The Elephant in the Room

It's amazing that two crucially important aspects of health care reform in the U.S. have barely gotten notice in the recent debate. The first elephant in the room is that our society is unhealthy and getting worse. Is it a wonder that health care delivery costs are going up when 35% of the populace is overweight? It's perfectly predictable!

We live in a free society. No one should be forced to do anything. However, unhealthy eating habits, smoking, excessive alcohol intake etc, burden the nation’s healthcare system and our society at-large. A person leading an unhealthy lifestyle should pay a higher insurance premium. Conversely, a person leading a healthy lifestyle (such as ideal weight, no smoking), should get a rebate or a lower premium. This would present a powerful incentive for people to lead healthy lifestyles, resulting in a lower health care cost burden for society. A car insurance analogy would be the case of a 16 year-old driver paying 3x the premium because they represent 3x the financial risk. The exact same logic applies for an obese person, particularly a smoker.

Additinally, companies that produce unhealthy products such as energy drinks (full of sugar), tobacco, alcohol, fatty-foods, etc. should pay an excise tax. Come on people! Childhood obesity is rampant. What kind of example are we setting for our kids! Recent non-partisan studies conclude that obesity costs our nation $120B (that’s with a B) a year from heart disease, cancer, diabetes, and lost productivity. This plan goes directly at the heart of healthcare reform and not just insurance reform, and would save huge costs because this is where huge costs originate. We live in a free country, but those freedoms should not be allowed to hurt others or burden society at-large. Health decisions tied to financial incentives are guaranteed to resonate with Americans. These initiatives could realistically be expected to save $100B per year, and result in a much healthier populace.

The second elephant in the room is out-of-control legal costs burdening our health and legal systems. Tort reform, such as mandating that lawsuit losers must pay the winners’ court costs, or capping awards for pain and suffering will not only reduce the number of trial lawyers trolling for clients, but will reduce the practice of defensive medicine. Medical practitioners use defensive medicine to prescribe unnecessary procedures in order to avoid lawsuits, not to enhance health. Estimates are that reducing the practice of defensive medicine along with lower malpractice premiums and excessive court judgments should realistically save $50B per year in unnecessary outlays.

These two elephants taken together save approximately $150B per year, enough money to expand coverage AND pay down the federal budget deficit.