Poverty in America

"At which point will it cross from being voluntary to mandatory?" I imagine when the state starts requiring MassHealth smokers to participate, rather than just offering the free service if they want it.

Ok, so that's the obvious answer.  But I've (at least on this coast - and believe it or not on a lot of forums populative by conservatives) heard quite a bit of mention about how stuff like this should or could be used as "cost controls".  The whole idea just chills me as a mandatory thing.  Voluntary yes. But mandatory?  We don't even have the sort of scientific documentation to say *for sure* that the blame belongs where we're trying to place it in many of these cases at least not as directly so as would be indicated by requiring 10,000 steps per day and a massive sin tax on sodas that aren't diet (or even for exempting diet soda)...

But maybe that's my narrow little libertarian-ish and rather rebellious streak showing.

Yeah, I too feel that this is a "slippery slope", and that ALL "Incentives for healthy living" they keep talking about in Health Care Reform debate/discussion could lead to any of the following:

1. Mandatory requirements... "if you want to keep your  insurance", Insurance for smokers is already more expensive, than non-smokers.

2. They'll offer the "Incentives" - that may start out as discounts on existing coverage.

BUT, before long they'll start to automatically figure-in those "incentive/discounts" into what they consider "affordable plans"... and if you are a smoker (or overweight people, or any number of other things) your coverage will be put in that category of "Cadillac Plans" they keep talking about.

And, since its (Somehow?) becoming more & more acceptable to (essentially) FORCE people (call it dis-incentivise, encourage, or whatever) into making politically correct - 'healthy choices'.

I can easily see employers, insurance companies, welfare/medicare/any public assistance programs giving people a false choice - and offering to pay for "smoking cessation treatment"... the premise being that this gives them no 'reasonable excuse' not to quit.

I've seen a few news stories on researchers working to find a "vaccine for nicotine addiction", that would basically stop the pleasurable/reward chemical action in the brain, meaning if it worked... you couldn't enjoy an occasional cigarette.

You could smoke, but you'd get no pleasure/satisfaction out of it!

Yeah, I'm very libertarian, cynical, and jaded for age.

There are already employers that are drug testing for nicotine use outside of the workplace. I can easily see bosses requiring workers to take a Nicotine vaccine, or parents even = (before the individual is old enough to make that decision for themselves).

This is a just the beginning of a REALLY "slippery slope" - that ends up with a world like the one in 'Demolition Man' where Stalone wakes up to find that everything bad for you has been made illegal.

And lets not forget 'immoral behavior', "John Spartan, You've been fined one credit for a violation of the Verbal Morality Statute."

Right, so back to the Original subject, if they want to OFFER this sort of thing to people fine, if someone wants to quit and needs the help, ok.

But, the people that have taken it upon themselves to assume that anyone who hasn't quit smoking already is a 'nicotine addict', and 'powerless to quit on their own'.

They can't see that someone (like myself for example) - having been fully informed of the risks, still chooses to smoke cigarettes.

Now here's the part that people who don't know me don't personally typically don't believe. I smoke about 4 cigs a day - usually when I'm taking my dog outside in the back yard. On average, I smoke about a pack and a half a week,

That's NOT a pack and a half a DAY, that's per WEEK!

I've repeatedly figured out the average... over a month, then several months, etc. It's somewhere about 4.2 to 4.6 cigs a day.  Sometimes, it's 1 or 2, sometimes its 6 or 7.

Over the last a 3 years its ~10 at max, and thats nearly always when I've spent several hours driving in my car. And for the 9-ish yrs prior to that -  I smoked about a half pack a day (=9-12 cigs),  'marathon' driving trips being the only notable exception.

I didn't intend to 'rant' like this, but the main point I wanted to make is that IMO and my experience, at least SOME people CAN & DO smoke tobacco =(cigs/cigars/pipes) in moderation.

Same thing with alcohol, I tapered down to two 6-packs of good beer/malt beverages (like the lemon-type beers or whatever) over 2 night camping trips... about 4 times a year.

Then at some point I just stopped drinking (FWIW... it was by choice = I decided I dislike hangovers - more than I enjoy being buzzed/drunk.)

