COVID-19 Thread [V2.0]

[Machu Peach]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

There are a number of issues with this.

1) It functions like a regressive tax, a tax on poverty. Obesity strongly correlates with economic level.

2) The burden of such of policy would be disproportionally felt by minority communities.

3) It disincentives people from seeing health care providers. Gain 10lbs over the last year? Maybe you skip this year's Dr appointment so you don't have to weigh in.

4) It gives your employer access to your health information (assuming you're talking about employee health insurance). There are a ton of reasons why your employer should not have your health info which I don't think I need to detail, but one additional problem is that it forces all employers to maintain HIPPA complaint record keeping, which is no small task.

5) It seems unlikely to actually work to me. I'm no expert in obesity, but anecdotally the few obese people I've chatted with about their weight badly wanted to lose weight. Their issue was not solely motivation.

[OldSchoolSnapper]

5) It seems unlikely to actually work to me. I'm no expert in obesity, but anecdotally the few obese people I've chatted with about their weight badly wanted to lose weight. Their issue was not solely motivation.

 

Right, and this is a big one. Like lots of these sorts of issues it gets whittled down a black and white thing where half the population starts believing obese people want to be obese because they get free stuff or something and just love the value insurance while eating whatever they want. Epidemic is the correct word to describe obesity in the USA.

 

Most people want to help themselves. They often lack the knowledge, access or understanding of how to do so. If you're obese by 8 you are fighting an immensely difficult battle to ever snap out of that.

[FVBrewerFan]

I don't think hardly anyone believes obese people want to be obese to get free stuff and love "the value insurance" (Not even sure what that means.) Everyone has knowledge of how to do so- eat less.

 

Motivation is a big part of it, just like quitting smoking. I'm not implying in any way it's easy. That's why it's worth trying different ways to motivate people. I wouldn't expect this to work on everyone, maybe it helps 10 or 15% of people. That's a big number.

 

HIPAA isn't an issue, it's just another factor being used for health insurance. Employer already has access to medical conditions, age, smoking, etc. I also don't think it's a disincentive to see a doctor. In fact, it would be an incentive, because you would have to go once a year to maintain your insurance.

 

I also wouldn't consider it a regressive tax. Obesity is an epidemic that extends to all races and economic status. When you use actuarial data, the numbers are the numbers. It's why insurance costs more for smokers, even though that affects low income and minorities more.

[igor67]

I think a bigger issue with tying insurance rates to obesity is that unlike other risk categories a significant part of the causation is not individual choice. Certainly there is a significant genetic component to the obesity, and based on the systematic increase over the years there are likely environmental factors outside an individuals control as well. It's far from clear as a case (nutrition research is challenging), but I'd look to target some things like food ingredients, sugar and high fructose corn syrup are both potential items that for example could be made less desirable with a tax to shift behaviors.

[Machu Peach]

I wouldn't expect this to work on everyone, maybe it helps 10 or 15% of people.

Where are you getting this number? Seems like wishcasting.

 

HIPAA isn't an issue, it's just another factor being used for health insurance. Employer already has access to medical conditions, age, smoking, etc.

This is absolutely false. Your employer has no access to your medical records or insurance claims without your written permission (outside of specific legal situations). Also, the record keeping requirements of HIPPA are very serious.

 

I also don't think it's a disincentive to see a doctor. In fact, it would be an incentive, because you would have to go once a year to maintain your insurance.

This means you're mandating a Dr visit and mandating a specific weight.

 

I also wouldn't consider it a regressive tax. Obesity is an epidemic that extends to all races and economic status. When you use actuarial data, the numbers are the numbers.

Obesity in high income countries is negatively correlated with socioeconomic status. This will impact more low income people than high income people, that makes it regressive.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298576/

 

It's why insurance costs more for smokers, even though that affects low income and minorities more.

Smoking does negatively correlate with income but I believe you are wrong that minorities smoke more. I believe that whites are slightly more likely to be smokers.

 

Either way, I'm generally against policies that have a disparate impact, particularly when things outside a person's control, such as genetics, clearly play a role.

[OldSchoolSnapper]

I don't think hardly anyone believes obese people want to be obese to get free stuff and love "the value insurance" (Not even sure what that means.) Everyone has knowledge of how to do so- eat less.

 

Value insurance was a term I made up to imply you can be as unhealthy as you want and your insurance is subsidized by healthy people.

 

I disagree completely with what you say here though. With every issue, Welfare, unemployment, whatever, a large segment of the population is convinced that every person on it loves it and is a mooch. A large segment of the population thinks fat people are all lazy. If you think "hardly anyone" believes that you then you need to talk to more people.

