[jobu]

Yeah, the headline could easily be flipped with the subheading and most people's reaction would be drastically different.

Overall I think a single-payer system is for the best. Having healthcare tied to your job creates another anchor to keep people tied to large, stable companies instead of taking risks with startups or small businesses.

The main downside is that companies have started doing tiered healthcare costs based on things like smoking or health indicators. Having income tax based on your weight or smoking status is probably a non-starter, so it removes some of the incentives for people to make good choices (and reduce healthcare costs).

[Fatnino]

Some system to earn tax credits if you can prove that you lead a healthy lifestyle. Maybe verified by the doctors in the unified health system.

[Maarten88]

A sugar tax will accomplish a lot and is much easier.

[jimbob45]

Yeah I was going to say this. If you want smokers and the obese to partially fund their own healthcare, you can very easily slap taxes on cigarettes and soft drinks, earmark that money to go to insurance, and call it a day.

[fortran77]

I think the obese should pay for their externalities directly. Also, if the best treatment for something is “lose weight” then that should be tried first and no other treatments given until the weight is lost.

80% of people with Type II diabetes who are also overweight or obese would be asymptomatic if they lost weight. Why spend public money if there exists a free treatment? Save the public resources for right-weight type IIs and type Is.

[kcplate]

Ahh yes, the old “just lose weight” argument, likely spoken by someone who is not and has never been overweight or obese.

Speaking as someone who has lost over a 170lbs…it ain’t eas. It is the hardest damn thing I have ever done and your body fights you every step of the way…forever. It never ends—for the rest of your life your body is constantly fighting you to get back up to the weight you were.

Also, your concept of preventing all other treatments until someone loses weight is absolutely barbaric.

[jimbob45]

That’s why you tax soft drinks instead of taxing weight directly. It may be difficult to lose weight but it isn’t particularly difficult to cut out the most extremely unhealthy foods.

[fortran77]

I have been obese. Please don't falsely accuse me of things.

[conanbatt]

But now it is tied to the government, which is way worse...You can't complain to the government.

[dragonwriter]

> You can't complain to the government.

Yes, you can.

And you get a vote on who is running it, too

[conanbatt]

Voting is not a great way to give customer service feedback to your doctor

[ceejayoz]

How do you currently give customer service feedback to your doctor?

[conanbatt]

I go to a different doctor. You can also use Yelp!

[ceejayoz]

You can do this in places with universal single payer healthcare, too.

[seanmcdirmid]

> But now it is tied to the government, which is way worse...You can't complain to the government.

Elections have consequences. Try un-electing your group plan provider.

[conanbatt]

Uh, you can change group plan providers. You cant change the gov. Hell you might not even be able to vote at all.

[seanmcdirmid]

You can change jobs you mean? Group plans are provided by employers, the majority way that Americans get health insurance.

[pandaman]

Employers change plan providers all the time. It happens because, unlike the government, people in charge of choosing the provider are also affected by their choice.

[seanmcdirmid]

> Having income tax based on your weight or smoking status is probably a non-starter

Australia has very high taxes on cigarettes mainly because they want to keep their (universal) healthcare costs down. They could do the same thing to sugary snacks as well, even the conservatives would get onboard if it was to save money on healthcare expenditures.

[twiddling]

and funnel money away from crop subsidies?