It's official: The totalitarian state is here

[notsheigetz]

Read this and draw your own conclusion about whether I am being paranoid or not.

http://junkscience.com/2012/11/21/the-n ... -revealed/

Excerpt (Note that I have ALREADY had the exact screening highlighted in red below at work - and my wife will be getting hers at the doctor's office on Monday).

Examples of health-contingent wellness programs in the new regulations are those that impose a premium surcharge based on tobacco use or that use biometric screening tests or health risks assessments to identify people with risk factors (BMI, glucose level, blood pressure or cholesterol) and that reward those who have numbers they say are in “a normal range.”?  To date, the most popular incentivized program, it states, has been health risk assessments.

The wellness programs also must require participants who are identified as being outside the normal range or “at risk”? to take additional steps, such as meet with a health coach, complete a health or fitness course, adhere to a diet program or other health improvement action plan, or comply with a care plan issued by an employee or agent of the plan or issuer.

And how large are these permissible penalties?

[F]or plan years beginning on or after January 1, 2014, increases the maximum reward to 30 percent and authorizes the Departments to increase the maximum reward to as much as 50 percent if the Departments determine that such an increase is appropriate.

[Pointedstick]

That article is a bit misleading. For example:

HHS stuck with a proposal that allows insurers to charge the oldest patients three times as much as they charge a 21-year-old. And the rates can go up a little bit with every birthday. But smokers can be charged premiums that are five times higher under the new rules….

Prior to Obamacare, the permitted number of payment tiers was 21, I believe. If the author is outraged by the fact that old people can now be charged three times as much as young people, he should have been even more outraged that prior to Obamacare, their payment could have been 21 times greater! And smokers being charged more is nothing new, either.

Next, doesn't the wellness program stuff strike you as permitting insurance to behave more like... insurance? I mean, my car insurance can charge me more if I have a bad driving record or live in a dangerous neighborhood, as well as for things I can't control like my age and gender, and we don't scream bloody murder about that. I think it sounds like a good idea to permit insurers to lower premiums for healthy people--it encourages them to adopt healthier behaviors, just like high car insurance premiums encourage people to drive better and buy cars that are easier to repair and less likely to be the target of theft.

I understand the author's opposition to Obamacare on its face as an intrusive government regulation, and I share it. But I can't find myself able to complain about any of its aspects that actually loosen the rules for what insurers can do. For years, insurers have been shackled with ever more federal mandates and regulations, causing their service to become less and less like actual insurance. As ham-handed and dangerous as Obamacare is, it seems silly to criticize aspects of it that actually reduce the market-distorting regulations in certain ways.

[MediumTex]

With the epidemic of unhealthy behaviors we have in this country, it seems like a good idea to help people identify things that they might do to become less unhealthy.

And when it comes to employer-provided health coverage, if an employer wants to provide some incentives to encourage employees to be healthier because they believe that healthy employees will be more productive, that all seems pretty reasonable to me.

For someone who wanted to get the benefits without actually changing his lifestyle, most of the things that are covered in the health screening can be manipulated over a 30 day period (cholesterol, blood pressure, blood sugar, etc.).  Thus, for someone who was overweight, ate nothing but garbage and smoked, if he simply quite smoking, went on a low carb diet and exercised for the 30 days leading up to the test, he would probably have scores of a much healthier person and then he could go right back to his unhealthy lifestyle is he wanted to.

[notsheigetz]

With the epidemic of unhealthy behaviors we have in this country, it seems like a good idea to help people identify things that they might do to become less unhealthy.

I thought the majority of us here were libertarian minded so the replies have surprised me.

You mean y'all really like the idea of the good-old federal government taking such an active interest in our health?

[Pointedstick]

You mean y'all really like the idea of the good-old federal government taking such an active interest in our health?

No, not at all. I was just pointing out that most of the criticisms made in the article actually already applied to the pre-Obamacare era, and that some of the criticisms of new Obamacare policies were actually criticisms of things that make the crippled health insurance industry more free-market-ish, not less. I don't like the law either, but it seemed silly of the author to criticize some of the very few aspects of it that libertarians should be happy about.

