Quote :

"Rather than discuss the ethics of a sex test, DrSteveo just spend the past half hour arguing about whether a test on the number of one's sexual partners would be useful in an actuarial model (I think it would, he thinks it wouldn't, neither of us are trained in this shit)."

Actually, I pointed out that we charge based upon behaviors which show simple correlations and are easy to detect. When the correlation becomes less direct, the requirement for information becomes much more intrusive. It is both less practical and more objectionable. The amount of information to establish a statistically valid inference from say, smoking or obesity is quite simple and easy to obtain. It is not nearly as intrusive, nor as variable.

ANALOGY. BROKEN.

10/7/2009 11:45:48 PM

Quote :

" but not much substance. So not much reason for me to hang around."

Sorry buddy, but your argument was shakier than a blind fag at a hot dog eating contest.

Sometimes it's hard to admit that you're just flat out wrong.

10/7/2009 11:47:53 PM

DrSteveo

not
disputed
irrelevant
to ethical
question

ahahaha now i'm gone for real!!! Night

[Edited on October 7, 2009 at 11:50 PM. Reason : its addictive!!!]

10/7/2009 11:48:44 PM

Here is the simple answer to your ethical question:

Quote :

"When the correlation becomes less direct, the requirement for information becomes much more intrusive. It is both less practical and more objectionable."

As the requirement for information goes up and the correlation grows weaker, the justification for more information grows more suspect. It becomes more objectionable. Strong correlations based upon easily detectable data are the more defensible cases. Weak correlations based upon a large number of variables which show a high amount of variance are much less defensible.

I can't give you a more direct answer than that.

10/7/2009 11:52:29 PM

haha per PM (just so my response is in thread as well):

Quote :

"And that is not an answer to the ethical question. Your objection is based on the lack of justification for the test, not about your concern (or lack of concern) for sexual privacy. Based on this response, it sounds like you have no problem with such a test in principle, so long as there is adequate statistical justification for it (that it can be used to accurately gauge your risk profile). If that is your answer, fine. Like I said, I suspected that few people have any concern for privacy per se. Its too bad it took you this long to admit it."

10/8/2009 12:09:50 AM

Since we're posting our PMs, I'll just re-post my response:

Quote :

"And that is not an answer to the ethical question. Your objection is based on the lack of justification for the test, not about your concern (or lack of concern) for sexual privacy."

How is that not an answer? It's as direct as it gets. How "objectionable" a test is a direct measure of the ethical question. We are applying a direct weight of the issue of privacy (the fact that is sexual is irrelevant) to the greater issues of fairness of the economic externalities imposed upon others.

In case you missed it, the whole reason this is an ethical dilemma is because we are weighting competing values. What I have proposed is a direct answer to that question: a criteria of how intrusive the test is (a direct answer to the issue of privacy) to how direct the correlation is statistically (i.e., how useful the results of the intrusion are).

Quote :

"Based on this response, it sounds like you have no problem with such a test in principle, so long as it there is adequate statistical justification (i.e. that it can be used to accurately gauge your risk profile)."

What I am saying is that it is a sliding scale. One weighs the degree of intrusion against how direct the results can be applied to a risk profile. Higher intrusions require a higher degree of statistically justifiability to be ethically justified as one with a lower intrusion threshold. One could directly apply this criteria to say, genetic testing.

What I am providing you is a generalized answer, applicable to many cases, which apparently you don't seem to like.

Quote :

"If that is your answer, fine. Like I said, I suspect that few people have any concern for privacy per se. Its too bad it took you this long to admit it."

I have every concern for privacy; inherently, any risk based profile is a trade-off of privacy. It is a question of when it is justifiable to make the trade-off.

Your holier-than-thou attitude is extremely off-putting, especially given the fact that you are exceptionally wrong in this case.

10/8/2009 12:20:37 AM

Quote :

"How "objectionable" a test is a direct measure of the ethical question."

Actually, the way you originally phrased this statement made it sound like a test was more objectionable when it was less justified by statistical evidence. And re-reading your statement I can't find any objection to "sex test" except that you think it would not provide insurers with much information regarding your health risks.

So, again, I am left with the conclusion that you would have no problem with a "sex test" if it was as "useful" as the "smoking test". If this incorrect, please explain.

Quote :

"It is a question of when it is justifiable to make the trade-off."

