessions a week. In perpetuity. Expensive solution for a problem that doesn't need to exist.

@Brute Fascism isn't the only way, you can still use cash incentives or a variety of 'nudges' (ok yes nudges can be viewed as 'fascism lite' if you really want to put the uber libertarian hat on)


@shade-tree of course right, but the odd are still on lifestyle diseases. Modify what you can and all...

EMJ
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Re: Who'd a thunk it? Obamacare not repealed

Post by EMJ »

Healthy youngish people get expensive to treat diseases that aren't self caused/ lifestyle diseases. i.e. autoimmune diseases, cancer (only about 40 percent is caused by environment, external stuff they say). Don't think it can't happen to you, kids
New Study Finds That Most Cancer Mutations are Due to Random DNA Copying ‘Mistakes’

http://www.hopkinsmedicine.org/news/media/releases

Johns Hopkins Kimmel Cancer Center scientists report data from a new study providing evidence that random, unpredictable DNA copying “mistakes” account for nearly two-thirds of the mutations that cause cancer. Their research is grounded on a novel mathematical model based on DNA sequencing and epidemiologic data from around the world.

/new_study_finds_that_most_cancer_mutations_are_due_to_random_dna_copying_mistakes

BRUTE
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Re: Who'd a thunk it? Obamacare not repealed

Post by BRUTE »

shade-tree wrote:
Wed Mar 29, 2017 11:02 pm
On this forum, I always hear folks (including comments above) telling us to take care of ourselves, that virtually all serious health problems are caused by unhealthy lifestyle and that exercise and diet can prevent them. That's dangerous, magical thinking and a threat to your early retirement.

Healthy youngish people get expensive to treat diseases that aren't self caused/ lifestyle diseases. i.e. autoimmune diseases, cancer (only about 40 percent is caused by environment, external stuff they say). Don't think it can't happen to you, kids.
brute isn't advocating not to carry insurance. but the majority of costs that make health care and health care system expensive in the west right now are lifestyle diseases. brute listed the top 10 causes of death in the US a few posts above, and about half of them are lifestyle diseases.

@Crazylemon

if "not weighing 500lbs" and "not going blind" and "not getting feet amputated" doesn't motivate some humans, neither will "nudging". this is a cultural problem, not a health care (system) problem.

Dragline
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Re: Who'd a thunk it? Obamacare not repealed

Post by Dragline »

shade-tree wrote:
Wed Mar 29, 2017 11:02 pm
On this forum, I always hear folks (including comments above) telling us to take care of ourselves, that virtually all serious health problems are caused by unhealthy lifestyle and that exercise and diet can prevent them. That's dangerous, magical thinking and a threat to your early retirement.

Healthy youngish people get expensive to treat diseases that aren't self caused/ lifestyle diseases. i.e. autoimmune diseases, cancer (only about 40 percent is caused by environment, external stuff they say). Don't think it can't happen to you, kids.
It is quite true that outside substance abuse and other risky behaviors, most medical catastrophes that befall people under age 40-45 are fairly randomized or genetic in origin. I have known a number of people ages 15 - 40 who have suddenly contracted cancer or something similarly serious without any real connection to lifestyle.

The "lifestyle diseases" don't usually begin to creep up until sometime in the 40s or 50s for most people, even though that die may be cast much earlier by bad choices.

What this means is that lifestyle choices are not a substitute for catastrophic health insurance any more than "driving slowly and only in the daytime when it is not raining" would be a substitute for auto insurance. Improving your chances cannot eliminate risk entirely. These early efforts are more akin to a form of health "savings" that you will rely on 20 or 30 years down the road by preserving your organs.

IlliniDave
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Re: Who'd a thunk it? Obamacare not repealed

Post by IlliniDave »

BRUTE wrote:
Wed Mar 29, 2017 7:50 pm

so while brute's "drop'em like they're hot" approach to pre-existing conditions might seem cruel, the alternative is really the state locking fat humans in cells until they're not fat any more.

thus, brute considers himself on the moral high ground with libertarian health care.
I don't necessarily agree with your outlook, but I'm increasingly convinced things will have to go to one extreme or the other:

-If you have the money buy your own insurance and/or pay for your medical bills yourself. If you can't pay for it, don't expect medical services, or

-complete taxpayer-funded "socialized" medicine.

I don't think we'll ever find a hybridized, half-measure system that works over time.

