I'm a balding, middle-aged, overweight American male. I have borderline hypertension and high cholesterol. I don't like to exercise, and I enjoy eating foods with mayonnaise and cheese. I am everyman. This is not an education problem. I know what I should do and generally how to do it—I just can't make myself do it. I know the consequences of my short-run gluttonous behavior will negatively impact my long-run health, but like many people, knowing something is bad for me is insufficient to discipline my behavior. What's worse, I am codependent on my health plan, and they are enabling my unhealthy behavior through the absolution of responsibility for my lifestyle choices.
I start each day with my morning “cocktail” of an ACE inhibitor, beta blocker and statin drug—all grossly subsidized by my health plan. I pay the same monthly premium as every other employee at my workplace with a family health plan. My wages have been reduced to fund the insurance premium behind the scenes, so I never know how much was taken from me. I know the only way to get my money back is to consume the services and drugs. I already paid for them.
It's ironic that I rarely speed on my way to my favorite fast-food restaurant. The consequence of speeding is real and immediate. I would like to speed and given the opportunity—free of consequences—I'd light up my big-block V8 all the way to the drive-through. Let's take it a step further. What if I purchased auto insurance the way I receive health insurance—priced independently of conduct, with a true premium cost hidden from view that covered all preventive maintenance? I would drive like a bat out of hell. The insurance also would be so costly that I wouldn't be able to afford it.
But unlike my auto insurance, my health insurance rates are not based on my underlying lifestyle choices, which are the primary determiner of how much healthcare I'm going to consume. We need to get to a world where I'm held individually accountable for the decisions that I make.