Exactly. And the vibe I am getting so far is that a trade-off is justifiable any time it provides insurance companies with useful information that will reduce your premiums (reduced by a dollar amount that could probably be quantified if we had the resources).

10/8/2009 12:56:38 AM

Quote :

"Actually, the way you originally phrased this statement made it sound like a test was more objectionable when it was less justified by statistical evidence. And re-reading your statement I can't find any objection to "sex test" except that you think it would not provide insurers with much information regarding your health risks."

Ok, let's play through some scenarios:

Holding intrusion constant:

Less direct statistical correlation -> more objectionable
More direct statistical correlation -> less objectionable

Hold statistical usefulness constant:

Less intrusion -> less objectionable
More intrusion -> more objectionable

Does the formula come across clearly, now? The statistical directness of the test, combined with its relative intrusiveness, provides us with a measure of how objectionable a test is.

A highly intrusive test with dubious statistical usefulness - in this case, the sex test, would inherently be more objectionable than a less intrusive test with a much greater statistical resolution - e.g., the smoking test.

Hence, one can apply this to many circumstances. A genetic test may be highly intrusive, but it's also highly accurate. This is actually where the true quandary comes into play as to which one becomes more controlling - the certainty or the intrusiveness.

Quote :

"So, again, I am left with the conclusion that you would have no problem with a "sex test" if it was as "useful" as the "smoking test". If this incorrect, please explain."

The sex test is still inherently more intrusive than the smoking test. Therefore, we set a higher bar for the statistical relevance to offset the intrusion. This is my point. One directly weighs against the other.

Quote :

"Exactly. And the vibe I am getting so far is that a trade-off is justifiable any time it provides insurance companies with useful information that will reduce your premiums (reduced by a dollar amount that could probably be quantified if we had the resources)."

Not "any time." The degree of intrusion has to be offset by the actual statistical relevance (i.e., how much it can reasonably be expected to predict, and thus reduce costs). Simply because it can save money does not necessarily justify the intrusion. Again, the two must be weighted against one another. A high intrusion for a nominal risk moderator isn't necessarily worth it.

10/8/2009 1:07:13 AM

Excellent. So it now seems you agree that my analogy was not broken after all. Indeed, as you pointed out, we are talking about a sliding scale of trading-off one thing we value (privacy) for other things we value.

IOW: The smoking test is not qualitatively different from the sex test, they are only different in terms of the amount of intrusion and justification involved.

That being the case, you would be just as willing to accept the sex test as the smoking test, if the intrusion of the test was offset by its statistical relevance and its ability to reduce your costs.

As I stated previously, that is not what I would have guessed. I was actually thinking that people would not willing to make any trade-off at all (at least in the context of sexual behavior), which I hoped would lead to them to reconsider their position on the smoking test. But, as I said earlier, I guess I misjudged everyone.

10/8/2009 2:03:00 AM

I think this is very applicable here:

Quote :

"Homosexual men are more likely to have HIV, gonorrhea, syphilis, and anal warts than heterosexual men. Obviously homosexuality is a less desirable lifestyle choice which results in higher overall health costs for Americans. Certainly it should be banned right? I mean, I thought it was only the right who looked at people in terms of monetary value and not transcendent values. How dare these men engage in risky behavior that might cause financial trouble to me due to costly and inefficient government funded health programs.[/satire]"

JCASHFAN

message_topic.aspx?topic=577207&page=1#13301858

And let's not get diverted on the gay issue--this is not about that. It's about behavior and risk.

Let's say it's a heterosexual engaging in frequent unprotected sex with multiple partners. Is North Carolina charging more for this activity? Testing for this activity? Asking the insured to fill out intrusive forms that contain very personal details about this activity?

No? Why not?

10/8/2009 2:18:56 AM

Quote :

"Excellent. So it now seems you agree that my analogy was not broken after all. Indeed, as you pointed out, we are talking about a sliding scale of trading-off one thing we value (privacy) for other things we value."

You were trying to compare two tests with wildly different aspects of statistical robustness and intrusiveness. Absent the criteria which I provided you, it was still a terrible analogy. Trying to directly compare the two in the absence of some outside guiding principle - like, for instance, weighing invasiveness against actual predictive power - is senseless. You're still not off the hook for that one.

Quote :

"IOW: The smoking test is not qualitatively different from the sex test, they are only different in terms of the amount of intrusion and justification involved."

