Ella8 hit on exactly what I learned when my wife had emergency vascular surgery to save her leg because she had smoked and not managed her Type I diabetes, both in disregard of medical advice. Walking the hospital while she recovered, I had an epiphany and asked one of her surgeons if I was right: “The biggest problem with the American health care system is the American patient. We turn our bodies into train wrecks and drag ourselves into the E.R. and demand that you fix us up so we can go out and do the same thing again.” He agreed.
Health care is headed to a regime where you have to behave yourself or else, regardless of whether it’s total EuroNationalObamaCare or complete free-market. Meds and procedures — and the “check everything” tests we demand — are becoming more expensive. That means we are demanding that the insurer pay out more and more money that ultimately comes from us. Even private health insurance is a form of socialized medicine, a private compact where the partners pay. I have excellent health insurance through my employer, but we are getting subtle pressure — wellness clinics, checks on basic vitals, health competitions — to do the right things and thus hold down costs. It’s only fair.
But people being what they are, I doubt it will work in the long run. Eventually everyone will have mandatory cholesterol, BP, A1c, lung function, and other checks every quarter. If your numbers go out of bounds, you get a prescription for diet and exercise. If you don’t shape up, your insurance rate rises until you have to drop out. If you have a chronic, unavoidable disease, like my wife’s Type 1 diabetes, you should not be penalized for that alone. But if you don’t take reasonable steps to manage it, you should.
It’s invasive. It’s fascist. It’s inevitable.
You want someone to pay your bills? Then they own you. And they have a right to demand that you live responsibly so they don’t have to pay for the live transplant ella8 mentioned.