Well, it also made my Doctor. happy...  I take antidepressants (who doesn't?) and it's common knowledge that you shouldn't drink when taking them. The first reason being they are a 'deppresant' IMO that's mostly semantics, but it can be a real issue for some folks. The second reason being its pretty hard on your liver to be taking those sorts of meds if you're a drinker.

And like I said, I rarely drank anyway (typically one weekend = a Friday & Saturday night every 3 months), so it wasn't hard to stop. I'll admit I'm probably the 'exception' to the more generalized 'rule', anywho...

I hate to see 'Sin Taxes' on some of the small basic pleasures in life, I don't care what the "social cost" or the 'cost to health care" (or whatever) is, 

I believe that is just part of the cost of living in a FREE COUNTRY, no one ever said Liberty was cheap!

I don't think that the judgemental "holier-than-thou' types have any right to insist that smokers, soda drinkers , overweight people, non-vegetarians, or people that make any 'less than perfectly healthy/safe' lifestyle choices, should have to pay more for it.

It's the same old debate about who wants to pay for public services, the Fire Department, Roads/Highways, the Military, property taxes to pay for Public Schools, etc.

And, now possibly some degree of Health Care for everyone - people complaining that they "don't want their money paying for somebody else's _whatever_", is ridiculous.

Just because someone doesn't want to pay for something - that is for someone else, or that they don't/won't use - doesn't mean they can say "I refuse to pay for _that_"... Unless your from the south and it it's full reproductive care for women.?

The right-winger social conservatives don't want any of "their money" (or any public funds) to pay for "_that_", because they don't want it to exist - I feel the same way about abstinence only Sex-Ed (2nd worse idea EVER, after D.A.R.E. - of course.

Didn't any of these people watch "A Christmas Story (1983)"? And what happens when you dare a kid NOT to do something, and make it that much more attractive, illicit, sexy, etc.

Seriously though Cigarettes costing the roughly the same as An hour of minimum wage pay is crazy, & a huge chunk if not most of that price is added Taxes "to discourage smoking".

HELLO! Can't anyone see that does NADA to stop the wealthy people from smoking, and for poor people it often means they aren't buying something else they really 'should' be buying... (but no, not forced to buy).

Like say, IDK maybe:  fruits & veggies, healthy food, gas for their car to go look for better work/go to school.\

TO get a decent computer so they can start "networking", have a web-based email account (you'd be surprised how big a roadblock not having one easily accessible can be) - and NO having PC's to use at the public Library doesn't cut it - it might have in back 1997 but not now.

I think the price of cigarettes shouldn't be 50% + 'Sin Taxes' and smoking cessation products - (especially the gum and the patches should be much cheaper) - if they really want people to help provide people that want to quit the means to do so.

I'm thinking it's something well intended but done heavy handed and gone (or at least going) horribly wrong.  Sort of like that college in PA that's in the news for mandating physical education/activity classes for anyone "overweight" as a graduation requirement. http://www.usnews.com/blogs/paper-trail/2009/11/20/pennsylvania-school-adds-bmi-test-for-graduation.html

Voluntarily changing bad habits is one thing; being forced to do so is quite another.  It's particularly heinous when bad science is the force behind the whole idea such as trying to blame all heart disease on being overweight or saying exercise is a cure-all for obesity and a long list of other problems.  I know from personal experience that there are many ethnic groups (in particular, several Native American tribes) that have high rates of type 2 diabetes and even "metabolic syndrome" - complete with all the complications - despite remaining active, if the individual simply eats the "modern American diet" with its refined grains and sugar.  The rates of diabetes and metabolic syndrome go as high as 2 out of every 3 and yes, that IS with the people exercising and yes, you'll see that many of those who aren't diabetic will be obese they've just managed to escape diabetes.  So clearly there's more to it than we're trying to admit or than we know so far.

Didn't mean to hijack it, but I've worked at employers who do stuff like this and it's sometimes a pretty short hop, skip and a jump from "voluntary" to "forced" and it's (in my experience) been done with explanations about cost.  Call it a learned distrust. I really hope to never see this from public plans.  Hopefully THEY know better.