If we want to generalize that far, sure. But that's not what you started out in doing. Your first attempt was to make a direct comparison of the two, as if one logically flowed from the other. Clearly, they do not. In fact, they are virtually on opposite ends of the spectrum - low intrusiveness and high resolving power vs. high intrusiveness and low resolving power. One does not logically imply the other.

Let me put it this way: I can compare an apple and and orange in that they are both fruits, and they both grow on trees. There, sensible comparison basically ends. You were attempting to make a direct comparison between the two, when they couldn't be more different in their nature.

Quote :

"That being the case, you would be just as willing to accept the sex test as the smoking test, if the intrusion of the test was offset by its statistical relevance and its ability to reduce your costs."

You realize that this is a remarkably high bar, right? The sex test is incredibly intrusive. The statistical resolving power would have to be better than the connection of smoking to cancer/lung disease, which frankly just isn't going to happen for the reasons I provided. It's extremely unlikely you'd be able to make that offset for this issue. This is actually the point; the more intrusive a test is, the more "payoff" there must be. At some point, a payoff just cannot be reached, and hence the test will not be accepted. (i.e., the required payoff is more than the benefit to the insurer.)

Quote :

"As I stated previously, that is not what I would have guessed. I was actually thinking that people would not willing to make any trade-off at all (at least in the context of sexual behavior), which I hoped would lead to them to reconsider their position on the smoking test. But, as I said earlier, I guess I misjudged everyone."

You do realize that after everything that has been pointed out, it is unlikely the sex test, given both its intrusiveness and lack of resolving power, would ever be accepted, right?

Again, trade-offs. People make them every day. The smoking test is a relatively less intrusive trade-off with strong resolving power. The threshold there is lower. The less intrusive the test, the less likely one is to object, especially if there is a robust resolving power.

Your sexual test is both highly intrusive and lacking in resolving power. It's not a very good comparison to the smoking test.

10/8/2009 2:32:01 AM

Don't be so fast to pat yourself on the back, home slice.

I did not provide a criteria for evaluating the two options because that was exactly what I was asking other people to do. I asked if they would submit to a smoking test and if so if they would submit to a "sex test", then I asked them to explain their answers.

Your initial reaction was that no such comparison could be made, yet with a little proding you were able to make the comparison fairly easily. I did not think the question was really that hard, I think you and others were just reluctant to actually say "sure, I would submit myself to this intrusive procedure if its results were robust enough that it would reduce my premiums by $X".

Personally, I would not submit to such a test even if i was compensated with a insurance premium of $0. I feel the same way about a smoking test As I have said multiple times in this thread, they are qualitatively the same and thats what makes the comparison valid (as you pointed out, they are only quantiatively different on a sliding scale). But thats just me. And that's why I asked the question. I wanted to know if others agreed. Apparently not.

[Edited on October 8, 2009 at 3:41 AM. Reason : You give yourself far too much credit.]

10/8/2009 3:31:09 AM

I find it amusing that Conservatives argue for personal liberty and accountability... only up until it affects them.

10/8/2009 8:20:57 AM

^^Would you also refuse to answer if you're a smoker or have had multiple partners on an insurance application? That's a far more likely method of determination than a costly test.

10/8/2009 8:36:33 AM

i suppose it would really depend on how they go about classifying obesity. if they use BMI it won't work for instance (will fail in court, hard)

10/8/2009 9:48:22 AM

the difference between the sex test and the smoking test is simple - your mere number of sexual partners increases your chance of a treatable STD at a very low rate, and pretty much all of that can be attributed to your level responsibility in doing so. Smoking or being obese increases your chance of serious health problems or death at a vastly higher rate.

Much different risk categories here - smoking and obesity have a huge probability of costing the insurers and the state money. Whoring it up? Not nearly so much.

10/8/2009 10:07:59 AM

Maybe it can be rephrased:

"North Carolina Health-Care workers will receive a discount on their health-care fee if they meet certain wellness standards. Workers can't become elligible for the discount if they do not submit to proper testing."

Doesn't seem so bad now does it?

10/8/2009 10:18:15 AM

because it's not raising your rate if your fat or smoke (though this could be masked easily enough)

10/8/2009 10:33:25 AM

Quote :

"Don't be so fast to pat yourself on the back, home slice. I did not provide a criteria for evaluating the two options because that was exactly what I was asking other people to do. I asked if they would submit to a smoking test and if so if they would submit to a "sex test", then I asked them to explain their answers."

