The Nanny State and Adipose Rex
In sterner eras, certain choices and behaviors were regarded as Deadly Sins. Two of those fatal transgressions were Gluttony and Sloth. Nowadays it might be difficult to get up a quorum to decide on whether Gluttony and Sloth are even undesirable, much less sinful. You see, that would be a “value judgment,” and no one wants to be accused of that. That’s because nowadays judgmentalism really is a sin.
Whether sinful or not, Gluttony and Sloth play a big part in the price of healthcare. One of the big problems with the price of healthcare is that we have an “unlimited” demand for products that are in limited supply. You know what classical economics says about that: prices will rise.
One classical solution to the problem of rising prices is: reduce demand. If more people were healthy, there’d be less demand placed on the healthcare system. Most folks can get healthy simply by changing their “lifestyle”: their daily choices and behaviors. Degenerative diseases due to lifestyle are unnecessary, self-inflicted “diseases of choice,” and they run up healthcare costs for everyone.
America leads the world in “morbid obesity.” Not only do we eat too much, but we eat the wrong kinds of food. We’re even seeing clogged arteries in children. What might be called “chronic inactivity” is also a problem; Americans just don’t get enough exercise. There are other factors that come under the rubric of “lifestyle” that don’t involve the essential activities of eating and moving; they include tobacco use, drug abuse, alcoholism, and other types of dissipation. And these lifestyles also contribute mightily to the cost of degenerative disease.
If health insurance companies still operated like insurance businesses, they would charge higher premiums to those individuals who pose the most risk, such as obese, sedentary, alcoholic chain-smokers who drive too fast and are addicted to cocaine and corn chips. But under ObamaCare, insurance companies can’t charge them more. That’s because of “community rating,” which requires that everyone pays the same for health insurance, regardless of how much risk they pose.
“Moral hazard” is a concept long used in the insurance business. The idea concerns this: by removing the costs and consequences of risks, folks are more apt to take risks. If someone else pays, that creates moral hazard. The insurance business deals with moral hazard by putting consequences back in the equation through higher premiums. For example, if one gets caught speeding, one’s car insurance premiums will likely rise. Such tactics create incentives for the policyholder to change his risky behavior by making him share in its costs. But ObamaCare forbids raising premiums on those who pose higher risks.
The ultimate threat for reducing moral hazard is the possibility that an insurance company might cancel one’s insurance policy. But ObamaCare forbids that, as well. In fact, “no lifetime or annual limits” on the dollar value of benefits are allowed (see page 131 of the text of ObamaCare).
The demand for healthcare is “unlimited” because there is an “unlimited” number of ways that one’s health can go bad. It should be especially alarming in America, a nation predicated on the idea of a limited central government, that a new federal program places demands on the private sector (businesses and individuals) that are essentially unlimited.
ObamaCare requires the responsible, prudent, taxpaying adults among us who “delay gratification” and regularly save and invest for the future to subsidize (with higher taxes and premiums) certain behaviors they would never countenance in themselves. Democrats think that a man who leads a life of dissipation should be able to check in at the nearest emergency room and get free healthcare. And you’re supposed to welcome him like he’s “some long-lost retard relative, shows up at your door in a wheelchair with a colostomy bag, says he’s yours now.” (page 22 of The Drop, a novel by Dennis Lehane and a good flick.)
But, if government can demand that some Americans buy health insurance for themselves as well as pay for the healthcare of those who either can’t or won’t buy health insurance, shouldn’t government also demand that those being subsidized improve their “lifestyle” and get healthy so that those who are paying won’t have to pay so much?
If America had a government-run, single-payer healthcare system, government would command us to diet and exercise, and would lay a penalty on us if we didn’t. Of course, someone would challenge that in court. And when it got to the Supreme Court the robed justices would descend from Mt. Olympus to tell us that the command is really a choice, and that the penalty is really a tax, and that the law is therefore really constitutional, (see NFIB v. Sebelius).
So will the ObamaCare bureaucrat busybodies issue new regulations that command us to do “the right thing” and start taking care of our health so that healthcare costs don’t spiral further out of control? They won’t because they can’t, and that’s the “dirty little secret” of ObamaCare. The government can’t constantly be monitoring everybody to ensure that we’re taking care of our health; i.e. ensuring that we eat our spinach and walk our five miles each day. Such monitoring would involve a mammoth bureaucracy; just what kind of fascist police state are you willing to put up with, anyway? We’ve been down this road before, during Prohibition, and that didn’t work out so well.
Besides, people have a right to be unhealthy. They have a right to eat whatever the heck they want, and in super-sized portions. They have a right to lounge on their sofas all day eating bonbons, listening to Oprah assure us that “this is the One.” They have a right to gorge on trans-fats, swill booze, smoke cigarettes, and dip snuff, and to their hearts’ content. And if it ruins their health and costs the taxpayer a fortune, that’s just too bad; after all, they didn’t set up the system.
Folks aren’t going to change their “lifestyle” just so some utopian government healthcare system can be made workable. And if the feds try to take away the few remaining pleasures in our dreary little lives here in Obamaland, there’ll be hell to pay and a nice revolution to boot. People have a right to be irresponsible as long as it doesn’t hurt anyone else, so pass the salt, Nanny Bloomberg.
What the utopians don’t seem to understand and will probably never accept is that the rest of us -- the jogging, tofu-eating, responsible rest of us -- shouldn’t have to finance bad behavior by paying the medical bills of the boozers, smokers, drug addicts, gluttons, and couch potatoes. It’s like demanding that we subsidize sin.
For each of us, biological life is a sinking boat that has a seating capacity of one. Even so, progressives expect some of us to paddle over to other sinking boats and bail them out, even while our own boats are sinking. And the occupants of those other boats sit back and watch us bail out their boats for them and complain that we’re not working fast enough and, hey, your boat’s bigger than mine.
I’m not sure that analogy works entirely, but if you’re 5’ 6” and have weighed 300+ for the last 30 years and your most strenuous physical exercise is hunting for the TV remote, then you pay for your hip replacement yourself, and all the other medical interventions coming your way; it’s not my problem. Your use of the healthcare system is becoming just a wee bit too gluttonous.
There’s no cure for any of this, other than getting healthy. And that’s what those of us with a proper “lust for life” are trying to do, despite the little snag of Lust being a Deadly Sin.
Happy New Year!
Jon N. Hall is a programmer/analyst from Kansas City.