Arizona's governor on Thursday proposed levying a $50 fee on some enrollees in the state's cash-starved Medicaid program, including obese people who don't follow a doctor-supervised slimming regimen and smokers.
The plan, if approved by the Republican-dominated legislature, would mark the first time the state-federal health-care program for the poor has charged people for engaging in behavior deemed unhealthy.
O-kay. Fining people who have little or no income seems like a strange way to go about things, but what do I know.
At least Brewer is pointing a finger at a serious problem. A friend, who is a well-traveled physician born and educated in Pakistan, once told me that America is the only place he's ever been where poor people are fat.
So why are our poor people waddling around with cigarettes dangling from their lips, making little attempt to participate in their own health care? I think that there are several reasons.
Reason one is the nanny state. The government pays for their rent, their food, and their health care. The government says "you're too ill to work!" and encourages people to plop down in their armchairs and munch on potato chips while they watch Oprah reruns on TV. These people become socially isolated (and sicker), and the most positive attention they get is from their health care team. The results of this dynamic are sadly predictable.
Reason two is food stamps, or whatever the hell they call it these days. Whoever designed the program is a moron. Whoever continues to administer it is bordering on brain dead. People should NOT BE ALLOWED to buy junk food with food stamps! No soda pop, no chips, no cookies, no processed meats. It's not rocket science. Food stamps should be restricted to lean meats, fresh fruits and vegetables, dried beans, rice, and pasta. Milk. 100% fruit juices. You get the drift, I'm sure. This chart illustrates how many millions of Americans are receiving the food subsidy. The health benefit of tweaking the food stamp program could be monumental.
Reason three is lack of accountability. Why not randomly screen people who depend on taxpayer largesse for their health care? Screen them for nicotine, alcohol, and illegal/unprescribed drugs. If they test positive twice, boot them out of the program. Hey, if you want to smoke and drink MD 20/20 from a paper sack....great! Get a job, pay for it yourself, and work it out with your new insurance company.
Another point: something that we desperately need in our country are more health clinics. Lots more! It would be oodles cheaper to build and staff 24-hour clinics than to continually run these people through our emergency rooms. As a nation, it would enable us to do more preventative care, and to catch major health problems early. If people feel good, they are more apt to get jobs and participate in our society.
A healthy, vibrant population means lower taxes, improved race relations (aren't you sick to death of dealing with that one? I am.), and greater national productivity. It would be a triple-win for everyone.
I had no idea you could buy junk with food stamps - that's crazy! I always thought it was more like WIC - there was a pretty stringent list of what could be bought with those monies.
ReplyDeleteAnd I second the clinic idea; I'd actually suggest two levels of clinics - most that deal with more ordinary things (perhaps staffed by nurses with a bit more training), and others that could handle non-life threatening emergency things - sutures, possible broken bones, etc. I loved the urgent care clinic we had near us in Ontario - they had X-ray facilities on-site, and more than once, I went there for treatment for something that would otherwise have ended up in the emergency room.
Perhaps a variation on limitations on food stamps: the stamps become vouchers that are used in exchange for food that is specifically healthy. You don't like it? You don't participate. As Lady Red's friend tells her, why are the American poor so fat? Oh, yeah, it's those evil corporations that point guns at their heads and make them eat KFC.
ReplyDeleteFor some reason it has become a bad thing to hold people accountable for their actions -- but it is fitting and proper to hold others for the actions of the reckless.
That is slavery, pure and simple. Why shackle them with chains when you can shackle them with their avarice and sloth?
"A friend, who is a well-traveled physician born and educated in Pakistan, once told me that America is the only place he's ever been where poor people are fat."
ReplyDeleteThis reminds me of an account by one of the "lost boys of Somalia". When he came to America and was taken on his first trip to a supermarket he was, of course overwhelmed. After the shock of seeing all the food and all the cosmetics (shampoos, deodorants, toothpaste, soap, etc.) the thing that puzzled him most of all were the pet food aisles.
"What jobs do dogs have in America" he asked.