Vaping and Healthcare... Are we nonsmokers?

[Uncle Willie]

I swear I'm going to stop .. but ..

Without a seller, there is no buyer .. and a seller is free to price as high or as low as they like .. they are also free to negotiate .. so, yes, the seller always determines the price .. yes, you must have a willing buyer, but we're talking about insurance here .. if the insurance seller had to figure out a way to reduce costs in order to get people willing to pay, obviously many more could afford Insurance .. not gonna happen .. it's a Risk business .. it's priced based on claims experience, not the cost of stamping out a widget ..

As well, yes, the cost of hoop jumping is a cost .. but trust me, it's a tiny fraction of the actual start up costs ..

Lastly, I promise .. we are required to have car insurance, we better have home insurance, most folks want life insurance for their loved ones .. Health Insurance is perhaps more important than all of these .. because, if you've ever suffered thru the real need, when you need it, you really, really need it ..

 

[AttyPops]

This is nothing. You should see the threads in the OUTSIDE about this whole ACA stuff (not just the 'are we tobacco users?'). If you really want to discuss it, get ready and head over there. lol. But have a thick skin, and get your facts in line (no matter what 'side' you are on).

It's a rather contentious topic, to be sure. I posed a video in one of em a while back about "Why is healthcare so expensive?" Basically, there's no one answer...there's lots of em, all at once. And that includes the fact that it's a cash cow...not only for providers but manufacturers, insurers, legal, etc. It's almost an economy in itself.

I still say "Pay the doctors and get out of the way as much as possible". But even the doctors have problems. Like they can't negotiate big discounts for stuff...like flu shots...that others can (Walmart, Walgreens, etc). There's a lot to it, and there's no one answer like "It's government" or "Government solves it all".

I still think an agent...a single agent...working for the whole system would help. Negotiating prices for stuff, getting bids, keeping expenses lower keeps costs down. And payment stuff can be streamlined. I don't think socializing it is good though. Let them bid/compete as private entities.

And...our standards and expectations are higher all the time. We do things now that we didn't used to do...I suspect that some procedures are "extra" because that's they can't make any money on medicare/aid for normal stuff. But, specialists get more. Special procedures are better paid. And there's referral fees. And hospital income/fees. Blah blah blah. It's a cash cow.

Pay the doctors so they can make a living. They make the decisions that impact everything. As to hospital costs...wow.

 

[Dac311]

It depends on how they test, and they will test. If they test for nicotine, then you will fail. Recently my brother was doing the health insurance thing. He did a physical fitness test and a smokers test. They measured the amount of carbon monoxide in his lungs. If it is that test, then you would be considered a non smoker.


Sent from my iPad using Tapatalk HD

 

[Barbara21]

There are a lot of myths about single-payer that people believe. One of them is the "longer life expectancy." What we have in the US is NOT a true open market because of all of the government rules and regulations that are the root of most of the problems we have with health insurance and costs.

See 'The World Factbook' (put out by our own government): https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

And I was wrong - Germans don't have 'about a year' longer life expectancy, it's closer to two years. (1.7 to be exact).

We have a single payer system in the US. It's called Medicare and Medicaid and even though that covers only the poor and the elderly, it is a nightmare of corruption, inefficiency and grossly over budget. (I dealt with the single-payer system when my late husband became disabled with MS. He lost his employer insurance when he lost his job, which is one reason I believe employer insurance is stupid. We had to wait a year to get him covered and once he was, innovative treatments that are now standard weren't covered. He died at 45 years old.) If the government cannot effectively run that single-payer system for just 70 million of Americans, what would happen if they were running it for ALL 313 million Americans?

First of all, I am sincerely sorry to hear about your husband. MS is a terrible disease.

But you made an important point that I think people might miss. You said that once your husband was covered by medicare/medicaid, "innovative treatments that are now standard weren't covered". Speaking as a nurse, 'innovative' usually means 'un-proven', as in <whatever> 'has not been proven to be effective".

The key word is 'proven'. Do we want medicare/medicaid paying for treatment that hasn't been proven to be effective? Of course not. So it seems that (in this case), medicare/medicaid did exactly what it's supposed to do.

(Again, I truly am sorry about your husband.)

 

[tnash]

Does anyone know specifially what some large insurers have determined in regard to e-cigs? Like Blue Cross/Blue Shield?

 

[Dac311]

I will ask. I have a friend who works for them.

 

[tnash]

I will ask. I have a friend who works for them.

Thanks Dac311. Interesting discussion.

 

[Albantar]

The problem with health care is that there is no true supply and demand market.

If your choice is between dying and getting a treatment, you don't really have the option of not doing it. But even if death is not (immediately) on the table, the supplyer of the medical treatment always has the "upper hand" over the person who needs it; because he needs it. Seen from a "market" perspective, the hospital is selling treatment, but the patient is buying the result of the treatment. Obviously, in a true free market, prices would skyrocket immediately. I mean, how much would you pay to stay alive?

