Health care and pork


Congress rushed this summer to obey President Obama's edict that they should enact a slow-motion government takeover of the health care industry before any of the members had to go home and start confronting an electorate that's actually read the thing.

They failed. And now that the Aug. 1 deadline has come and gone, some of the reasons for the rush are starting to become clear.

There's a lot more in that thousand-page legislative package than mere health care.

For starters, the draft Senate bill would provide up to $10 billion annually for a "prevention and public health investment fund," building or subsidizing bike paths, sidewalks, farmers markets and other "community interventions" meant to curb chronic and costly conditions including, well, being fat.

One critic, Sen. Mike Enzi of Wyoming -- an accountant who's the top-ranking Republican on the Health, Education, Labor and Pensions Committee -- called the provisions "an $80 billion slush fund for additional pork-barrel projects."

"The bill will pave sidewalks, build jungle gyms and open grocery stores," Sen. Enzi said, "but it won't bring down health care costs or make quality coverage more affordable."

Not so, insists Richard Hamburg, director of government relations for the Trust for America's Health, a nonpartisan organization. "We know these programs work. In and of itself, prevention makes sense."

There are two obvious problems with this logic.

First, the assumption that the government -- that it to say, the taxpaying "collective" -- "saves money" by reducing each person's need for medical care is true only if government is somehow required to pay for all their health care. Although this is the statist's pipe dream, it is not currently true, nor need it be true. If a person has enough money to pay for his or her own health care -- or to buy insurance, which amounts to the same thing -- what business is it of government should he choose to adopt an "unhealthy" lifestyle? Why should his neighbors have to buy him a jungle gym or pave him a jogging path, any more than they should have to buy him his medicine?

But just as importantly, it's simply nor true that healthier lifetsyles "work" to decrease lifetime medical costs. From a purely bottom-line, actuarial perspective, the opposite can be true.

Good diet and exercise may very well "work" for the individual if his or her goal is to feel healthier this year and next. But if we embrace the underlying assumption above -- that each person's lifetime medical costs must be minimized since the government collective is somehow obliged to foot those bills -- then the ideal death is that of an overweight person with diabetes, high blood pressure, etc., who simply keels over one day of a massive stroke or heart attack while still under 65, incurring no more "medical costs" than the brief visit of the doctor required to sign the death certificate.

On the other hand, persons who adopt a healthy lifestyle and avoid high blood pressure, diabetes, heart disease and stroke till they reach the age of 85 or 90 are likely to impose enormous costs on any "collective" medical system during their final year of life, as they receive massive medical interventions to stave off death from a number of simultaneous and interacting maladies best summarized as "old age."

The authors of the bill under consideration have long ago lost sight of the doctrine that a "reform" should be as simple -- and as simply stated -- as possible. Instead, the "health reform" bill now under consideration is a grab bag, a wish list of "lifestyle improvement reforms" which is virtually unlimited in goal as well as cost. Heck, why not require that everyone sleep at least nine hours a night on a $5,000 mattress best designed to prevent back pain, wear $500 orthopedic shoes ideally designed to prevent sore legs and fallen arches, consume a $45 pint of cod liver oil and ten pounds of citrus fruit each month, while banning alcohol, tobacco ... oh, wait.

From subsidized "farmers' markets" to proposed "higher rates for smokers." it turns out most of that is already in there.

 

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