[notsheigetz]

No, not at all. I was just pointing out that most of the criticisms made in the article actually already applied to the pre-Obamacare era, and that some of the criticisms of new Obamacare policies were actually criticisms of things that make the crippled health insurance industry more free-market-ish, not less. I don't like the law either, but it seemed silly of the author to criticize some of the very few aspects of it that libertarians should be happy about.

I look at the regimented societies of North Korea and Communist China under Mao and ask myself could it happen here in freedom loving America? It was mostly MT's post, not yours, that led me to believe, well, maybe. A database where we record everybody's BMI, blood pressure, glucose level and offer them counselling if they don't fall within government guidelines and giving "incentives" or "penalties" to do so - what could possibly be wrong with that? We all know this is being done for the common good don't we?

[moda0306]

I'll take the government taking interest in my health decisions before the government forcing me at gunpoint to engage in war against others, or recognizing me as a piece of property not worthy of voting or owning property, or being unable to drink alcohol, or imprisoned because of my national heritage, any day.  Totalitarian State?  Hardly.

[Pointedstick]

moda, something doesn't have to be the worst thing in the world to still be a step in the wrong direction. Yes, the government isn't forcing you to murder strangers (thank goodness), but it is asserting more power and control over you, and me, and all of us. You approve of it wanting to make you healthier. Heck, so do I. But wanting something doesn't automatically make it happen, and as we here are fond of discussing, health is often a counterintuitive affair. For decades the government has been pushing whole grains, complex carbs, and fruit juices, and discouraging the consumption of meat, animal fats, and cholesterol. Do we want to give this government more power to supposedly improve our health when it so clearly has as little of an idea how to do it as we evidently do?

[notsheigetz]

I'll take the government taking interest in my health decisions before the government forcing me at gunpoint to engage in war against others, or recognizing me as a piece of property not worthy of voting or owning property, or being unable to drink alcohol, or imprisoned because of my national heritage, any day.  Totalitarian State?  Hardly.

Okay I see the light. Governments in the past have forced me to to got war at gunpoint (I'm a Vietnam veteran and I can assure you that never once was a gun pointed at me to accomplish this). They have treated people as property, forbidden the drinking of alcohol and imprisoned the Japanese only because they were Japanese.

But we have now turned the corner? Government is now a force for good? Can you point to the singularity in time when we made this transition?

[KevinW]

I do object to state involvement in health care. However I also object to being forced to subsidize reactive care of other peoples' preventable lifestyle diseases. Policies that incentivize individuals to take preventive measures, and expose them to some of the consequences of their actions, are better than nothing.

I don't think it's inconsistent to hold a long-term goal of an entirely market-based health care system, and also a short-term goal of nudging the current system to resemble that a little bit more.

[notsheigetz]

I do object to state involvement in health care. However I also object to being forced to subsidize reactive care of other peoples' preventable lifestyle diseases. Policies that incentivize individuals to take preventive measures, and expose them to some of the consequences of their actions, are better than nothing.

And what, pray tell, are the "preventable lifestyle diseases" that we may rightly discriminate against and expose people to the "consequences of their own actions"? Care to list them?

[moda0306]

I'll take the government taking interest in my health decisions before the government forcing me at gunpoint to engage in war against others, or recognizing me as a piece of property not worthy of voting or owning property, or being unable to drink alcohol, or imprisoned because of my national heritage, any day.  Totalitarian State?  Hardly.

Okay I see the light. Governments in the past have forced me to to got war at gunpoint (I'm a Vietnam veteran and I can assure you that never once was a gun pointed at me to accomplish this). They have treated people as property, forbidden the drinking of alcohol and imprisoned the Japanese only because they were Japanese.

But we have now turned the corner? Government is now a force for good? Can you point to the singularity in time when we made this transition?

Everything the government has us do is effectively, at some point, at gunpoint.  Some are more avoidable than others, but eventually if you don't feel like shucking and jiving the government, a gun will be put in your face.