This means that in a true free market, healthcare simply would not function. There needs to be some form of regulation. This regulation can be provided by a "middle man", the insurance companies. The insurance companies purchase the product (medical treatment) for their clients (the patients). You can then get a healthy market again.

But this is not an overnight change. It's no light switch that you can just switch. The whole system needs time to adapt. In the Netherlands, the switch from fully public healthcare to a system governed by private (but regulated) insurance companies took over a decade. In the US, there was a dysfunctional free market system. You can't expect that to change into a fully functional private/regulated system overnight. It takes time. Obamacare needs at least a decade to fully mature. Right now it's being kicked while it's down - and while everybody knew it would still be down.

 

[MD_Boater]

The key word is 'proven'. Do we want medicare/medicaid paying for treatment that hasn't been proven to be effective? Of course not.

Really? In 1910, heart transplants, lung transplants, chemotherapy, and a whole list of procedures and treatments that are commonplace now were ALL unproven back then. They become proven by actually trying them and seeing how they turn out. If we never try, we never advance. I absolutely want "unproven" treaments tried at every possible opportunity. Otherwise, we would be stuck in the medical stone age.

 

[skoony]

i like post's with long legs.very interesting disscussion.
back to the main subject though.
after doing some research it seems that some states reserve the right to make the call what is
and what is not tobacco use in regards to the insurance premium.
of these some are and some are not including ecigs.
in the other states they are letting the insurance companies make that call.
there some companies are and some are not including ecigs.
i think this was designed into the new system to cause as much confusion as possible
among us customers.
check with your state insurance regulator to make certain.

regards
mike

 

[2coils]

I am currently in the process of buying insurance through the Small Business Marketplace for our company. I have been told by my broker (who I am still going to use even though I no longer need one) that under Obamacare, ANY nicotine use is chargeable as tobacco use, including NRT. Our state however, has decided not to apply the surcharge. I've also been told, same goes for life insurance. Any Nic use is tobacco use.

I also had surgery a couple of weeks ago. The hospital said I am still a smoker. They consider ANY Nic use as smoking.

It seems to me, we are automatically being lumped together with smokers.

 

[bluecat]

Link for an article on HCR (Obamacare) and smoking. Issues are arising from the smoker's "penalty". While I know we aren't smoking we are vaping, I just wanted to put this in.

Smokers may get temporary break from Obamacare penalties - CBS News

Also have been reading that smoker's are getting upset with the 50% penalty. Since this healthcare is supposed to be for everyone the dude who drinks too much, the dude that eats too much or heck be a addict to some of the bigger stuff and you won't be penalized.

Major public health groups are getting involved because they say this unfairly targets just smokers and maybe those who vapes.

Give us the ability to shop across state lines and really open up competition.

 

[bluecat]

I am currently in the process of buying insurance through the Small Business Marketplace for our company. I have been told by my broker (who I am still going to use even though I no longer need one) that under Obamacare, ANY nicotine use is chargeable as tobacco use, including NRT. Our state however, has decided not to apply the surcharge. I've also been told, same goes for life insurance. Any Nic use is tobacco use.

I also had surgery a couple of weeks ago. The hospital said I am still a smoker. They consider ANY Nic use as smoking.

It seems to me, we are automatically being lumped together with smokers.

Those who prefer not read Fox News should not clicky the link. It explains a little about the 50% penalty and some states that are ignoring it.

ObamaCare slams smokers with sky-high premium costs, could backfire | Fox News

Those of us who like to get all sides can. Yes, I am a Conservative with Libertarian tendencies and even side with Liberals on one issue.

 

[Barbara21]

The key word is 'proven'. Do we want medicare/medicaid paying for treatment that hasn't been proven to be effective? Of course not. So it seems that (in this case), medicare/medicaid did exactly what it's supposed to do.

Really? In 1910, heart transplants, lung transplants, chemotherapy, and a whole list of procedures and treatments that are commonplace now were ALL unproven back then. They become proven by actually trying them and seeing how they turn out. If we never try, we never advance. I absolutely want "unproven" treaments tried at every possible opportunity. Otherwise, we would be stuck in the medical stone age.

I really do see your point. As I've said before, I'm a nurse, my two brother-in-laws are doctors, both my parents went through long illnesses, and I've been involved in many medical discussions. What I'm trying to make clear is that what is good for the individual/family is not necessarily good for society.

As an individual I'd want to try anything, even if it's unproven. At least it's a chance, right? But in real life, money is not unlimited. As a society, we simply cannot afford to try every unproven treatment that's out there. Yes, the procedures you mentioned have proven life-saving to many. But I can give you a list a hundred times longer of things that didn't work out. You've never heard of them because...well, they didn't work.

