Massucci's Take: Can a fat tax fix our health care system?
The high cost of illness, insurance and treatments is one of the key factors driving the U.S. health care reform debate in Washington. The Medical Expenditure Panel Survey, which was published last week, allows people to see just how much certain illnesses will cost them and their insurer based on age and, of course, the condition. After looking at these charts you'll pray you never get diagnosed with diabetes, rheumatoid arthritis or emphysema.
Keep in mind that the personal costs referenced in the study aren't necessarily coming straight from the insured person's pocket. Employers cover the bulk of the cost, says Alan Miller, CEO of Universal Health Services. 'It doesn't cost that much to the individual. It certainly costs a lot for the employer to have you covered."
This could help explain an interesting shift I've noticed in workplace dynamics regarding sick days. As the costs associated with illness continue to rise for employers, they're more likely to encourage workers to use sick days. After all, it's in the employer's best interest for workers to recover sooner rather than later, and it's a better way of preventing other employees from falling ill as well. Especially since the H1N1 outbreak, it seems as if co-workers are less likely to snipe about someone being out sick than they are about a sick person coming into the office and spreading their germs around.
Playing Offense Is Key to Cutting Costs
Maybe this is a sign that the U.S. is turning the corner in how we approach illness. If getting sick is costing everyone more -- me, you, your company, my company and U.S. taxpayers -- isn't it in our best interest to beat the illness before it starts, as much as that's possible?
"The U.S. health-care system has historically focused on cures for illness and disease rather than effective prevention," Christopher Fey, CEO of U.S. Preventive Medicine, said in an e-mail. "An estimated 10% to 20% of the workforce either has, or is at high-risk for developing, a chronic condition. Subsidizing expensive interventions that treat sickness rather than prevent it is a burden taxpayers and employers can't afford."
Assume that's true, are we willing to adapt? The culture in the U.S. is a long way from being proactive toward illness. The government needs to consider whether they will take a carrot or stick approach.
If there were a so-called "fat tax" or a similar tax for not being healthy in the U.S., a mob would descend on those trying to enforce such a law. As it is, some resent the police because of an occasional ticket, which is, in essence, a tax for faulty driving or parking. Imagine the outrage against the Twinkie-police.
Should the U.S. government take a more charitable route and consider reforms that encourage folks to lose weight or otherwise be healthier, they need to take into account that Americans are likely to demand no one tell them not to smoke, eat, or drink, in excess. Perhaps the U.S. should keep an eye on things in the U.K., which is testing a plan in 2010 that allows people to earn money by losing weight.
"[The government is] still fighting over what the [health care] bill ultimately will be. None of the details have been ironed out, it's very complicated," said Miller, who recently wrote Health Care Reform that Makes Sense.
The complexity of health care and who should pay for it could cause the debate to rage on for years. Meanwhile, I think we're fighting the wrong side of this battle. Sure, if you lead a so-called "clean lifestyle," you may still get sick, but is that reason enough not to be healthy? Putting a price tag on certain illnesses entices people to look at the actual expense. If a problem hits you in the pocketbook, it's more likely to move you to action than a philosophical argument regarding the systemic cost of illness.
Anthony Massucci is a senior writer and columnist for DailyFinance. You may follow him on Twitter at hianthony.