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Ego
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Re: Who'd a thunk it? Obamacare not repealed

Post by Ego »

Dragline wrote:
Thu Mar 30, 2017 7:31 am
The "lifestyle diseases" don't usually begin to creep up until sometime in the 40s or 50s for most people, even though that die may be cast much earlier by bad choices.
That is changing fast.

https://www.cdc.gov/pcd/issues/2013/12_0316.htm

Conclusion
The prevalence of having 1 or more or 2 or more of the leading lifestyle-related chronic conditions increased steadily from 2002 to 2009. If these increases continue, particularly among younger adults, managing patients with multiple chronic conditions in the aging population will continue to challenge public health and clinical practice.

More than 70.0% of deaths in the United States and about 75.0% of health care spending costs are attributable to chronic diseases. The 5 leading causes of death — heart disease, cancer, chronic lower respiratory disease, cerebrovascular disease, and diabetes — accounted for more than half of all deaths in 2009 and represent a high percentage of the nation’s health care costs. Other chronic conditions exact a heavy toll in terms of disease, disability, quality of life, and economic costs.

Because the roots of the chronic conditions that are the leading causes of morbidity and mortality can be traced to lifestyle factors — principally smoking, diet, and physical activity — it is likely that, despite significant reductions in the prevalence of smoking, the continuing erosion of a low-risk lifestyle profile (9) could result in an increase in the incidence, prevalence, and co-occurrence of lifestyle-related chronic conditions.



I have no idea how to solve the problem other than to follow 7w's prescription of doing the work that is in front of me.

IlliniDave
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Re: Who'd a thunk it? Obamacare not repealed

Post by IlliniDave »

Laura Ingalls wrote:
Wed Mar 29, 2017 4:04 pm
[quote=IlliniDave

My dad was 75 and had 15+ years of retirement. He also made some crappy lifestyle choices notably smoking for 30 years.

We declared ourselves FI on the lean side with the understand that if we "failed" we would go back to"real" jobs. As opposed to the low stress low pay gigs we have now.

So far so good.
If I had been younger when I started serious pursuit of "ER" I might have taken an approach similar to yours. Starting where I did, it didn't make sense. I also have a relatively high paying job that for me is low stress. I have sort of an inverted approach to yours--if down the road fate conspires against me, part-time low wage work is an option. In my profession it's very hard to get back in after a prolonged absence, especially if you are getting a bit long in the tooth. After one or maybe two years there's essentially no going back for me. Another of the several consideration that led to the belt plus suspenders approach.

Was talking with a colleague today who cited a recent report he'd seen (can't give a reference, sorry, just don't remember), that on average Americans live 18 months after they retire. That is in line with numbers I've heard in the past (for my employer, it's even shorter allegedly). Mind boggling to me. Certainly provides a sense of urgency to me that counterbalances my conservative (not in the political sense) nature.

ThisDinosaur
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Re: Who'd a thunk it? Obamacare not repealed

Post by ThisDinosaur »

IlliniDave wrote:
Thu Mar 30, 2017 9:04 am
Was talking with a colleague today who cited a recent report he'd seen (can't give a reference, sorry, just don't remember), that on average Americans live 18 months after they retire.
I heard a story from a coworker about a guy here who died of a heart attack in his car, in the work parking lot, with his key in the ignition, at the end of his last day of work before retirement. They got a full day's work out of him.

Laura Ingalls
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Re: Who'd a thunk it? Obamacare not repealed

Post by Laura Ingalls »

[quote=IlliniDave

We have chosen to work part-time now in part because we are currently teethered to the public school schedule anyway. We have both would work more pleasant when we have given ourselves permission to quit too.

IlliniDave
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Re: Who'd a thunk it? Obamacare not repealed

Post by IlliniDave »

ThisDinosaur wrote:
Thu Mar 30, 2017 10:37 am
IlliniDave wrote:
Thu Mar 30, 2017 9:04 am
Was talking with a colleague today who cited a recent report he'd seen (can't give a reference, sorry, just don't remember), that on average Americans live 18 months after they retire.
I heard a story from a coworker about a guy here who died of a heart attack in his car, in the work parking lot, with his key in the ignition, at the end of his last day of work before retirement. They got a full day's work out of him.
That's truly unfortunate. Retirement is actually extremely stressful for many people.

I've known several people who have died shortly after retiring, but in all their cases either a terminal diagnosis or other grave health problems prompted the retirement. I'm sure folks like that skew the statistics a bit.