My apologies to the OP for drifting off subject. In an attempt to get back on course, I can say that my insurance company asked if I 'use tobacco'. That's it - not do I 'smoke', 'use tobacco products', anything like that. I said no.

 

[MD_Boater]

Agreed.

I had a prescription for Chantix a year or so ago. It did not work. I had to stop taking it due to loss of sleep, and the fact that it just generally made me feel lousy. However, it is an "approved" smoking cessation product according to my insurance. I plan on vaping 0mg for a week, and then taking the "wellness exam" for my employer insurance which includes a cotinine test. I am going to state that the Chantix worked, and claim non smoking status. If I fail the cotinine test, the surcharge will apply. If I pass, it won't. If at some point down the road I fail a different test for nic, I will say I had some serious cravings and chewed some nic gum instead of going back to smoking. There is no way for them to prove that I haven't been a non smoker since I had the perscription for Chantix. I will not tell any health care professional that I vape. Period.

 

[Cavediver]

Agreed.

I had a prescription for Chantix a year or so ago. It did not work. I had to stop taking it due to loss of sleep, and the fact that it just generally made me feel lousy. However, it is an "approved" smoking cessation product according to my insurance. I plan on vaping 0mg for a week, and then taking the "wellness exam" for my employer insurance which includes a cotinine test. I am going to state that the Chantix worked, and claim non smoking status.

IMO, you should not tell them it worked. In fact, you ought to tell them it didn't work. Even better, offer to give them back the remaining medication in either a suppository or a projectile format.

OK, I'm mostly kidding about that last part, but there's no good reason I can think of to perpetuate the idea that Chantix works for everyone.

 

[Dave_in_OK]

As an individual I'd want to try anything, even if it's unproven. At least it's a chance, right? But in real life, money is not unlimited. As a society, we simply cannot afford to try every unproven treatment that's out there. Yes, the procedures you mentioned have proven life-saving to many. But I can give you a list a hundred times longer of things that didn't work out. You've never heard of them because...well, they didn't work.

I think this is the best argument as to why a society should never be in a position to make life decisions for an individual. We are nonsmokers but society wants to call us smokers so they can afford to pay the bills.

 

[Jman8]

Regarding OP, I'm currently about as anti-health insurance as they come. I don't have it and don't see me getting any in the foreseeable future. Just had recent experience with doctors (5+ visits) and worked out very well without insurance. Perhaps my best experience ever as an adult and dealing with medical billing.

Anyway, I say don't skirt the issue when dealing with insurance company. As has been said on this thread, the discussion is one to have with the carrier, and to make the case of what you feel is accurate. But also to take all of 5 minutes and look at it from their perspective. If you are a proud vaper, that wants to continue indefinitely, then why dance around your lifestyle choice? If something happens down the road with your health, and vaping plays any part in that (at all), then you'll be covered if you didn't skirt around the issue up front. But if you did dance around it up front, then you'll continue to dance when in medical care, wondering whether you need to lie to your own doctor or not.

Lying/withholding the truth always seems easier on the front end, but on the back end or down the road, it always seems like a lot of work to maintain that lie.

If carrier is adamant about lumping vaping in with smoking, I'd drop that carrier in a second. If there were no other choices, but that carrier, I'd go without insurance. Which I currently do, so I'm all good.

 

[GunArm]

I wouldn't suggest going and asking the provider about it. You are likely to get someone who knows nothing about ecigs and will tell you yes you are a smoker, which is better for the insurance company anyway. The fact is, you do not smoke. There is no combustion happening, there is no smoke. It is the literal truth. Answer all questions honestly, but don't go out of your way to bring it up. If it asks if you smoke, the (true) answer is no. If it asks if you use tobacco products, the (true) answer is no. If it asks if you "consume nicotine" (I have never heard that question asked), then the answer might be yes. If it asks if you use ecigs, the answer is yes.

 

[ancientgeek]

I wouldn't suggest going and asking the provider about it. You are likely to get someone who knows nothing about ecigs and will tell you yes you are a smoker, which is better for the insurance company anyway. The fact is, you do not smoke. There is no combustion happening, there is no smoke. It is the literal truth. Answer all questions honestly, but don't go out of your way to bring it up. If it asks if you smoke, the (true) answer is no. If it asks if you use tobacco products, the (true) answer is no. If it asks if you "consume nicotine" (I have never heard that question asked), then the answer might be yes. If it asks if you use ecigs, the answer is yes.

I concur. I answer the "Smoking" question honestly. Do I smoke? No. Do I use tobacco products? No. If I were to elaborate and say, "But I vape" is to perpetuate the myth that vaping is so like smoking that it must be qualified. Vaping is so unlike smoking that it is an entirely different subject. No one would respond to, "Do you smoke?" with "No, but I read books." Different question, different subject.