The Affordable Care Act (aka: Obamacare) was passed in the U.S. Senate in middle of the night in just before Christmas, December, 2009. It was signed into law by President Obama on March 23, 2010. And yet, health care costs continue to rise — despite the best efforts of the masterminds in Washington, D.C.
Given the complexity of the issue, it’s no shocker that different groups are singled out as “bad” guys and “villains” who need to be brought to justice. However, I was a bit surprised when the folks at open-access medical journal PLOS opened the door for the “social justice” crowd to demonize Americans who exercise daily.
Writing for the Bioethics Forum blog, David B. Resnik lays the foundation for rewarding smokers and the obese for their unhealthy behavior with lower health insurance rates.
Charging smokers higher health insurance rates is popular and legal, but is it ethical? A close examination of the arguments for and against this policy reveals that it is not. …
Mr. Resnike first demonstrates two reasons why one would argue in favor of charging smokers more for health insurance:
- “According to the utilitarian argument, charging smokers more will encourage them to quit, which will improve public health and reduce society’s smoking-related costs.”
- “It is actuarially fair [to charge smokers higher rates] because individual insurance rates should be based on expected payouts. Insurance is collective protection against risk. Charging individuals rates based on their risk helps to ensure that money paid out from the pool will not exceed money paid into the pool. Charging people rates based on their personal risks protects insurance companies against ‘moral hazard,’ people taking risks without bearing the consequences. By charging smokers higher health insurance rates, insurance companies can make people pay a price for the risks they take.”
Then, Mr. Resnik links to National Institutes of Health, which uses the PLOS study’s findings: Healthy people actually incur more health care costs because they live longer. In short, the medical needs for a person who lives into his 90’s are generally more expensive than the guy who drops dead of a heart attack at 50.
[E]ven if charging smokers higher insurance rates encourages them to stop smoking, reducing smoking may not save society any money. Van Baal and colleagues compared the lifetime health care costs of three groups: smokers, obese individuals, and healthy individuals. Until age 56, obese people had the highest health care expenditures, but in older age groups smokers had the highest costs. However, because smokers and obese people die younger than healthy individuals, healthy individuals had the highest lifetime health care expenditures.
The authors concluded that reducing smoking and obesity will not save society health care costs.
Makes sense, right? We can have a debate about what those findings mean for hours. We can also have a debate about whether or not we should craft public policy that punishes the individual for living a healthy responsible life. However, that task gets tricky when the phrase “social justice” enters the equation. When ‘fairness’ undefined comes into play, you almost always know you’re dealing with someone who believes his ideological allies should be able to use coercive power of government (i.e., force) to achieve their vision of “fairness.”
The arguments against charging smokers higher insurance rates appeal to considerations of social justice and fairness. This practice may lead many people to forego health insurance even though they may have to pay a fine under the ACA. Since smokers tend to have significantly lower incomes than non-smokers, they could be especially vulnerable to increased health insurance costs.
If smokers opt out of health insurance this could have a detrimental impact on their access to health care and negatively impact their health and well-being. Most insurance plans cover smoking-cessation programs. It would be ironic–and tragic–if charging smokers higher health insurance rates prevented them from accessing services that could help them stop smoking. To avoid this unfortunate outcome, rate increases should be kept low enough that they do not lead smokers to forego health insurance. However, if rates are too low they may not provide a sufficient financial incentive to stop smoking.
Cloaked within a seemingly neutral academic paper are the telltale signs of a man who sees more meddling into your life — not less — as the “answer” to any number of problems. These academics are the people our elected representatives turn to for the “solution” to any number of problems the media is demanding they solve.
Take the following passage for a better glimpse into the mind of the author:
[S]ome might argue that incentivizing smokers to quit is unjustified, paternalistic interference in personal autonomy. Smokers should be allowed to make lifestyle choices free from coercion from employers, insurers, or the government. This objection is not very persuasive, however, because financial penalties do not significantly limit personal freedom. Charging smokers higher health insurance premiums is no more objectionable than imposing taxes on tobacco products, alcohol, guns, or gasoline. Taxes do not prohibit people from engaging in behavior, but they can help to ensure that individuals bear the costs of their behavior.
Actually, financial penalties are one way in which statists try to attack freedom and liberty. It is objectionable for the federal government to say, “Yes, the Second Amendment exists, but we’re going to tax your right to defend your life, liberty and property into oblivion so as to render the Second Amendment moot.”
It is objectionable for the federal government to say, “You can have your car, but I’m going to tax gasoline so much that you will never think of owning an SUV, let along go on a cross-country road trip, because I find fossil fuels distasteful to my green sensibilities.”
Why is it that over and over again it is the responsible person who seems to get screwed over by those with their hands closest to the levers of power?
Did you take out a mortgage you could barely afford during strong economic times and can’t pay your bills now that things have gone sour? No problem! Did you take out $100,000 in student loans for a degree in underwater basket weaving that isn’t panning out? Let’s see what we can do about that. Do you put s**t into your mouth all day long for years on end and now wonder why you have liver disease at 30? Let’s see if we can lower your health care costs and maybe jack them up on the guy who eats sensibly and exercises.
How is the current system of governance supposed to stand when well-adjusted, law-abiding citizens keep getting the shaft? It can not.
I can run longer, harder and faster than person ‘x’ because I exercise while he stuffs his face with chips and soda in front of a video game console on a daily basis. I have a job because I work my butt off and I try to continuously improve at what I do.
When one studies a specific aspect of life and sees inequality it does not always mean that there is also an absence of “fairness.” In fact, sometimes the existence of inequalities means that equality (of opportunity) is being taken advantage of in spades. That is not a bad thing.
If you are a free-thinking and honest member of society who hasn’t been paying attention to the political landscape, I highly suggest surveying the terrain. With each passing day the dependence peddlers make it less attractive to do what is right. The behavioral dregs of society are elevated to something more, while the man who lives his life in accordance with time-tested recipes for greatness is politically thrown in the stocks and pummeled until he adopts the hunched-back and hobbled posture of his sheepish peers.
I do not smoke. I do not make a habit of decadence. I exercise my mind, body and spirit. Hopefully, that will be enough to be an advocate for freedom and individual liberty for years to come. Since I’ll need a hand, I invite you to join me.