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"It's not how Obamacare you make it, it's how you make it Obamacare!" - Blather. Rants. Repeat.
A Møøse once bit my sister ...
"It's not how Obamacare you make it, it's how you make it Obamacare!"

(Points to anyone who recognizes (a) the original ad slogan that riffs on and (b) the comedian who pointed out how sick it is.)

I'm safely signed into Silver for 2014, although, as usual, I've yet to receive the Magic Card and policy decoder ring that will confirm that. I'm going in to my doc for my only visit of the year next week, to get checked out, my scrips renewed (and hopefully refilled on the current plan) and any needed testing done before year's end, and I've cashed out most of my FlexFit debit card to prepay my basic gym membership for all of next year.  Despite all the agitas out there, I'm not seeing the ACA's Advent (see what I did there, Sarah Palin?) as being the terrible horrible no good very bad thing it's made out to be.

Not that it's perfect, and not that New York's variations on it are perfect.  Here's one I just caught a reference to yesterday that I have pretty negative feelings about:

Smokers face higher insurance costs, except in NY

Nationally, the act, commonly known as Obamacare, will allow insurers to impose on smokers penalties of up to 50 percent of the cost of a policy, starting in 2015.

Potentially, that could cost smokers thousands of dollars a year in extra insurance premiums.

But that's not true in New York, five other states and the District of Columbia, who all prohibit those penalties that the law oddly describes as "incentives."

Still, New Yorkers who work for companies based in other states may continue to face out-of-state insurance policies that include smoking penalties.

The article goes on to analyze whether higher premiums serve as an incentive to get people to quit- the naysayers, obviously, say "nay," but point out that most people still get addicted in their teens when they're not paying any premiums and there's therefore no correlation.

But you damn better believe there's a correlation between the addiction and the costs to the medical system in treating it- the addiction itself, the withdrawal from it, and the direct and indirect health consequences of it both before and after the patient is a smoker.

I'm also a bit concerned about how this New York change will impact Eleanor. Wegmans has a very good plan for even its part-time employees (although they did up the minimum hour requirement and changed their way of computing it, to reduce their Obamacare costs), but when she signed up a few years ago, there were two different rate sets for smokers and non-smokers. This company seriously walks the walk when it comes to this issue: Wegmans stopped selling death sticks in its stores some years back, scaled back employee smoking-break options, and actively assists in smoking cessation efforts for those previously hooked.  If this change now prevents them from separating the pools, then it's likely costs will increase, coverage will be cut back even further, or both.

Personally, I have never smoked beyond a couple of sickening junior-high experimentations, although I grew up in a house full of nicotine and, like the younger of my two sisters, was disgusted enough by the habit's smells and inconveniences and never saw the appeal.  Likewise, Eleanor has never smoked, although her brother does like the proverbial chimney.  So maybe it's unfair for us to rail against essentially taxing the one habit we've never had when there are others we do have as, essentially, pre-existing conditions that we want Obamacare to cover.

Cover? Fine- but since this is a non-genetic and ultimately breakable addiction, I don't see anything wrong with upticking the smoker for expecting that coverage.


What are you?

A smoker, no intention of quitting
A smoker, tried to quit and couldn't
A non-smoker, but used to
A never-smoker
A ticky-boxer

What say you- surcharge the smokers or not?

No- it's no different than any other pre-existing condition
No- but provide free preventive coverage to help smokers quit
Yes- but not as much as 50 percent
Yes- it's a fair approximation on the addiction's cost
Ticky box the stinkers!
9 comments or Leave a comment
platypus From: platypus Date: December 17th, 2013 05:13 pm (UTC) (Link)
I am vehemently anti-smoking -- I grew up in a house with chain smokers, and I have asthma, and one of the small luxuries of being an adult is never having to breathe in other people's smoke. I also have zero problem with laws prohibiting smoking in restaurants/bars/etc; people can smoke where it doesn't affect anybody else. They don't need to be able to smoke everywhere.

But increased insurance premiums? Then why not increased premiums based on weight, or waist circumference (mine doesn't budge, no matter if I lose weight or not), or other things that might arguably involve behavior? Got heart disease? Should've eaten less red meat! No low-cost insurance for you! Are premiums increased for people who drink heavily? People who ride motorcycles or bikes? If the point of health insurance reform is to take people as they are and provide the care that will, one hopes, prevent worse problems later, then it should do so, period. It does no good to price smokers out of health insurance as some kind of punishment for their behavior. (I admit, it does affect my answer somewhat to know that they WILL be coming for me next, since I'm overweight, and there are already plenty of programs where insurance costs more if you're fat, or don't lose weight, or don't lose ENOUGH weight, or don't give some third-party nannies all your health information so they can tell you you ought to lose weight.)
i_beckygardens From: i_beckygardens Date: December 17th, 2013 05:47 pm (UTC) (Link)
I swear I wrote my answer then read yours, but since it's almost duplicate let me say GMTA.
digitalemur From: digitalemur Date: December 17th, 2013 05:15 pm (UTC) (Link)

One of the biggest risks for smoking is being poor, which is made worse by how regressive extra taxes on nicotine products are. This is why I'm against sin taxes across the board-- they're an extra burden on people whose financial lives are already much more precarious.

One of the other biggest risks for smoking is having untreated or ill-understood mental health issues.

My favorite aunt has struggled with these things all her life. I firmly believe that it is wrong to surcharge her, and other people like her, for it. It's as wrong as it would be to surcharge me for my body mass index, because while nicotine addiction and obesity work somewhat differently, they are similarly tough problems. Now, my aunt has some fears about the privacy of her health information that I don't have; I've sought mental health treatment and she has not. But you know, I'm still fat. And I'm still deeply, deeply triggered by some of the things my doctors have said that indicate they're seeing my weight instead of my lengthy fight with chronic endocrine and mental health issues. So no, I don't support treating smokers as anything other than one more pre-existing condition. Nor alcoholics. Nor drug addicts. Punitive measures will not help any of us with our bad habits.
i_beckygardens From: i_beckygardens Date: December 17th, 2013 05:46 pm (UTC) (Link)
Today smokers, tomorrow fat people, then drinkers, then those who eat chocolate, then those who eat pizza, how about a premium on motorcycle riders? Where does it stop exactly?
bktheirregular From: bktheirregular Date: December 17th, 2013 05:57 pm (UTC) (Link)
Smoking's the odd duck out in that list; if someone next to me chooses to light a cigarette, he or she has effectively decided that I am going to smoke whether I choose to or not. Alcohol, chocolate, and pizza don't fall into that category...
xiphias From: xiphias Date: December 18th, 2013 12:11 pm (UTC) (Link)
That's a reason for restricting smoking in PUBLIC, but not for insurance premiums.
xiphias From: xiphias Date: December 18th, 2013 12:10 pm (UTC) (Link)
There ARE premiums for motorcycle riders in many plans.
warriorsavant From: warriorsavant Date: December 19th, 2013 09:37 pm (UTC) (Link)

The near-quote.

"it's not how good you make it, it's how you make it good"
I think it was Winston cigarettes. Showing my age here.

Edited at 2013-12-19 09:38 pm (UTC)
captainsblog From: captainsblog Date: December 19th, 2013 09:51 pm (UTC) (Link)

Re: The near-quote.

I'm pretty sure that's right. And Carlin was the comedian:


Edited at 2013-12-19 09:52 pm (UTC)
9 comments or Leave a comment