OTCW
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Re: Who'd a thunk it? Obamacare not repealed

Post by OTCW »

I don't think exercising and eating well are magic that can be used to forego insurance, but they definitely help greatly reduce the chances of developing lifestyle diseases. This is good if you want to reduce healthcare costs. (also good for quality of life in general). Insurance is still good (necessary?) to have for the rest of what may come your way like certain cancers, broken legs, etc.

My point is simply that if more people maintained healthy lifestyles, overall medical costs would go down, meaning health insurance costs would go down. How we get there is a harder discussion. Carrot approach? Stick approach? Carrot and stick approach? No approach is going to lead to disaster IMO.

My opinions are based on what I've seen happen to my premiums and deductibles/out of pocket limits the last 5 years of purcasing insurance as an individual (costs have ~ quadrupled in these three areas), based on not getting a subsidy, and based on watching the plan options in the ACA Marketplace in my area go from more than a dozen from 5 companies across all coverage levels (bronze, silver, gold, and platinum), down to only 2 this year from the same company (a bronze and a silver), and down to not a single plan available next year.

BRUTE
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Re: Who'd a thunk it? Obamacare not repealed

Post by BRUTE »

OTCW got it exactly right.

brute didn't bring up the lifestyle diseases to argue against individuals getting insurance. lifestyle diseases are why health care costs are exploding. it doesn't really matter which system of (re)distribution is used, the costs are simply too high. the only way to make health care affordable for almost all humans it to make almost all humans not have lifestyle diseases - which is a cultural long-term issue, nothing a law could fix.

single payer for 30% diabetics is going to be as expensive as the ACA or AHCA or whatever for 30% diabetics. the system doesn't matter much if the cost is simply too high.

brute's argument is also not that a Libertarian Health Care Act would solve this cost issue - merely that it would allow brute and other somewhat healthy individuals to escape subsidizing the treatment of lifestyle diseases, while still getting insurance against low-risk, catastrophic events, which is actually extremely cheap. at the same time, this would prevent heavy-handed lifestyle controls that would certainly come up even more to get humans to have "skin in the game". examples are the soda taxes proposed in some parts of the US. brute isn't for soda, but the idiots in charge will likely go for fatty foods next, which brute very much enjoys.

thus, a single payer system would force brute to subsidize humans who don't care about their lifestyle diseases, while potentially enforcing ill-informed "health" laws unto him in the future.

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Ego
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Re: Who'd a thunk it? Obamacare not repealed

Post by Ego »

BRUTE wrote:
Thu Mar 30, 2017 12:23 pm
lifestyle diseases are why health care costs are exploding. it doesn't really matter which system of (re)distribution is used, the costs are simply too high. the only way to make health care affordable for almost all humans it to make almost all humans not have lifestyle diseases - which is a cultural long-term issue, nothing a law could fix.
My thinking is changing somewhat on this. The more I learn about transgenerational epigenetic inheritance the more I realize that what we call lifestyle diseases are actually highly influenced by the lifestyle of parents, grandparents and great-grandparents. Hat tip to Jennypenny who has been saying a version of this for years.

http://www.radiolab.org/story/251885-yo ... ndpa-eats/

If your grandfather suffered famine from ages 9-12, you will have 1/4 the risk of heart disease than non-famine suffering grandchildren. Not only heart disease. The grandchildren show significantly lower incidence of all lifestyle diseases. So much so that on average the famine-grandchild lives thirty years longer than the grandchildren of those who did not suffer famine. Thirty years! Shit!

The more we learn the more of these intergenerational ghosts in the machine we discover. This shadow aspect is going to compound as we continue to live self-harming lifestyles. It will snowball.

Obviously, you are not responsible for the lifestyle of your grandparents. Is it fair that you'd be kicked off of your health insurance policy because your grandfather was pre-pubescent in a time of plenty? If not, then the only real solution is to influence those things that are within our control......
BRUTE wrote:
Thu Mar 30, 2017 12:23 pm
at the same time, this would prevent heavy-handed lifestyle controls that would certainly come up even more to get humans to have "skin in the game". examples are the soda taxes proposed in some parts of the US. brute isn't for soda, but the idiots in charge will likely go for fatty foods next, which brute very much enjoys.
You cannot change your grandparents. There is plenty you can control. We should be discouraging bad habits.... and maybe consider a policy of caging and starving pre-pubescent boys. :lol:

vezkor
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Re: Who'd a thunk it? Obamacare not repealed

Post by vezkor »

Tax fast food corporations the same way big polluters get hit, and for the same reasons ;) collateral damage

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