Media reports say that 20 million Americans will lose their “healthcare” under the Republican plan to replace ObamaCare, as if healthcare is like a cellphone, wallet, or item of clothing unintentionally left somewhere or stolen by someone.
Such confusion about “healthcare” stems from the misuse of the word itself. In common usage, the word “healthcare” is used as a synonym for “medical care” and “medical insurance,” although these words have widely different meanings. This is more than an issue of semantics. There are serious policy implications of using the wrong words, and the misuse reflects an entitled attitude among the populace and lazy thinking by the media, academia, and politicians.
Healthcare means taking care of one’s health. It’s what one does to stay healthy—namely, to have a heathy diet, exercise, not abuse alcohol or drugs, and avoid risky behaviors.
Medical care or treatment is what you seek from medical professionals when you have a medical problem and aren’t in good health.
Medical insurance is what you obtain to protect yourself financially from a catastrophic illness or injury requiring expensive medical treatment. In insurance terms, you pool the risk with others.
The total cost of medical care in the USA would be reduced significantly if American simply took care of their health. For example, the cost of overeating alone is estimated at $200 billion, just for the treatment of diabetes and heart disease. This doesn’t include the cost of Social Security Disability payments or other income support for those incapable of working due to medical problems stemming from overeating. Nor does it include joint problems from being overweight or gastrointestinal problems from eating too much of the wrong foods.
In addition, the medical costs stemming from smoking are estimated to be $133 billion. Alcohol and drug abuse add another $350 billion. Sexually-transmitted diseases add $16 billion. Reckless driving and other reckless behavior add untold billions more.
Using these figures, the total cost of preventable illnesses and injuries is $699 billion at the minimum, and probably $1 trillion when all the other costs are included. That comes to $2,184 to $3,125 per citizen, or $5,024 to $7,187 per household. In a very real sense, the 30% of the population that foregoes healthcare—that is, that doesn’t take care of their health—are inflicting these costs on everyone else.
Much philosophical gibberish has been written about the moral responsibility of society to provide medical care to those who can’t afford it (as if society is an individual moral agent). But virtually nothing has been written about the moral responsibility of individuals to not inflict costs on the rest of society because they lack self-control and self-respect. Of course, with nearly a third of Americans not taking care of their health, this is too large of a group for the media and their advertisers to make angry by stressing the point—especially given that much of advertising is for drugs, magic elixirs, and snake oil to address the infirmities and ailments stemming from a lack of personal healthcare. Certainly, no politician in his right mind would dare to raise the issue.
These cowardly framers of public opinion also are silent about the fact that spending on medical care/insurance ranks about fifth compared to other spending categories, such as housing, food, transportation (cars), education, and entertainment, as I’ve detailed in previous commentaries. It’s not hyperbole to say that medical care/insurance is subsidized and socialized in the USA so that the masses can buy expensive cars that are loaded with gadgets galore, instead of saving money for the infirmities of old age. It’s a matter of making tradeoffs.
In the same vein, many (most?) of the framers of public opinion say that medical care/insurance should be socialized; that is, provided entirely by the government. Yet, strangely and inconsistently, they don’t advocate the same for food, shelter, clothing, and transportation. Unless they are hardcore Marxists, they don’t say that these industries have to be socialized in order to help the poor—that everyone, rich, poor and in between, should have to buy food in government commissaries, live in public housing, wear standard Mao uniforms, and ride the same model of bicycles to work. Instead, the poor are aided with targeted social-welfare programs, such as food stamps, housing vouchers, and over one hundred other forms of welfare and entitlements.
The counterargument is that medical care/insurance is different, because it doesn’t have the immediacy of food, shelter, clothing, and transportation. It’s not something that people need every day. It requires people to plan ahead, defer gratification, make tradeoffs, and save for medical emergencies. That’s a valid point. However, there are ways of addressing this inescapable fact of human nature other than socializing the entire medical industry, or engaging in massive income transfers, or hatching monstrous central plans in Congress that will only serve to raise costs and make people even less willing to take care of their health. I’ve detailed the other ways in other commentaries, including commentaries in the Wall Street Journal, a professional medical journal, and other publications.
Oh, well, if you can’t beat ‘em, join ‘em. I have to end now so that I can drive to the convenience store in my $30,000 car to buy a big bag of Cheetos, a Big Gulp, a package of beef jerky, a package of Twinkies, a Snickers bar, a pack of cigarettes, five lottery tickets, and a bottle of antacid tablets. Or to use the popular lament, I’ll be “losing my healthcare” at the convenience store.