[jerichoholicninja]

When I go in for the health screening for my wife's insurance the nurse that weighs me is obese and sounds like she smokes a pack a day. I shake my head at the fact that if she doesn't get the wellness credit, which she probably does because the parameters are a joke, her poor health is supposedly only costing the insurance company $300 more than mine.

[RobertR]

I tend to think that the US has a structural problem with obesity. Agricultural subsidies and other pressures have made junk food cheap and plentiful. How cheap and plentiful is soda?

 

The US has knocked down smoking to a large extent. We don't have the political will to knock down obesity.

[LouisEly]

Depends on what you define as "junk food".

 

I've heard the argument for years that poorer people are more likely to be obese because junk food/fast food is cheap. That is patently false.

 

A 1/4 lb cheeseburger at a fast food restaurant will cost at least $3. Ignoring the cheese, bun, and ketchup/mustard, that's $12/lb for 70% lean beef; with the cheese/bun, let's say $10/lb (but that's also ignoring how much of the 30% fat that gets cooked off). A value meal with fries & a soda, at least $5; I don't know how much the fries weigh, but it's not a pound; let's say that the value meal comes to $10-12/lb of food. The "value menu" double cheeseburgers are at least $1.69; they use 1/10th of a lb patties, so for two patties it's 20% of a pound or at least $8.50/lb.

 

I buy chicken breasts at the grocery store for $3-$4/lb. A one-lb bag of peeled & ready to eat carrots is $1.50-$2/lb. Apples are $2/lb. Bananas are $0.69/lb. Sweet potatoes are $1/lb; baking/russet potatoes more like $0.69/lb. Beets are $1/lb. Brussel sprouts are $2/lb. Zucchini is $1-$1.50/lb. 85% lean ground beef is $4/lb. A 15oz jar of peanut butter is $2.50-$3. And a gallon of water is $1 (a 2-liter of soda is at least $1.79).

 

Fast food is not cheap - it's expensive. Fast food is easy.

[MrTPlush]

Which brings me to the stick. You should pay more if you're obese. Health insurance already factors in age and other criteria, why not weight? If you're obese, you pay $100 more a month for insurance, or whatever the amount. Not the whole answer obviously, but it may have some effect.

There are a number of issues with this.

1) It functions like a regressive tax, a tax on poverty. Obesity strongly correlates with economic level.

2) The burden of such of policy would be disproportionally felt by minority communities.

3) It disincentives people from seeing health care providers. Gain 10lbs over the last year? Maybe you skip this year's Dr appointment so you don't have to weigh in.

4) It gives your employer access to your health information (assuming you're talking about employee health insurance). There are a ton of reasons why your employer should not have your health info which I don't think I need to detail, but one additional problem is that it forces all employers to maintain HIPPA complaint record keeping, which is no small task.

5) It seems unlikely to actually work to me. I'm no expert in obesity, but anecdotally the few obese people I've chatted with about their weight badly wanted to lose weight. Their issue was not solely motivation.

 

My first thought was the people making claims are typically older and much so once you get close to retirement age. If we started trying to skew premiums towards those higher risk groups you would create an even bigger problem with older people being able to afford healthcare. People should just think of higher premiums at a younger age as prepayment for their later years. Skewing those payments towards later years would require people to acknowledge that and plan for it...I don't have confidence in people doing that.

 

Additionally, everything you stated I tend to agree with. I think all you would do is create a bigger need for government assistance with healthcare and I don't think that is benefitting the people needing it or anyone else.

[jerichoholicninja]

Hours after encouraging Denver residents to avoid Thanksgiving travel, the city's mayor office confirmed he is flying to Mississippi to spend the holiday with his daughter and wife, according to his office.

 

...

 

Earlier this month, California Gov. Gavin Newsom received backlash after he and his wife attended a birthday party at the French Laundry restaurant with a dozen others from several different households despite state health guidelines recommending against such gatherings amid a surge in Covid-19 infections.

 

...

 

New York Gov. Andrew Cuomo canceled his plans after facing criticism for planning to have a holiday meal with his 86-year-old mother and two of his daughters amid escalating numbers of Covid-19 cases.

The governor had previously warned New Yorkers who plan on holding Thanksgiving celebrations as usual that it was dangerous given that the virus can spread in large indoor gatherings.

 

https://www.cnn.com/2020/11/25/us/denver-mayor-thanksgiving-plans-trnd/index.html

 

What is the saying? Rules for thee but not for me.

[homer]

re: obesity

 

Generally speaking, people have a very hard time making what they know to be the correct decision when the consequences are far out in the future. This has been shown time and time again - credit card debt, excessive drinking, not saving for retirement, overeating, too much sun, etc. Thinking/acting in the moment served us well as hunter-gatherers and we haven't evolved past that.

