Today’s edition of “When Orange County sees blizzards” is brought to you by…
Here’s Robert Waldman:
One politically unfeasible approach to this would be to assign people randomly to HMO’s and pay the HMO’s based on their health but have the HMO’s pay for their health care. Then the HMO decides incentives. You have to decide how much a life is worth (and eyesight and all that) but it doesn’t depend on individual income and the decisions are made by an organization with tons of data.
No way this is going to fly in the real world.
And it damn well shouldn’t.
Am I the only one who sees how profoundly fucked up it is to construct a health market entirely on the end goal of making everyone a picture of perfect health?
Disturbingly similar to Japan’s Metabo program*, this plan would create a world where people with chronic health conditions are punished for having the audacity to lack the ability to wave a magic wand and instantly be free of whatever ails ’em.
My access to health care, in short, would depend on me being something I can never be. No amount of walking, spinach and stir-fries are ever going to take away my pain processing disorder, the tumors in my breasts, the endometrial implants in my pelvic area, or the fucked-up family history and genetic profile that leave me susceptible to severe anxiety and depression.
(Although, incidentally, if you take away all my medication, maybe I’ll finally drop from my current BMI of 25 to the BMI off 16.7 I was at before I started them. You know, the BMI where my doctors were noting in my medical records that I was visibly undernourished and my family members were afraid to hug me because I was so frail? But hey, at least I wouldn’t be overweight!)
Instead, I would be required to jump through so many extra hoops just to get the health care I am already fighting to get on a regular basis.
I do not want to see my doctors, pharmacists, and insurance company docked payment because I fail to live up to the yuppie ideal. I do not want to have to fill out countless health profiles and participate in incentive programs that hinge on me being able to do things I am not able to do.
And if you find a way to exempt people like me from this sort of incentive? You’re pretty much negating the entire point of the whole setup.
So, yeah. Over my dead fucking body. I know it’s not going to happen anyway, but I’d rather not see this sort of attitude fostered in the background. Because it leads to bad, bad places.
*See. I’d disclaim that I’m not calling fat a detrimental health condition, but honestly I think the need for that disclaimer comes out of a fear of the negative attitudes directed toward people with disabilities — and I don’t think that disability/illness/etc. is something we should be shying away from for those reasons.
And consider this a warning that any hatred regarding either fat or disability is going to be smacked down in comments. I have no tolerance for that shit.