You provided two completely disparate situations and then yelled "OBFUSCATION!" at anyone who dared to point this fact out to you. Yeah, I wouldn't exactly be trying to claim that this was your brilliant plan all along, Sherlock. Nobody else is convinced.

Quote :

"Your initial reaction was that no such comparison could be made, yet with a little proding you were able to make the comparison fairly easily. I did not think the question was really that hard, I think you and others were just reluctant to actually say "sure, I would submit myself to this intrusive procedure if its results were robust enough that it would reduce my premiums by $X"."

No, and no. I said neither of those things, in fact. I said that the smoking test does not logically scale to the sex test. And they still don't. Then, I actually came up with a reasonable, generalized criteria to answer the question for you - something which you weren't capable of doing. (And don't tell us all "this was my plan all along," because your ability to even parse out responses thus so far has been questionable at best.)

You then further insist upon assigning me to the category of, "Sure, I'd submit to your extra-onerous test for $X." When in fact, I said:

Quote :

"It's extremely unlikely you'd be able to make that offset for this issue. This is actually the point; the more intrusive a test is, the more "payoff" there must be. At some point, a payoff just cannot be reached, and hence the test will not be accepted. (i.e., the required payoff is more than the benefit to the insurer.)"

I said that it is highly unlikely that an agreement could be reached. Because the test is so intrusive and has such poor resolving power, the required offset would be extremely high, if existing at all. It would clearly not result in a reasonable agreement. It is almost certain an insurer would not value the results enough for me to submit to their extra-onerous test, and vice versa.

Quote :

"Personally, I would not submit to such a test even if i was compensated with a insurance premium of $0. I feel the same way about a smoking test As I have said multiple times in this thread, they are qualitatively the same and thats what makes the comparison valid (as you pointed out, they are only quantiatively different on a sliding scale). But thats just me. And that's why I asked the question. I wanted to know if others agreed. Apparently not."

Actually, no, I never said that they are only "quantitatively different." They are completely of completely opposite character. The only way to compare them is to come up with an outside criteria - which I did - for which they weigh them against. So wipe that smirk off your face, because the fact that you still don't understand why your original argument was completely broken and the comparison senseless until I actually provided a criterion for you is evidence that you're out of your league here.

But perhaps if you're feeling so principled now about decoupling risk and insurance, you'd care to go back and answer the question I asked you on the last page, which you decided to ignore:

Quote :

"Here's a counter-question for you: should insurance not track by well-correlated risk? Should we not charge differential rates for behaviors that are known to increase risks substantially? Ones that are well-characterized, easy to measure, etc.? Should we just ignore those and charge everybody the same rate?"

[Edited on October 8, 2009 at 12:19 PM. Reason : Seriously, you're out of your depth.]

10/8/2009 12:15:50 PM

Good grief you love writing long posts. I don't.

There was no grand plan, I simply asked a question and you answered it (finally). Yes, you had to clarify which criteria you were using to answer the question, but that's kinda what answering such a question entails. If you have lost track of the conversation that badly, you should probably check out the very first post of the thread. You will see that I asked two questions. Thats it. 90% of the conversation after that was me trying to get everyone to focus on those questions and not perfrial details (like whether or not a sex test could be conducted as this is a hypothetical scernio or whether or not smoking is more or less risky than sex as this is irrelevant unless it is made to support some sort of "cost-benefit" ethical argument like the one you provided after some 50 posts, one which I do not personally agree with).

And while I'm typing let me note that yes, you did say that the difference between the two scenarios was quantitative and not qualitative:

Quote :

"ME: "IOW: The smoking test is not qualitatively different from the sex test, they are only different in terms of the amount of intrusion and justification involved." YOU: If we want to generalize that far, sure."

Now, you apparently have an emotional investment in disagreeing with me at this point if you're contradicting statements you made only 2 or 3 posts ago (expected responce: "oh what i uh really meant to say was..."). And hey, you must be fired up to keep pounding out page long rants. But I have already gotten what I was looking for out of this discussion (and it did surprise me though i guess it shouldn't have). So I think I will let you say your peace on this one and move on.

Have a good morning!

[Edited on October 8, 2009 at 12:44 PM. Reason : ``]

10/8/2009 12:35:58 PM

You know what? I'm done. It's obvious you're not going to put the effort into say, reading and comprehending, and therefore I'm not going to put the time into writing.

