14 October 2009: Health care choices may not be choices at all

Health care choices may not be choices at all

The medical definition for obesity is being 20 percent or more above one’s weight, resulting in a score of 30 or above in one’s BMI—body mass index—calculated on the proportion of one’s weight to his/her height.

Statistics show a reverse correlation between a state’s wealth and its obesity rate: fatter wealth-wise states like Colorado, which according to the Centers for Disease Control was the only state in 2008 having less than a 20-percent obesity rate, are thinner body-wise.

But this writing is neither about the obesity of 100 million Americans nor of an economic system that encourages mortality among its poorer citizens. It’s about the part of that system that is not only fat, but also a useless, worthless and unnecessary weight, a bloated albatross around the neck of our national body: the health insurance “industry.”

While the relationship between our obesity epidemic and health insurers is not correlative, it is metaphorical and telling.

This space is far too limited to detail the slew of numbers about the myriad aspects of health care economics: the percentage of the annual rise in overall costs, of the take of the middleman insurer, of the increased portion of the American GDP, of rising out-of-pocket co-payments, of much more. When doing your personal analysis though, that 20-percent figure is a good base to keep in mind:

The dust is beginning to settle on the health-care-reform—pick your noun—debate/squabble/fight/war, coming down to the either-or of the issue.

For the liberal/progressive left, it is part of the ongoing pursuit for social justice, the inalienable human right for everyone to access health care.

For the conservative right, it is about a government takeover, another step toward socialism, and, so they say, about being denied choice. But choice in what context: the right to freely choose among competing insurers or the right to freely choose one’s own medical provider? We know that’s not happening.

Is it a choice to forego signing up with a health insurance provider and not risking economic ruin should one find him/herself in a catastrophic health situation? Many not only make that choice, but also MUST make it because it’s the only one they have. That then logically makes it a non-choice.

Given that many others are stuck with a health insurer selected by his/her employer or retirement agency or agreed upon in their labor contract, it is farcical to think they have options.

Think about other insurance needs. There are primarily three: house, auto and life, the purchase of each involving true choice. After all, no one is obligated to buy a home or vehicle or to buy a policy that pays dividends upon death.

But one really doesn’t have choice in large part about his/her body. As former Secretary of Defense Donald Rumsfeld might phrase it, you come to the battle of life with the body with which you were born. In the end, it’s primarily the individual’s genes that dictate how much and in what ways he/she will need to access a doctor’s care. Life choices and circumstances, such as where one lives, are key but nonetheless secondary factors.

Having — not choosing — to buy into a plan is more than a whole different enchilada; it is an enchilada packed with fatty red meat, over-stuffed with cholesterol-raising cheese and baked in trans-fat oil.

My trusted American Heritage says manufacturing, along with hard work and diligence, is necessary for any enterprise to be called an industry; but health insurance is often referred to as an “industry,” which is curious for it does not manufacture anything. Besides, the only thing of which the health insurers have been diligent is getting its propaganda out and having it mindlessly and happily repeated by shills.

It comes down to this: in addition to having no real choice, the “health insurance industry” is a mammary gland on the nation’s economic, social and political bull body: unsightly, unnecessary and inconvenient to the other functions of the bull.

If a real man chooses to adorn his physique in such a manner, he should have a right to do so. And if he chooses to pay through the nose to exercise his inalienable right and to aid and abet in promoting lavish lifestyles for “health-insurance industry” CEOs despite their doing nothing to promote the general welfare of the nation, so be it.

But they should be choices, not de facto realities, outcomes of an economic system manipulated to have ensconced within it a huge chunk of its wealth dedicated to a purposeless enterprise: having middlemen taking a cut by standing between patients and their doctors.

The fundamental truth is this: Your “either/or” option is to buy into it or to suffer and die, slowly or quickly. In a sick way, one might call that choice.

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