Letters to the Editor
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Rebates for actually taking care of yourself
One of the biggest (pun intended) problems with Americans and many in the West is that many of our diseases stem from a profoundly unhealthy lifestyle. We eat crap, we're obese, we stress ourselves out beyond sanity, we don't exercise, and then we take powerful drugs to counter the inevitable problems caused by these lifestyle choices: heart disease, hypertension, cancer, diabetes, et. al.
One solution I think makes a great deal of sense is to establish a government healthcare system that yes, uses increased tax dollars to pay for some basic level of care for all citizens and legal residents. But also, the same system should establish benchmarks for self-care that would be validated by primary care physicians in annual physical exams, which too many people don't get anyway. It would work something like this:
a. You'd visit your personal MD after the plan went into effect and get a baseline picture of your health.
b. If you have health problems like overweight, high cholesterol, etc. that can be attributed to lifestyle, you're given goals to meet to reach benchmarks that would be determined by, let's say, the CDC, healthcare professionals, and the Dept of HHS. If you're in good health, you're expected to maintain that same level of health.
c. You go back a year later for your next physical. If you've met some or all of your health goals, your doctor registers you to receive a tax rebate based on the goals you have met and their fiscal value. The more ground you've gained (losing 50 pounds and lowering your cholesterol and BP into normal ranges without drugs, let's say), the bigger tax credit or refund you get.
d. If you maintain crappy health or like being sickly fatass, then you keep shoveling money into the system.
I'm not saying this would be simple to set up or administer. And of course, we'd continue to see disease born of genetics or bad luck along with injuries from accidents and crime. But this would provide a financial incentive for Americans to get health and stay healthy. Since some studies have shown that 60% or more of premature deaths from heart attack and cancer could be prevented with radical lifestyle changes, this might be worth trying. Just as in companies that have instituted incentive systems, those who don't give a shit about their health would subsidize the system for those of us who do. And if 50 million adults got healthier, their lower healthcare costs would balance out the lost revenues from tax rebates.
And please don't start with the "glandular problem" excuse for obesity. That's largely a convenient excuse for too many nights on the couch watching "American Idol" and eating Domino's. I told myself that until I found out a year ago that I had very high blood pressure. Since then I've lost 55 pounds and am off any medication. Incentive works; self-deception does not. We as a country should stop deceiving ourselves.