CENTRAL VIEW for Monday, January 31, 2000

The "perfect" health plan

So, how about a system whereby those who impose the greatest burden on the health-care system pay the most and those who place the smallest burden on the system pay the least?

Take automobile insurance as an example. Drivers who don’t smoke, who install certain recommended safety and security devices and who don’t get involved in auto accidents pay lower car insurance premiums. Why can’t this principle be applied, with appropriate modifications, to health insurance?

Okay, what about Fate? Sometimes people are hurt in accidents and must have medical care. Sometimes disease strikes people who consume “perfect diets,” take regular exercise, attain and remain at the correct weight for their height and age, don’t smoke, don’t abuse alcohol, don’t take illegal drugs and don’t indulge in risky social behaviors.

Not to worry, my “perfect” health plan takes Fate and good health habits into account. If the accident was not the result of their own reckless behavior or if the person afflicted by disease can show a record of good health practices, they pay the minimum. On the other hand, those who engage in reckless behavior and those who refuse to observe good health practices would pay the maximum.

Frankly, I don’t like the idea of providing a lot of detailed health and life-style information to any bureaucracy, be it governmental or a private health-care system. That is why my “perfect” health plan is unlikely to be adopted.

But I do like the idea of fixing of personal responsibility on those who engage in reckless behavior and the fixing of personal responsibility on those who think cigarettes and Twinkies® are two of the four food groups and refuse to stop smoking and observe other good health practices such as regular exercise.

The class-war mongers will complain the poor and uneducated don’t have access to good dietary information and regular exercise and it would be unfair to make them pay for their health care. Poppycock. Television is awash with public-service messages about proper diet and the benefits of regular exercise such as walking.

Be that as it may, let’s continue to explore the “perfect” health plan. We happen to live at the dawn of an era in which the individual, rather than Fate, will have a major impact on both how well and how long he or she lives. Granted, heredity and genes will still play a major role. But we are beginning to alter genes, to re-grow organs and tissue and even clone vital parts.

Medical science says most humans ought to live 120 years. But even if the bionic person becomes a reality, until we learn to slow down the aging process, it probably wouldn’t be very enjoyable to live that long. Moreover, the health-care costs of our aging populations will become enormous.

That is why a health-insurance system and a health-care delivery system that reward the life-style behaviors that reduce the need for medical care will have to be invented. Unfortunately, those systems will also have to impose negative sanctions on people whose behaviors put their own health and the financial health of the system at risk.

Granted, my “perfect” health care proposal doesn’t have a snowcone’s chance in El Paso, but it is a starting point for discussion. Meanwhile, the presidential hopefuls on both sides will continue to promise the sky and voters looking for free “bread and circuses” will continue to listen to them with dewy eyes.

Canada’s socialized medicine system is falling apart. Indeed, health-care is severely rationed in every socialist nation. America’s problem is finding a fair and equitable method of paying for the world’s best health-care delivery system. Hopefully, the politicians will at least start talking about personal responsibility.

William Hamilton is a nationally syndicated columnist and a featured commentator for USA Today.

Dr. Hamilton can be contacted at:

Email: william@central-view.com