The American Way

Folks,

Back in August, Arthur Caplan, Ph.D., Director of the Center for Bioethics at the University of Pennsylvania, wrote a commentary for MSNBC, titled Privacy Is True Price of Healthy Worker Discounts, blasting the notion of giving discounts on employee health insurance premiums for plan participants demonstrating healthy lifestyle choices.

Caplan points out, "Workers can lower their annual deductible (the amount you pay each year for health care or drugs before insurance kicks in) if they take company-administered tests every year to check blood pressure, cholesterol levels, and weight and to see if they smoke. For each health goal employees meet, $500 is knocked off their deductible."

He asks, "Do you really want your bosses and the insurance company giving you physicals and snooping around in your health care records to find out the most intimate details of your mental, sexual and physical health? It’s a pretty high price in terms of privacy to pay for a discount."

He goes on, "HMOs and insurance companies have proven completely unable to contain rising health care costs. This is mainly due to the fact that costs are fueled by an aging population using more services, an increased reliance on technologies and drugs whose prices are out of control, topped off by a massive dose of error, fraud and administrative waste."

Get a grip, Dr. Caplan! Of course people with healthy life habits should accept discounts on health insurance deductibles or premiums.

Ours is purportedly a free market system. The cost of goods and services are driven by their availability and usage. For example, our auto insurance is based largely on our driving behavior. And when we go to the supermarket, we don't pay a flat fee, we pay for the amount and quality of the groceries we choose.

By some estimates, three quarters of our American population is overweight or obese. One quarter of the population continues to use tobacco, despite being warned for fifty years of the dire health consequences. These people consume a disproportionate quantity of the available healthcare resources. Based on the free market system, if nothing else, these people should either show improvement in their lifestyle choices, or make a larger contribution to the funding of the healthcare resources that are available.

Furthermore, if people making poor lifestyle choices are not provided with incentives to change, why should they?

As far as privacy goes, it is readily apparent to the most casual observer that Brian is several hundred prime rib dinners and 12-packs over the line. We don't really need a health assessment to know that Sally's hacking and gasping for breath is directly connected to her 30 year love affair with the Marlboro Man. Or that 50 year-old Thomas looks 65, has high cholesterol and diabetes because he hasn't had his lazy ass out of the barcolounger for a 30 minute walk since Tatum O'Neal was jailbait.

Are the HMOs failing us? You bet. But even the best healthcare management system cannot protect us from ourselves. Mark Twain said "It's easier to stay out of trouble, than to get out of trouble." I'm so tired of the fat, prescription-addicted, cigar smoking gasbags pointing to the less fortunate members of society and pontificating on codes of personal responsibility.

The healthcare ship is sinking. The reasons are many, the remedies debatable. However, personal responsibility for one's health must improve. We are advised everyday that we have a personal responsibility for our financial well being. We have a personal responsibility to reject violence. We have a personal responsibility to curtail the illegal drug trade by not participating in its use. Why then is it someone else's responsibility to provide expensive healthcare to me for conditions I can prevent by living a healthier lifestyle?

Your Pal, and Doin’ the Left Thing