Further, saying "the totalitarian state is here" implies that it wasn't here before, but recent healthcare legislation has brought it about. I don't mean to put words in people's mouth, though.  I just see today's world as remarkably free compared to times when we were engaging in far more oppressive behavior.  Either at the federal or individual level.  Our government still has broad powers to hold weapons of mass destruction, define, allocate and defend private property, declare war, etc. if they are as incompetent and/or illegitimate as some say, we shouldn't have any government at all and just go full on anarchy style.  Until then, I'll accept any and all forms of government as coercion, deciding after that whether I think it might be the proper role of government on a functional level, in spite of said coercion, since there's nothing particularly liberating to me about pure anarchy.

[KevinW]

I do object to state involvement in health care. However I also object to being forced to subsidize reactive care of other peoples' preventable lifestyle diseases. Policies that incentivize individuals to take preventive measures, and expose them to some of the consequences of their actions, are better than nothing.

And what, pray tell, are the "preventable lifestyle diseases" that we may rightly discriminate against and expose people to the "consequences of their own actions"? Care to list them?

When I drove a muscle car, my insurance premium was about twice what it is now that I drive a sensible station wagon. Presumably because an actuarial study showed that muscle cars cause twice as many claims than sensible station wagons. Is that just or unjust?

[moda0306]

Why can't you cut down that tree?  Are you sure it's not a housing association?

I know I don't have those limitations.  Sorry to hear you might. 

[MediumTex]

Why can't you cut down that tree?  Are you sure it's not a housing association?

I know I don't have those limitations.  Sorry to hear you might.

I also want to know why he can't cut down the tree.

[Pointedstick]

Is the tree actually on your property? Or is it on the strip that's in front of your house between the sidewalk and the street? That strip is actually owned by the city.

It's possible though. Where I live, a tree on your private property can be tagged by the city with a little notice that it's a "historic tree" or something like that, and you can't even prune it without permission. It's ridiculous.

But the thing is, you're both right. In some ways, we're freer than ever, while in other ways, we're subject to more bureaucratic control. I think it all really boils down to what burns you up more. The highly regulated bureaucratized state really drives some people batty, but it's a different kind of control than forcing you off to war. It's more subtle, more all-encompassing, and less direct. You don't know it's coming because the law book is 5,000 pages long and you practically don't know when you're committing a crime.

On the one hand, I'm incredibly grateful that the government doesn't force me to murder strangers. But on the other hand, I'm resentful that if I want to build my own house, they can tell me exactly how many nails of what grade and length I can and cannot use, and exactly where I have to nail them, and what I can and cannot nail them to. I have to read and comply with literally thousands of pages of regulations. Never before have homebuilders suffered such unnecessarily detailed and onerous building regulations like the ones the entire country is blanketed with today.

[Benko]

And what, pray tell, are the "preventable lifestyle diseases"

Seriously?

There are health consequences to obesity, eating unhealthy food, smoking, etc.  Diabetes, heart disease, lung disease...

[notsheigetz]

Why can't you cut down that tree?  Are you sure it's not a housing association?

I know I don't have those limitations.  Sorry to hear you might.

I resigned as V.P of the housing association last year. I can tell you that they WOULD have objected to me cutting down the oak tree but this was preempted by city law. It is against the law in my city (Oldsmar, Florida) to cut down a tree without government permission. I asked for permission to cut down the oak tree but it was denied. My argument was that the oak tree had grown so large that it was dropping acorns all over the side-walk and creating a health hazard to pedestrians passing by on the side-walk (seriously, the acorns were inches deep). The government agent who came to my house said that this was not a valid reason to cut down the tree.

If I had asked him for permission to terminate the life of a human being in the womb I'm sure this would have been granted but that is a moot point because I would not have had to ask permission to do such a thing. That is already a settled right in American. The cutting down of trees on your own property has never been tested in the Supreme court to my knowledge but I suspect that it would not fare nearly as well as the right to terminate a pregnancy.

Go figure.

