none of the reform efforts have done anything to address how the personal choices people make - in their diet, exercise, and lifestyle habits - affect the cost of health care and health insurance.This is extremely difficult ground for the government to tread on, and I fear that most "solutions" to this problem would represent far too great an intrusion of government into our private lives. Tax on soda and candy is one thing...but it's not too hard to imagine where the slippery slope leads.
Moreover, let's look at two people:
Person A sits around watching TV all day. He eats Domino's Dots and drinks giant screwdrivers. He stays out drinking til 3 a.m., even when he has work the next day. He weighs roughly 400 pounds. He drops dead of a heart attack at age 40 while playing tennis for the first time in 17 years.
Person B is the picture of health. He lives to be 90. Along the way he has various health problems associated with growing older, but thanks to modern modical innovations is able to beat them. He passes away peacefully with his wife by his side.
While Person A will live an uncomfortable life, his medical costs will be nothing compared to Person B's chemotherapy or whatever. We are living longer thanks to medical innovation, but many of these treatments are extremely expensive.
The point is that "rising health care costs" are not solely linked to unhealthy behaviors like being fat and not exercising. I believe this has to be taken into consideration when crafting policy to correct unhealthy lifestyles - if dictating lifestyle choices is an acceptable role of government in the first place.
First and foremost, there will be tangible benefits to a reformed system that will outweigh the corresponding costsI would interject here that the Democratic cost estimates will almost surely be lower than the actual costs. The CBO and others have commented on how many of their assumptions do not hold up to political reality.
I wouldn't call it a "right," but I would say that it is in our national interest to pursue such a goal. B and his conservative allies might disagree, or say that it is pie-in-the-sky idealism to believe that our nation is even capable of achieving anything near universal, quality coverage.Conservatives have offered a number of ideas for how to expand coverage (e.g. portability of coverage). I think conservatives are more inclined to say that if the costs associated with expanding care are too high, universal coverage becomes neither attainable (due to limited resources) nor desirable.
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In sum, I believe C. and I have the following disagreements on the House health care bill:
- Since expanding coverage is C.'s primary interest, he is willing to accept a flawed bill in order to get momentum in the direction of universal health care. I value expanding coverage, but not as much as C.
- Since I disagree with quite a few provisions of the House bill, I fear the same momentum C. craves for fear of a "runaway freight train" of government control/intervention and a ruinously expensive new entitlement.
- C. appears ready to accept the Stupak amendment, whereas if I were a pro-choice liberal, I would not find the House bill worth the cost in terms of reproductive rights.
B.
I must begin by saying that I have an enormous amount of respect for both C. and B., and that I see the issues related to our failing health care "system" as being highly-complex, with multiple variables, many of which we can only guess at as to how they will behave in the future. That said, as citizens of a democratic society, it is incumbent upon all of us to do the best that we can to come to terms with the situation, and act in what we perceive to be our best interest. So, in all humility, I offer the following: (next comment)
ReplyDeleteB. and C. have each articulated their apprehension about government involvement in areas related to certain lifestyle choices, such as exercise and diet. B., in particular, expressed his feeling that any solutions to such problems "would [likely] represent far too great an intrusion of government into our private lives." Plainly stated, I feel that this fear is over exaggerated, and narrow in view. For instance, how do people feel about the government informing citizens-especially teenagers- as to how to properly use condoms, and the risks associated with unprotected sex? This is "government intrusion" into one of the most private, and personal realms of human existence. Yet, I believe it is an important, and welcome intrusion-one that will save lives, and boost the quality of lives for thousands, upon thousands. Not to mention the benefits related to the prevention of unplanned pregnancies. (Certainly, there are many who feel that sex-ed does not belong in schools, but such persons are in the vast minority, and often argue against such programs because they believe them to be ineffective.) Furthermore, is gym class an unacceptable intrusion? Health class? How about classes that teach Chinese? Japanese? German? And how about scholarships that reward excellence in particular areas of study? What our schools teach, and what government scholarships are awarded unavoidably influences what people choose to study, which in turn influences what careers they pursue, and on down the line. These are obviously important personal choices; do we do away with public school? Is this unacceptable? Moreover, are we so delusional as to believe that our exercise habits (or lack thereof) and our decisions related to how much and what we eat are truly matters of choice? I think it would be a stretch to believe so. For instance, the food industry spends billions upon billions of dollars figuring out what kinds of advertisements will get us to buy their products. And, once we do buy their products, we end up consuming food that has been engineered by some of the most gifted scientists/geneticists/etc. to cause us to experience pleasure when we eat it. Elicit enough pleasure, and you can create a bit of an addiction. I am not saying that things are entirely beyond our control, but these factors and others unavoidably influence what decisions people make. Now, while it is true that the health care reform bills on the table presently do not specifically address these issues, they do, I believe, take an important step in the right direction. That step is as follows: the more our society begins to take collective ownership of our national physical health, the greater the incentive will be that we utilize our public institutions to influence individual decisions in beneficial ways. In our current system, we pool collective resources through private insurance. I am a big fan of insurance as a means to spread out costs, but private insurers care very little about how much health care costs, so long as their premiums get paid and they turn a profit. Moreover, insurance companies have comparatively little ability to impact communal institutions that can be employed to help educate American citizens to make healthy choices. As such, I believe that the current reform bill being proposed by the Democrats will help spread the cost over the body politic, which, in the future, can be used to engender the political will to re-capitalize our fledgling health educational systems, and other institutions of public health. As is customary with this page, further discussion is welcome.
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