I should probably stay away from this altogether, and in view of that, I’ll endeavor to make this brief, to the point. Since this is a health and fitness blog and we tend to have our own ideas about "reform" (like: eat real food; and the fact that’s not even materially in the debate ought to be a big clue right there), feel free to raise your own issues in comments.
So, I’ve been stewing about it a bit since reading this op-ed from Michael Pollan sent by friend and reader Kathleen:
Let’s cut to the chase.
As for the insurers, you would think preventing chronic diseases would be good business, but, at least under the current rules, it’s much better business simply to keep patients at risk for chronic disease out of your pool of customers, whether through lifetime caps on coverage or rules against pre-existing conditions or by figuring out ways to toss patients overboard when they become ill.
But these rules may well be about to change — and, when it comes to reforming the American diet and food system, that step alone could be a game changer. Even under the weaker versions of health care reform now on offer, health insurers would be required to take everyone at the same rates, provide a standard level of coverage and keep people on their rolls regardless of their health. Terms like “pre-existing conditions” and “underwriting” would vanish from the health insurance rulebook — and, when they do, the relationship between the health insurance industry and the food industry will undergo a sea change.
The moment these new rules take effect, health insurance companies will promptly discover they have a powerful interest in reducing rates of obesity and chronic diseases linked to diet. A patient with Type 2 diabetes incurs additional health care costs of more than $6,600 a year; over a lifetime, that can come to more than $400,000. Insurers will quickly figure out that every case of Type 2 diabetes they can prevent adds $400,000 to their bottom line. Suddenly, every can of soda or Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits.
When health insurers can no longer evade much of the cost of treating the collateral damage of the American diet, the movement to reform the food system — everything from farm policy to food marketing and school lunches — will acquire a powerful and wealthy ally, something it hasn’t really ever had before.
So, think it’ll work? Let’s just say I’m skeptical: all mega-corporations (which I consider a branch of the state: they exist by state statute and are protected by statute) will do whatever it is that brings them the most revenue at least cost because officers, directors & owners are shielded from liability. If Pollan’s logic, above, turns out to be that which accomplishes that objective, then it might work. Otherwise, it will just be more and more money out of your pocket.
But let me be generous and pretend that Pollan’s scheme is sure to work. Well, guess what? I don’t care.
You see, I have this irritating instinct. When someone asserts that something is sure or likely to work, I have an automatic response: work for whom, and at whose expense? And with striking — I jest: it’s not at all striking — regularity, institutions and programs of state are designed to "work" for those who aren’t bearing the expense. It’s kinda the point, right? After all, if everyone was bearing their own expenses, with resort only to friends, family, church and community charity…ah, never mind. …That would never "work."
But what of the "right" to health care? There can logically be no such thing as a right to goods and services produced by others. We used to have a word for it: slavery.
Sorry; call me overly principled, old-fashioned, or something. I’m just not pragmatic enough. After all, how would the Pyramids have been built? And how about the agrarian Southern United States, circa 1800? I could go on all day, y’know? There’s just no end to folklore about how great the state is when they "make the trains run on time." But I know…this is just too important not to have a final solution. After all, final solutions typically "work" for somebody.
So what’s my plan, you ask? I don’t have one. I might suggest genuine freedom and real free markets — since that’s never beed tried — but, you know…"that would never work."
I’ll end with a modest plea. I’m happy to shut up if we can simply call it what it is, and I’ll offer a suggestion: a complex protection racket funded by extortion. And it just might "work." Anyone got anything better?