Make the Fat, Smoking Drunks Who Are Lousy Drivers Pay!
We're hearing a lot about health-care reform these days. Just today, I heard Dr. Governor Howard Dean discuss it on C-SPAN radio; Dr. Senator Tom Coburn is slated to discuss his own plan. (Can I just say that I love C-SPAN?) I read an article about a plan from Sen. Edward "Tedward" Kennedy, in which Americans can buy long-term care insurance from Uncle Sam. And I spoke with a doctor who's spending two weeks at her beach house. (OK, that doesn't have to do directly with reform, though many changes could reduce compensation and beach houses for health-care workers. It also made me temporarily question my decsion to not become a doctor, even though I was pre-med in college.)
Here's the thing that bothers me the most about health care: We all pay for other people's inability to control what goes in their mouths and how much they don't move their legs. I attended a conference in March during which one of the speakers said that 80% of our health-care costs are due to lifestyle choices, and since it was stated by someone on a stage with a microphone, it must be true.
OK, so I don't know how accurate that percentage is, but the basic point is true. A quick search of the Internets will turn up some articles on the topic, such as this from Colorado state representative Jim Riesberg: "Statistics show that preventable illness and disabling conditions are the root causes of rising costs, namely chronic diseases. Obesity is the primary cost driver and the major cause of many chronic conditions. It is estimated that 65 percent -- 191 million -- of American adults are overweight, and 30 percent -- 60 million -- of American adults over age 20 are obese. In many cases, obesity and chronic conditions are preventable and result from personal lifestyle choices." (And if it's on the Internets, it must be true. Otherwise, why are you reading this?)
Since I didn't go to med school and don't have a beach house, I don't know exactly which behaviors cost us the most money. And some people making bad-smelling decisions, such as smokers, will argue that they arlready pay through cigarette taxes and supporting the tobacco industry, which provides jobs and pays its own taxes. Maybe they're right.
The idea of a "fat tax" was proposed as far back as the 1970s, and it's come up again in the last couple of years. I have to say that I find it kinda funny that a vocal opponent is Rush Limbaugh, who's not known for being fat-free. But like Mr. Limbaugh, I don't think a tax is a good idea, because the revenue would likely be spent on something other than keeping down health-care costs for the people who eat right, exercise, and limit their excesses to weddings, New Year's Eve, and local productions of "A Christmas Carol."
No, I think a better option would be a basic insurance rate for everyone in the pool (whether we're talking government or private insurance), and then adjustments upward based on factors that are within a person's control. It's all certified by each person's physician during the annual checkup (which is something everyone should do anyhow, and will help doctors pay for their beach houses). Or, conversely, people could get discounts or tax credits for certifiying they are in good shape, drive safely, avoid the malls the day after Thanksgiving.
Possible? Practical? I'm not sure. But it sure bugs me that, through higher taxes and health insurance premiums, I pay for other people's really bad decisions.