Under Nationalized Healthcare Systems, Are Fat People Considered Felons?

7/10/2009

The government usually is the entity that take care of the roads for us- building and maintaining the highways, byways, and residential streets. They use part of our yearly tax money to pay for their upkeep and creation.

So, if I were to willfully damage (or cause damage through negligence) to the roads or other public properties- I might be charged with vandalism, destruction of public property, or at least be forced to pay some sort of restitution.

So now that the government is seriously considering going toward a National Healthcare plan, meaning that the government will be the entity primarily responsible for the upkeep costs of the human body, does this mean that if I eat too much junk food, get fat and need treatment for diabetes I'll be charged with destruction of public property or vandalism?

Just curious.

I talking purely "bad choice" injuries and diseases here, not the genetic ones or ones caused by natural causes. It just seems to me that anyone who willfully destroys themselves might not be the sort of person that the rest of us want to pay taxes to cover?

Jeff link

7/10/2009 11:32:50 pm

For better or worse, I don't think this is particularly unchartered territory. For example, I think we've already been there, done that with the debate on motorcycle helmets. States not requiring motorcycle helmets are in the minority, I think. Most of the reasoning for requiring people to wear helmets is based on the public cost of paying for head injuries.

The health thing, though, has a variety of interesting wrinkles which you allude to. One is the viewing of our bodies of property of the state. Another is the question of who sets the bar for health: do we outlaw twinkies and french fries now? A third is the economic component of all this: A national health care system is intended to benefit the poor, along with the rest of us. But any college student can tell you it's cheaper to live off ramen noodles than off of healthy fruits and veggies. And it's a lot easier to get exercise if you can afford health club memberships and live in a neighborhood where it's actually safe to be outside. Would health requirements put us back where we started, in terms of unfairly the burdening the poor?
I think that there are oppurtunities here, to think outside the box. A precedent that's already set is the idea of a "sin" tax. Alchohol and cigerettes are destructive substances. We tax the crap out of them.
It's worth exploring whether we could legitimately extend this idea. Taxing unhealthy food is an idea I'd support if the proceeds funded health education, nutrtional research, and subsidies for people who want to eat healthy but can't afford it.

Nathan link

7/11/2009 04:05:01 am

Jeff, Thanks for taking my question seriously! I really was looking for an answer here and I like your motorcycle analogy. We've actually done away with helmet laws in Florida for Motorcycles but I think they are intact for bicycles, or at the very least minors who ride bikes.

I guess the only difference is that helmet laws are regulations we place on someone who is operating equipment that has a risk factor attached to it. But when you say, let's treat unhealthy foods the same way as smoking since they have a risk factor- I think it falls in line very nicely. Both motorcycles and cheap foods have a heightened risk factor than Cars and Organic Vegetables.

I guess the only problem with a tax is that (like you pointed out in your response) the folks who eat the cheapest foods are often the ones who also need the free or reduced healthcare costs. It's partly education, partly finances, and partly the fact that they live in areas that are saturated by cheap, convenient food.

So, the only problem I see there is that in an attempt to create a healthier system you might very well UNDO any good that Nationalize Healthcare did in saving money and making things more affordable.

It's a quandary.

And the other terrible thing is that just as the Atkin's Diet and other low carb choices basically put a ton of small convenient places out of business, what do we do with the fall out of nationalized healthcare if we do start "sin taxes" on lower quality foods. Those places who sell them or produce them will quickly fade away, and the jobs with them. I'd hope that some of the higher quality food produces would begin adapting and hiring, but since they're no assurance- we might be in trouble there too!

It's a quandary, no doubt.

Jeff link

7/11/2009 10:06:29 pm

It is a quandry. For me, the biggest quandry of all this is this:
#1) Assuming that someone is competent to make decisions for themselves, I recognize they have a right to make risky choices for themselves. (Such as not wearing a helmet or eating unhealthily or not having comprehensive medical insurance.)
#2) By definition a risky choice will sometimes lead to negative results.
#3) As a Christian, I take seriously the idea that I am my brothers keeper. When these risks lead to negative results, what should I do?

So the motorcycle rider chose not to wear a helmet. The feeling of the wind in their hair was worth the risk of brain injury in a crash to them. I think that they have the right to make this decision.
Further more, I think that this motorcycle rider has the right to choose how much insurance he pays for. He has the right to decide he'd rather have money in his pocket on a monthly basis then be fully insured.
The dilemna is this: When the ambulance comes into the emergency room, what do we do?
If we fund his medical care despite his ability to pay, if we make case-by-case exceptions, we effectively do have nationalized health care. It's just that this guy wasn't paying into it. The alternative is to let him die because he does not have the ability to pay. I am quite convinced of the wrongness of this.
This all holds equally true around unhealthy eating: A person, in some sense, I think, has the right to eat whatever they want. But when there health reaches a point that they need medical intervention, can we really say that the moral thing is to say, "Sorry, your kids are going to be orphans now because you were unprepared."
In addition to the moral problems with all this is the pragmatic problem that medical crisis management is much more expensive than preventive care. Many states offer free emergency room care for quite some time in the U.S.
We end up, for example, with a very poor person being hospitalized in some unmanged symptom of diabetes due to their poor eating. The cost is astronomical, of course.
It would have been much cheaper to give this person exposure to health education courses, years before. It would have also been much cheaper, in the long term, to allow his disease to be managed outside of an emergency room setting.

I do hope that places that (particularly if there was some form of subsidy for healthy food) unhealthy restaurants would transform themselves, or new places would pop up. My hope would be that the millions of entry level fry cooks would simply become salad-tossers, or something.

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Under Nationalized Healthcare Systems, Are Fat People Considered Felons?

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