But I'll ask my same question to you a third time. Who knows? Maybe the third time's a charm:

Quote :

"Here's a counter-question for you: should insurance not track by well-correlated risk? Should we not charge differential rates for behaviors that are known to increase risks substantially? Ones that are well-characterized, easy to measure, etc.? Should we just ignore those and charge everybody the same rate?"

10/8/2009 12:48:16 PM

All this is moot - our wonderful state government has been pulling money from the state employee health care fund to pay for their fuckups in other areas. There is no money, and if you make it more expensive for current employees (i.e., overweight/smokers) to use the state plan, they're not going to use it, making it more expensive for those left, and eventually nobody's going to use it. BLUF - there will be no state employee health care soon enough. It's already happening. Everytime I go home to see the folks, my mother brings this subject up.

10/8/2009 12:55:26 PM

My problem with this is that it does not discern between getting the nicotine from cigarettes or the gum. So you could be an individual who has quit smoking, but still relies upon the gum to get them through the urges, and you are still fucked over by it.

Yes, I know you can get a note from a doctor saying you are going through an approved smoking cessation program, but for those who are doing it on their own, they are shit out of luck.

10/8/2009 1:14:48 PM

I support a "Fat Sales Tax" over trying to work an overweight rule into health insurance policy. If done right it could work but from what I have heard so far the criteria would be to simplified. The level at which someone is "overweight" or "obese" is to relative and subjective. I did not read through page 1 but remember hearing about this before and a premium was going to be charged on people based on BMI alone. There is obvious problems with this as the BMI gets skewed as you move to the high and low ends of the height scale. Secondly BMI does not incorporate those with high proportion of muscle who are clearly fit and not fat but are "heavy" due to major muscle proportions.

A Fat Sales Tax would be easy. Charge a 5 cent tax on a 2-liter and $profit. If alcohol and tobacco can be taxed why not coca-cola?

10/8/2009 1:22:49 PM

because it creates tax distortions and we should be lowering excise taxes, not increasing them. In terms of sales and use tax, everything should be taxed at the same rate.

10/8/2009 1:58:14 PM

^^They're going to have go by obese (not overweight), and they should probably be very generous in what they count as obese (like a BMI of 35 or higher, not 30 or higher). I'm no longer obese, but I would have been pissed had I been put in some special category.

I was under the impression that we have always been at risk of paying more for other people when it comes to insurance. My friend is an extreme exercise addict...her doctors have told her to stop exercising and she can't stop...she's had several (maybe 15?) surgeries to fix parts of her body that she's destroyed through overuse and misuse. She's 25. Other people pay for her surgeries, and I think that's fine--that's the way insurance works.

Obesity is definitely different in that there are tons (literal tons--aha) of people threatening the insurance pool, but the same general workings should apply. We all pay in, and whoever needs care (the exercise addict, bulimic, habitual smoker, cokehead, fast food junkie, mom of six with twins on the way) gets it. There's something comforting and commonsense to me about that, and I think that's the way it should work. If you think you're some perfect specimen, then let's start a perfect specimen plan in which you undergo rigorous military-style exercises and DNA testing to determine your perfect specimenishness...I bet you could save twenty or thirty dollars a month on that plan!

There are other ways to incentivize and encourage healthful behaviors.

10/8/2009 3:03:46 PM

the only problem I have with this is that they are planning on using BMI as the metric for determining if someone is obese. they need to use percent body fat instead. anyone who works out knows that you can be very well built, muscular and have low body fat percentage but be in the over weight range on the body mass index.

10/8/2009 4:23:06 PM

^ Yep. And just because a person is skinny doesn't mean that person is healthy. When I was in the Army, I routinely saw some chubby guys who never failed a PT test and who could run circles around many of the skinny guys.

10/8/2009 4:37:34 PM

From the Bulletin:

Quote :

"Editor's Note: In order to implement the wellness initiatives, the state of North Carolina has elected to exempt the State Health Plan from the federal HIPAA rules that protect employees, retirees and their dependants from discrimination based on health status related factors, including health status, medical condition (physical and mental illnesses), claims experience, receipt of health care, insurability, and disability."

http://www.ncsu.edu/bulletin/archive/2009/10/10-15/letters.php

How in the fuck is this even allowed? When the fuck is somebody going to get busy suing these assholes?

