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While one can no doubt find a sizeable contingent to defend any belief, the more common and reasonable argument people such as myself would furnish against focusing on personal agency is not that it is 'wrong' but that it is useless. If we are approaching this from a policy perspective how much control any particular person had over their health is only important insofar as it impacts what we need to do to remedy poor health now, on a society-wide scale. Politicians and academics are generally in the business of policy, not personal advice.
What is really useless is creating policies that distort incentives and make problems worse. You can’t just ignore personal agency interacting with incentives just because the scale went up.
You have to consider effects on incentives for future behavior and “willingness to pay”, when it becomes a black hole of government spending for everything because it’s labeled a “chronic disease.”
In this case, individuals being shielded from bearing the cost of their poor lifestyle decisions will almost certainly make things worse.
A long life into old age costs the taxpayer a lot more. Smoking and obesity are cost saving for society. Nothing is more expensive than 10 years in assisted living.
Neither of those facts remotely modifies the argument I presented about incentives.
Assisted living and end-of-life care should also not be subsidized by taxpayers. Entitlements need reform across the board.
Perhaps they do. But in the current climate, smoking and heart disease save money for everyone.
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It may be true for the retirees who reverse-mortgage their house and go on cruises around the world, but if the elderly do what they've done historically, they can be a welcome support in inter-generational homes, helping their children raise more grandchildren.
You'd have to factor the cost of that lost fertility before saying that the elderly are a net cost per year. There are some other benefits that the elderly provide, as outlined in this article.
Elderly people being a net cost on society would just be an additional sign of a sick society. I'd be surprised if a successful grandma who supports children and grand-children 'cost' more to society than a childless woman in her 40s.
I am speaking in healthcare costs. Also, Multigenerational households consistently make up about 3.8% of all households in the US. https://imgur.com/Cgv9Lrm So it really shouldn't factor into accurate cost saving simulation of costs. If that is a sign of a sick society, then we are terminal and in hospice already. It is just a true fact that the elderly take more than they give and it is much cheaper to have people die at 65 from smoking or heart disease.
I don't think that is GOOD thing! Far from it, but raising rates on fat people and smokers to save money is actually going to cost a lot more money. So if you want to save people from themselves, great, but it isn't for the ratepayers or the taxpayers.
Well healthcare costs are over-inflated anyway. Hospital systems, doctors and Big Pharma writing themselves blank checks off the government or third-party insurance.
From my personal experience, parents of families with grand-parent help look at least 30% less stressed-out than the ones without. Not necessarily in a same household.
I'd expect multigenerational households to have lower healthcare spending for the elderly: younger relatives can look after them, notice any serious health issues, and social interaction is important for health outcomes.
Instead of promoting obesity to decrease healthcare spending, I think it'd be preferable to promote family unity, as this would also help with the drop in birthrates.
It seems that the West will be a theocracy again or it will stop existing.
I agree that "it takes a village" and parents and kids have suffered from not having it in the nuclear family system we have fallen into in the states. I'm not promoting that as an end goal, just as I am not promoting the idea that we should have people smoke and overeat to die sooner and reduce the surplus population.
I am pointing out that it is silly to think it would save the taxpayer any healthcare money to incentivise healthier living in the current environment due to the cost of elder care being crazy high. If your Dad smokes you might get an inheritance, if he doesn't you and the taxpayer are on the hook for 10 years of declining mobility in a retirement home at 8k a month and 5 years of dementia in a 20k a month memory care unit.
Or just bring him home. People pay for these things because they have too much money to know what to do with it.
And you know, maybe the next time a 'deadly' pandemic that's mostly fatal to the very elderly comes around, maybe just don't freak out as much?
I didn't do any freaking out. I think people who are still worried about it are literally insane.
People don't put mom in a home because they have too much money, they put mom in a home because living with a full grown adult that needs to be carried to the bathroom and fed 3 meals a day and taken care of, driven to all health appointments, administered drugs, entertained and bathed and who is getting worse over time is 2 full time jobs.
If you're working or raising kids you literally can't do it.
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The degree of personal responsibility does have an important policy implication - who pays? If someone is completely blameless for the state of their health, it's reasonable to say that it's deeply unfair that they be charged more for medical insurance, or even that they should pay more for medical care than someone that isn't utilizing those services. If, on the other hand, people carry the weight of their own choices, Hovde's suggestion seems correct.
One could do away with this concern by declaring that no one should pay for medical care and it should always be government spending or that government should pay for zero healthcare and to each their own, but neither of these is going to win in the United States anytime soon.
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