Sunday, November 21, 2010

Texas Legislature Considers Dropping Medicaid

The Republican-controlled Texas legislature is considering opting out of Medicaid altogether. State Representative Warren Chisum, the most vocal opponent of the program, echoed the sentiments of others when he said: "It breaks my heart when there’s someone who smokes, and who stays drunk half the time, and we’re supposed to provide their health care."

Amen to that Mr. Chisum. It doesn't seem fair, does it? After all, why should people have to pay out of their own pockets for other people's self-destructive lifestyle choices? So it begs the question: Why is our private insurance system structured to do just that? The answer, of course, is obvious.

The millions of smokers and alcoholics (and the epidemic of obese Americans) who do have private insurance are running up medical bills that far exceed what they pay out in personal premiums (estimated to be One-Half-Trillion Dollars this year alone). So, who foots their bills? Other insureds of course, who – through escalating insurance premiums – must pay to treat the unbridled appetites of fellow insureds. That's right – and you can quote me – "It breaks my heart when insured Americans smoke, engorge themselves with food, and stay drunk half the time, and we’re supposed to provide their health care."

There are a growing number of insured Americans who make the effort to change their eating and lifestyle habits but who are nonetheless expected to help carry the financial burden for the millions of insureds who don’t, other insureds who somehow feel entitled to other people's money. But we do it. Why? I suppose it's because we are our brothers’ keepers, insured or not. Look, I'd rather not pay for the medical treatment for gluttons, alcoholics and smokers. And I'd rather not pay to treat today's leading – and expensive – health problems that can be reversed through dietary and lifestyle changes: from Type II diabetes to heart disease, hypertension, and many forms of cancer directly related to diet. I guess folks like me regard folks like Representative Chisum in the same way that Mr. Chisum regards the uninsured: Pay out of your own pocket to treat your excessive lifestyle habits. If you feel you can hold the uninsureds feet to the fire for making poor lifestyle choices, then the same standard should be applied to you. Individual responsibility, though, has never been a serious part of the national dialogue on containing health care costs, and yet it remains the defining solution to the problem.

Conservative-minded people like Mr. Chisum actually do believe in socialized medicine – but their own particular version of it, and one they personally benefit from. No, they don't want their hard-earned money used to pay for those who lack health coverage of any kind; but, yes, they are quite generous with my income to pay for the health costs of those who are insured but neglectful of their health.

If Representative Chisum, and other insureds, feel entitled to spend other people's money to treat the illnesses that inevitably arise from their own poor lifestyle habits, surely they can find it in their enlarged hearts to extend that kindness to the uninsured as well. Otherwise, Mr. Chisum, and others like him, live with this double standard, which makes them hypocrites, and selfish.

Beck vs. Oprah

Earlier this year, Americans voted t.v. entertainer Glenn Beck their second-favorite television personality, after Oprah Winfrey.

In 1938, a decade before the advent of commercial television in America, the children's author and essayist E.B. White (Charlotte's Web, Stuart Little) saw his first demonstration of the invention.

"I believe television is going to be the test of the modern world," he wrote, "and that in this new opportunity to see beyond the range of our vision we shall discover either a new and unbearable disturbance of the general peace or a saving radiance in the sky. We shall stand or fall by television – of that I am quite sure."

It is interesting to note that the two top-rated television personalities stand in direct opposition to each other. Oprah Winfrey challenges us to seek out and develop the best of the human spirit. She believes in our innate intelligence. Glenn Beck's success rests upon the ignorance of his viewers as he exploits the darkest sides of human nature.

Which will prevail? The jury is still out on that, but I believe E.B. White got it right.