10/16/2009 9:11:14 AM

Quote :

"Yep. And just because a person is skinny doesn't mean that person is healthy. When I was in the Army, I routinely saw some chubby guys who never failed a PT test and who could run circles around many of the skinny guys."

Exception but not the rule, and only to a certain degree. A man with 50% body fat will not be able to run circles around anyone.

10/16/2009 9:16:27 AM

^ Who in the fuck would have 50 percent body fat? Just shut the fuck up, okay? Seriously.

10/16/2009 9:19:49 AM

http://en.wikipedia.org/wiki/Body_fat_percentage

Obese: Women - 42%+, Men - 38%+

10/16/2009 9:22:35 AM

"chubby guys" =/= "50% body fat"

Quote :

"Just shut the fuck up, okay? Seriously."

10/16/2009 9:40:01 AM

You're saying that it's bogus because you know fat people who can "run circles around" skinny people.

I'm telling you that most of the time that's not the case.

Besides, they're trying to reduce obesity.

[Edited on October 16, 2009 at 9:44 AM. Reason : ]

10/16/2009 9:43:56 AM

Quote :

"How in the fuck is this even allowed? When the fuck is somebody going to get busy suing these assholes? "

i don't see your problem with this hooksaw you should be heralding such a move. finally the state is telling the federal government that they can't tell them what to do and they will enact their own policy.

its funny to me, though, that your reaction was that people should sue these guys when in reality the people covered in this plan do not have to work for the state and contribute their abilities to such socialized employment.

10/16/2009 10:05:48 AM

I don't want to pay more for my insurance so I reduced my BMI.

10/16/2009 7:09:15 PM

When I think of people who support this type of idiotic legislation, I always think of:

10/17/2009 4:57:03 PM

^^^ That's really a ridiculous response. Yeah, I generally support more control and decisions being handled at the state and local levels--but I don't support selective waivers by the state that lessen employees' rights.

You can mangle the truth concerning the malicious move in question by North Carolina all you want. But the fact remains that HIPAA protections are being selectively set aside so that the state government can discriminate against its own employees--and this isn't right.

And since when does a state get to simply opt out of portions of a federal act that it deems inconvenient? I'm no lawyer, but this doesn't pass the smell test to me.

State delves into employee info
October 16, 2009

Quote :

"RALEIGH (WTVD) -- Many state employees were already hot under the collar because their health benefits will be limited for those who smoke or are overweight. Now, they're learning North Carolina did an end run around federal privacy rules to get that information. Some are now questioning if the exemption for federal HIPAA rules means their privacy is no longer protected."

Quote :

"'In fact, that's why [North Carolina] had to apply for the waiver - to discriminate against state employees because that was prohibited under HIPAA,' said Toni Davis with SEANC. Davis was not surprised so many state workers are asking questions about the HIPAA exemption."

http://abclocal.go.com/wtvd/story?section=news/local&id=7069014

If the people being affected were Gitmo detainees, some of you would be screaming bloody fucking murder.

10/18/2009 5:50:55 AM

Quote :

"You can mangle the truth concerning the malicious move in question by North Carolina all you want. But the fact remains that HIPAA protections are being selectively set aside so that the state government can discriminate against its own employees--and this isn't right."

this is exactly my point. if many of the deregulation arguments you've made here would come to fruition the result would be exactly what you've written above, allowing reduction of workers rights and in some cases discrimination of employees. however, in situations where you've defended such actions you evidently only evaluated them at face value and did not consider what the true repercussions would be.

I'm not saying you have to have one position or the other, but I would like you to be consistent in your beliefs.

I suspect you're not in this instance because being overweight is something which finally impacts you directly, thus you become conveniently up in arms over it.

the funny thing is imposing stricter fees on heavy people is no different than higher insurance rates being provided for diabetics which is commonly accepted, except, however, for the fact that weight is largely within the control of the individual in question while type 1 diabetes would not be

10/19/2009 9:35:57 AM

what about when obesity is a preexisting condition?

10/19/2009 9:42:43 AM

Seems fine to me. Being obese means you're a greater burden (and risk) to the insurance carrier. If I put in the time and effort into being healthy, why should I pay the same premiums as the guy that hasn't exercised in 15 years and has a diet consisting primarily of doritos and butterfingers? The healthy individual is much, much less of a risk...that much is obvious.

Quote :

"Yep. And just because a person is skinny doesn't mean that person is healthy. When I was in the Army, I routinely saw some chubby guys who never failed a PT test and who could run circles around many of the skinny guys."