[Pointedstick]

I resigned as V.P of the housing association last year. I can tell you that they WOULD have objected to me cutting down the oak tree but this was preempted by city law. It is against the law in my city (Oldsmar, Florida) to cut down a tree without government permission. I asked for permission to cut down the oak tree but it was denied. My argument was that the oak tree had grown so large that it was dropping acorns all over the side-walk and creating a health hazard to pedestrians passing by on the side-walk (seriously, the acorns were inches deep). The government agent who came to my house said that this was not a valid reason to cut down the tree.

A similar thing happened to my uncle in Sacramento, CA. He actually fought the city by eventually hiring an arborist to testify to the problem, at which point the minor bureaucrat who was so unnecessarily throwing up the roadblock just decided that it was too much effort and let him cut the tree down.

This kind of thing is maddening to people who hate bureaucracy. They may not be prohibiting you from voting or declaring you a witch, but they're still getting in the way of you living your own life in a completely unnecessary and infantilizing manner.

[notsheigetz]

And what, pray tell, are the "preventable lifestyle diseases"

Seriously?

There are health consequences to obesity, eating unhealthy food, smoking, etc.  Diabetes, heart disease, lung disease...

"eating unhealthy food".....

Can you provide us with a definitive list of which foods are unhealthy?

[Pointedstick]

And what, pray tell, are the "preventable lifestyle diseases"

Seriously?

There are health consequences to obesity, eating unhealthy food, smoking, etc.  Diabetes, heart disease, lung disease...

"eating unhealthy food".....

Can you provide us with a definitive list of which foods are unhealthy?

http://perfecthealthdiet.com/the-diet/ 

Surely you acknowledge the role that diet plays in one's health, no?

[moda0306]

Liberalism/progressism is often tyranny under the pretense of good intentions with unintended consequences from hell.

The same could be said for private property... Or at least to the extent western civilizations decided to take it (allocating vast swaths of natural resources to very few).

PS is right, though. One person's liberty is another person's coercion.  It's all about what we individually prefer.  I for one feel the draft and war is about the most coercive act the government can engage in. Some feel welfare is far worse.  Both are coercion. 

[notsheigetz]

Seriously?

There are health consequences to obesity, eating unhealthy food, smoking, etc.  Diabetes, heart disease, lung disease...

"eating unhealthy food".....

Can you provide us with a definitive list of which foods are unhealthy?

http://perfecthealthdiet.com/the-diet/ 

Surely you acknowledge the role that diet plays in one's health, no?

Given what limited knowledge I have at this present time I would surely NOT acknowledge that there is any such thing as a "perfect health diet" as alluded to by the link in your post.

[Pointedstick]

PS is right, though. One person's liberty is another person's coercion.

I might rephrase this as "Every type of coercion enrages some, while merely irritating others." But that doesn't eliminate the fact that's all coercion, as indeed you said.

You're clearly extremely agitated by the possibility of a government forcing you to murder strangers, moda, while not really caring much about the government preventing notsheigetz from cutting down his tree or me building my house without having to ask permission from and kowtow to 500 bureaucrats. That's fine; we're all different, and we have different preferences and value scales. But I think it's important to keep in mind that it's all coercion, and retain empathy for people who are miffed by a type of coercion that you don't really mind so much.

[Pointedstick]

Given what limited knowledge I have at this present time I would surely NOT acknowledge that there is any such thing as a "perfect health diet" as alluded to by the link in your post.

Might wanna check it out before you dismiss it. But even if you don't believe in a definite "perfect health diet" (which is totally legitimate, since we all have a slightly different biochemical make-up), you must surely admit that one's diet has an effect on one's health, right? You don't have to believe in a certain set of ideal foods to acknowledge that constantly shoveling your face full of soda, onion rings, and M&Ms will make you obese.

That's what we're discussing here: whether the government should permit or prohibit health insurance companies from charging you more for eating crap like the aforementioned food-like substances, on the justification that it will negatively affect your health and cause you to file more claims. I think they should, and if a part of Obamacare loosens the chains previously placed on them and allows them the freedom to do so, I welcome it.

This would ironically represent a diminution of the totalitarian state, not evidence of its further encroachment.