[nodakfan17]

I’m on my wife’s employer-sponsored plan because it’s slightly better than the one offered by my company. Employees who score an 85 or better on their annual health risk assessment pay a lower rate than those who score below 85. That’s a pretty good incentive to avoid bad choices. After regulary scoring in the high 80s / low 90s, I came in at 85 on the dot this year. Can you imagine the grief I’d catch from my wife if my snacking made her paycheck go down? I’ll be more careful this year.

 

This system has its limitations because if one’s health care is heavily subsidized by the government anyway, where is the incentive to improve their score?

[Baldkin]

Depends on what you define as "junk food".

 

I've heard the argument for years that poorer people are more likely to be obese because junk food/fast food is cheap. That is patently false.

 

A 1/4 lb cheeseburger at a fast food restaurant will cost at least $3. Ignoring the cheese, bun, and ketchup/mustard, that's $12/lb for 70% lean beef; with the cheese/bun, let's say $10/lb (but that's also ignoring how much of the 30% fat that gets cooked off). A value meal with fries & a soda, at least $5; I don't know how much the fries weigh, but it's not a pound; let's say that the value meal comes to $10-12/lb of food. The "value menu" double cheeseburgers are at least $1.69; they use 1/10th of a lb patties, so for two patties it's 20% of a pound or at least $8.50/lb.

 

I buy chicken breasts at the grocery store for $3-$4/lb. A one-lb bag of peeled & ready to eat carrots is $1.50-$2/lb. Apples are $2/lb. Bananas are $0.69/lb. Sweet potatoes are $1/lb; baking/russet potatoes more like $0.69/lb. Beets are $1/lb. Brussel sprouts are $2/lb. Zucchini is $1-$1.50/lb. 85% lean ground beef is $4/lb. A 15oz jar of peanut butter is $2.50-$3. And a gallon of water is $1 (a 2-liter of soda is at least $1.79).

 

Fast food is not cheap - it's expensive. Fast food is easy.

 

It's not the cost of food that is the problem, it is the cost of time.

[TURBO]

I'm curious. I see a lot of people saying they won't get the vaccine right away and want to make sure it is safe first...

 

Has there ever been a vaccine in the USA that was deemed unsafe after doses were given out? Has there ever been a vaccine that was known to cause health issues years down the road?

[Machu Peach]

RotaShield, a rotavirus vaccine, was associated with intussusception in something like 1 of out 10,0000 children under the age of 12 months. It was used for 9ish months in the late 90s before being withdrawn from the market, though there's some level of debate about if the increased intussusception was real or a statistical blip.

 

The oral poliovirus vaccine is no longer used in the US in favor of inactivated poliovirus vaccine in part due to safety reasons ...but that's more of a risk/reward and route-of-transmission thing than a this-vaccine-is-unsafe thing. Oral poliovirus vaccine is still used by many counties because it makes more sense for their specific situation.

 

The most famous vaccine with issues was a swine flu vaccine in 1976 that lead to an increase in Guillain-Barre Syndrome in something like 1 out of 100,000 people. I think about 400 people ended up with GBS. It's still not particularly well understood why it occurred.

 

There also have been issues with specific lots of vaccines, most famously the Cutter Lab Incident in 1955.

[MrTPlush]

Pfizer is currently distributing it's vaccine while it waits for approval. The vaccine is currently arriving in the U.S. and being stored in Pleasant Prairie, WI.

 

Moderna plans to officially ask for final approval today.

[owbc]

I'm operating under the assumption that proof of vaccination is going to be required for air travel, international travel, and possibly sporting events and concerts. So I'll be first in line when it is available. Also hoping to book some cheap flights on the 737-Max while people are still afraid of it.

[FVBrewerFan]

I'm operating under the assumption that proof of vaccination is going to be required for air travel, international travel, and possibly sporting events and concerts.

 

I think that's a safe bet. Also a safe bet a lot of people freak out about that, not wanting anyone infringing on their privacy. I'm curious if this will extend to employers or restaurants, medical facilities, etc. I have a feeling this type of thing snowballs, and everyone will require it, or at least a lot of states will.

[owbc]

I'm operating under the assumption that proof of vaccination is going to be required for air travel, international travel, and possibly sporting events and concerts.

 

I think that's a safe bet. Also a safe bet a lot of people freak out about that, not wanting anyone infringing on their privacy. I'm curious if this will extend to employers or restaurants, medical facilities, etc. I have a feeling this type of thing snowballs, and everyone will require it, or at least a lot of states will.

 

It will be interesting what government entities like schools decide to do in terms of vaccine requirements. I have no doubt that industries that depend on large gatherings (air travel, cruise, sports, concerts) will implement vaccine requirements (or proof of a negative test result).