I always hear this kind of anecdotal evidence, yet I've never encountered someone that could be considered obese who has higher physical endurance than a person at a normal weight. I mean, yeah, it's possible that the person does cardio 6 days a week but just eats way too much, and managed to obtain a gut as a result. That has to be the rare exception, though. I guess it depends on how you define chubby. Is chubby a little extra belly fat? That might slow you down a bit, but not too much. Once you get a lot of extra belly fat, though, running is not a fun activity.

And, even if you do have higher endurance than a skinny person, that doesn't make you healthy. Having a lot of extra body fat is never healthy.

10/19/2009 9:58:36 AM

i would be willing to bet that a lot of fat folks pay way more attention to their diet than non-fat folks.

10/19/2009 10:01:35 AM

They might pay attention to it more, but ultimately, they are taking in an excess of calories, or took in an excess of calories sometime in the past. Fat people will often claim that they eat a pretty healthy diet, or not that much food. The reality is that usually, they forget the trips to Golden Corral where they consumed 2500 calories in one sitting, or the entire box of Oreos they ate. It's easy to block those "slip ups" out of your mind, but those are the things that really cause you to pack on the pounds.

Other explanations are that they're old and have a slow metabolism. Or, for the "skinny" people that seem to eat whatever they want...a higher metabolism. Though, truthfully, I find that those skinny people that seem to eat junk food at least have a basic understanding of portion control. If someone shovels down food at 2-4 times the rate they need to, they're probably going to get fat, unless they have a jacked up metabolism and/or are extremely active.

In other words, if you're fat, you're either guilty of binge eating/large portions, not exercising enough, or both. Which means you're unhealthy.

10/19/2009 10:23:16 AM

I actually don't disagree with this tax at all.

10/19/2009 10:23:48 AM

^^ i can't agree with you entirely.

Outright there aren't statistically relevant (>5%) obese people who are healthier than skinny people, but I do believe there are people who are overweight who can be just as healthy as someone who might be at average weight and appear thin.

being skinny does not guarantee any sort of cardiovascular health, nor does it guarantee that the individual is active and tone.

I have been skinny all my life and only in the past few years have i been actively health conscious.

I used to eat two hot pockets at a time for a snack, drink a 2 liter of mt. dew code red, and then get a triple stack with bacon for dinner biggie sized. i did this almost every day during college and my high school and middle school years were equally as awful. i had friends who ate much better than i did but were significantly heavier than me. however, my cholesterol could have been through the roof, while they were fine. statistically speaking i would be a greater risk for heart disease and diabetes than they would be.

I don't think my situation is uncommon. we're very looks focused in culture today. if you're skinny you're healthy, no questions. so skinny people don't mind what it is they eat. they do not pay attention to cholesterol, sugars and trans fats in food the way other people may and as a result can be just as much a risk as anyone else.

i swim, bike and run frequently and frequently there will be an 'overweight' person out swim me or out run me even though if based on appearances alone people would assume I would be the victor in those events.

simply put there are health conscious people and those who are not and that ethos is what determines your risk factor far more than your weight. while obese people are typically not in the former category, you'd be surprised at the comparable number of overweight to skinny people who are.

10/19/2009 11:09:15 AM

I'm not suggesting that skinny people can't be unhealthy. They very well can be, and many of them are. If you eat junk rather than a nutritious diet, then you will see negative results. It might not come in the form of obesity.

Obesity is unhealthy, though, and is the result of an unhealthy lifestyle. It doesn't matter that skinny people can be unhealthy too. Obese people have a specific unhealthy attribute, which is that they've taken in way more calories than they've used. The skinny guy may also be unhealthy, for other reasons, but he hasn't taken in a lot more calories than he has burned.

10/19/2009 11:24:52 AM

but taking in more calories than you can burn is far less unhealthy than taking in much more cholesterol than you can healthily push through your system.

this is something that needs to be considered. obviously i'm in favor of this bill, i think its just disingenuous to suggest those people who are skinny are necessarily healthier because they have a lack of fat or that those who are obese are unhealthy because of the fat % alone.

10/19/2009 11:43:51 AM

Quote :

"but taking in more calories than you can burn is far less unhealthy than taking in much more cholesterol than you can healthily push through your system. "

Yeah, maybe, but obese people are generally doing both. It's not like they're eating 4,000 calories a day in fruits, vegetables, whole grains, and healthy proteins. They're eating high calorie foods, which a lot of the time, are also high in cholesterol.

And excess calorie consumption (and the resulting obesity) is just as unhealthy as a high cholesterol diet, honestly. Cholesterol opens you up to clogged arteries and heart disease, sure. Obesity can lead to diabetes, heart problems, skin problems, transportation problems, lethargy...the list goes on. I'm not sure you can really make the case that high cholerestol is "more unhealthy" than obesity, on the whole.

Quote :

" think its just disingenuous to suggest those people who are skinny are necessarily healthier because they have a lack of fat or that those who are obese are unhealthy because of the fat % alone."

All other health factors equal...a skinny person is necessarily more healthy than an obese person. The lack of fat is one way in which they are healthier than the obese person. And, obese people are necessarily unhealthy if they have excess body fat. I don't care if the obese person is supposedly in good cardiovascular health or eats a healthy diet (pretty much never the case)...they would be healthier without the extra fat. That's my point. You can't be obese (and not as measured by BMI - body fat %) and healthy in the long-run. The argument that skinny people can also be unhealthy doesn't somehow prove that fat people are not unhealthy. They just happen to have had their unhealthy lifestyle manifest in the form of fat.

10/19/2009 12:05:44 PM

your claims here are unsubstantiated and filled with both misinformation and bias.

Quote :

"Yeah, maybe, but obese people are generally doing both."

this is simply not the case. studies have shown that a large part of the problem with obesity in the US is due to liquid calories. meaning fruit drinks, sugary coffees, sodas, etc.. These items do not have hardly any cholesterol in them, and usually are at 0%.

Other factors would include unhealthy snacking, as in grabbing a candy bar instead of an apple. you'd be hard pressed to find a candy bar with >4% of cholesterol in it.

as stated earlier when it comes to people there are health conscious and those who are not. calories in vs calories out are more heavily correlated with weight than the nutritional metrics of food consumed.

Quote :

"obesity can lead to diabetes, heart problems, skin problems, transportation problems, lethargy...the list goes on. I'm not sure you can really make the case that high cholerestol is "more unhealthy" than obesity, on the whole."

higher sugar consumption is what leads to diabetes II, not increased weight. there are plenty of overweight people who are not type II diabetics and it is ignorant to assume all who are overweight are on the path to develop the disease. regardless given that heart disease is the leading cause of death in the united states and far far far above anything diabetic related I think it is a sound conclusion that cholesterol is more unhealthy as a whole than weight difference.

Quote :

"All other health factors equal..."

Quote :

"And, even if you do have higher endurance than a skinny person, that doesn't make you healthy. Having a lot of extra body fat is never healthy."

this isn't what you said above. it may be what you meant (doubt it based on what you argued immediately above this statement) but it isn't what you said on any occasion. you even point out that a fatter person who is in better cardiovascular shape is simply less healthy than a sedentary person based on fat percentage alone.

i agree that if you take the same person with the exact same eating habits that they will likely be healthier if they drop from being obese, but the health benefits seen will diminish significantly once the 10 - 15lb over weight mark further indicating that lifestyle, and not weight, is what determines if one is healthy or unhealthy.

its evident that you have some biased mentality and inherent discrimination towards people who have fat, however, fat in and of itself is not unhealthy.

10/19/2009 12:42:33 PM

There is nothing "inconsistent" about my positions, IRSeriousCat. And you have yet to answer this question:

Quote :

"And since when does a state get to simply opt out of portions of a federal act that it deems inconvenient? I'm no lawyer, but this doesn't pass the smell test to me."

hooksaw

Quote :

"I always hear this kind of anecdotal evidence, yet I've never encountered someone that could be considered obese who has higher physical endurance than a person at a normal weight."

d357r0y3r

Then you've had your head buried in the sand. For example, there are any number of conditions that can cause people of "normal weight" to have lower "physical endurance." And if you can't admit that there are normal and underweight people who are not physically healthy enough for exercise or much of anything, then you're simply fooling yourself.

Trust me, when the sleeping giant of state employees finally awakens concerning the issue in question, the shit is going to hit the fan. The news coverage of this is going to ramp up in the next couple of weeks as the state attempts to explain itself.

I saw on former speaker of the North Carolina House on TV this weekend and he said that the politicians are going to rue the day that they supported the measures in question. I believe him.

10/19/2009 1:01:00 PM