[3and2Fastball]

The proof of vaccination thing will be very interesting to watch play out. For air travel and train travel? I could see it. For attendance at outdoor events? Less likely but possible.

 

I will be fascinated to see how much pushback there will be from people about taking the vaccine. Considering that for many people, the side effects of the vaccine (body aches and pains for a few days, temps up to 102) will be worse than actually getting the disease, I think there will be a significant portion of the population that will resist getting the vaccine, at least at first. Especially those who tested positive but were Asymptomatic or had very mild cases, and have recovered.

 

There will also be a little bit of panic about the vaccine from some people when they start hearing about people feeling sick for a few days after getting their shot. Social Media plays a very distorted role in all of this.

 

It is such a roll of the dice. Many people won’t have any side effects from the Vaccine. Just as there are many people who test positive who are Asymptomatic. Moderna’s statement that their vaccine is 100% effective at preventing severe cases is eye opening. Few things are 100% effective at anything.

 

The data I haven’t seen is how long does the immunity last from the vaccines? Do they even know?

[MrTPlush]

Last I saw it was about 50/50 on whether people said they would get the vaccine or not. Even nurses had a 30% 'No' response. Of course who exactly they asked and the accuracy is certainly questionable...still not great response.

[owbc]

I just think that venues are going to want to get close to 100% capacity before enough people are vaccinated to knock the COVID case counts close to zero (~75% of the population, late 2021 maybe?). The only way to do that is to keep unvaccinated people out or require negative test results. Otherwise we're talking 10,000 people at most being allowed in the Brewers' indoor stadium in April/May.

 

Most major airlines are already using apps like CommonPass for COVID test verification so it will be extremely easy for them or any other business like MLB or LiveNation to require vaccine and/or negative test verification through one of those third-party services. Yeah, 10-20% of the population will complain, but the other 80-90% will demand safety measures.

 

I bet 50% would get the vaccine tomorrow and another 40% will get it once they see that nobody is getting really sick from it. The last 10% will never get vaccinated which is irritating but probably fine.

[PeaveyFury]

Has anyone seen a recent estimate of what percentage of the U.S. population would need to get the vaccine for effective herd immunity? Someplace in the past, I saw a 70% estimate for combined vaccinated + post-infection immune people, which I think (and I'm certainly not sure) is based on historical success rates for herd immunity vs. viruses in general. Not sure what the current estimate is for people with antibodies currently or what the necessary amount of vaccinated people would be as a result?

 

A lot will depend on the length of post-infection natural immunity, which I think is still unknown, especially in contrast to the immunity from the vaccines, which is also unknown.

[Fear The Chorizo]

I just think that venues are going to want to get close to 100% capacity before enough people are vaccinated to knock the COVID case counts close to zero (~75% of the population, late 2021 maybe?). The only way to do that is to keep unvaccinated people out or require negative test results. Otherwise we're talking 10,000 people at most being allowed in the Brewers' indoor stadium in April/May.

 

Most major airlines are already using apps like CommonPass for COVID test verification so it will be extremely easy for them or any other business like MLB or LiveNation to require vaccine and/or negative test verification through one of those third-party services. Yeah, 10-20% of the population will complain, but the other 80-90% will demand safety measures.

 

I bet 50% would get the vaccine tomorrow and another 40% will get it once they see that nobody is getting really sick from it. The last 10% will never get vaccinated which is irritating but probably fine.

 

To repeat earlier information, the vaccine will not knock down COVID case counts on its own initially, and perhaps ever - its purpose is to make just about all COVID infections asymptomatic, which will help expedite the virus' spread across the general population without stressing the health system. And at this point there is no good idea how long a vaccine provides immunity from symptomatic immune system responses. However, getting as many people some form of immune system exposure to the virus or even better a vaccine capable of diminishing the symptoms it causes will only help get us to the point where it is comparable to the seasonal flu.

 

The US is somewhere around 14 million confirmed cases via testing at the moment - simply by factoring in an order of magnitude it's very likely that 1/3 of the population has been exposed...that's not saying 1/3 currently have antibodies capable of fending off another infection, but it's saying the US already has a large percentage of its population where the virus is no longer 'novel' even before a vaccine is distributed to expedite it. If people put this in the proper perspective, an effective vaccine distributed to the right ~30-40% of the US population (targeted to the elderly, medically vulnerable and healthcare/high risk workers) can bring this country back to business as usual rather quickly - but if the perspective is for nobody to ever get ill/die from COVID-19 again and for community-wide COVID testing programs chasing an increasing percentage of asymptomatic infections, we'll be under a rock indefinitely - because even with a vaccine and multiple years of developed herd immunity, the most elderly/at risk medical cases will continue to have COVID cases that lead to severe health distress and death (just not nearly at the rate that has been occurring due to COVID being novel to most everyone).