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Shouldn't Healthcare Reform Reward Accountability?

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Barack Obama’s healthcare reform plan is a series of compromises that don’t go far enough, but certainly promise improvements. As I write, a vote in the US House of Representatives looms close, and there is much uncertainty that a healthcare reform bill can pass—or should.

A recent Wall Street Journal opinion piece called so-called Obamacare “The worst bill ever.”

What’s missing, unless I missed it in the reform proposal, is so glaringly obvious it’s hard to understand how the Obama Administration could let it slip by:  Accountability, and rewards for it. My bad, I’m not following politics enough since leaving Washington two years ago, so this opinion is way too late. I should have followed healthcare reform much sooner, certainly before the House vote came so close.

I’m looking at accountability as reward, and absolutely not a penalty. Example: My auto insurer provides a discount for good driving record; it’s not positioned as penalty for when there are tickets or accidents. The discount is a reward. Similarly, shouldn’t people be rewarded with lower health insurance premiums for healthy behavior?

People who don’t drink alcohol or smoke cigarettes (that’s me) should pay lower premiums. People with body weight appropriate to their height (that’s, ah, not me) should pay less, too. Companies offering employees onsite weight rooms, physical trainters or gym memberships should receive discounts, and employees going to the gym should receive yet additionally lower premium payments (That’s double discount for good behavior). Healthcare, whether as political policy or business enterprise, should make encouraging healthiness the top priority.

That said, people shouldn’t be penalized for bad health or their genes. Penalization is fundamentally what’s wrong with US health care today. People are punished for being sick. Some people can’t help being fat or getting cancer. It’s genetic. They shouldn’t be denied coverage or charged extra for it. But a hefty person regularly going to the gym should receive a discount like someone much thinner.

I’m politically agnostic. I don’t believe in either the Democratic or Republican agendas. That as preface, I’m stunned by Republican resistance to healthcare reform. Doesn’t accountability nicely fit with Republican politics and longstanding socioeconomic goals? Why aren’t the Republicans out in front with a bill that encourages Americans to be healthier? The cost savings for having more healthy people are seemingly immeasurable, as they go much further than actual healthcare costs, such as improved worker productivity as one small example.

Conflicting agendas surrounding healthcare reform, whether they be government or industry, go oddly together. Good healthcare should be a right, not privilege, whether government or industry delivers it.

After starting to write this post, I Googled “health care reform, personal accountability.” There is plenty of commentary asking about accountability, too. Some examples:

My feelings are otherwise mixed about the current healthcare proposal(s) sleeking through Capitol Hill. My biggest concern: President Obama has expended political capital on healthcare reform he really needed for economic reform. With US unemployment now above 10 percent nationwide, the number of newly uninsured individuals and families increases daily. Wouldn’t a more prudent healthcare policy seek to keep people insured in jobs where employers provide coverage? But that’s topic for future post.


    • The reward would come from trying, Larry. If you’re naturally overweight but regularly exercise, you should receive same incentive discount as someone who is naturally thin. Likewise, if there is breast cancer or prostrate cancer in the family and you get yearly checkups, you should receive a discount for being proactive.

      As for President–eh, Speaker–Pelosi breaking promises, should anyone be surprised?

    • Really? How is that constitutional? Some places in America, such provision would violate some people’s religious liberties.

      Something else: Federal law basically allows health insurers to operate as legalized monopolies. So now the government wants to make people obtain services from these monopolies or risk jail sentences? Isn’t government supposed to protect Americans from the consumer harm monopolies cause?

      Funny aside: Maybe there will be nationalized healthcare after all. If you don’t get health insurance willingly, the government puts you jail, where you are provided healthcare. State pays for prisoners’ healthcare, right?

  1. Theo@WA says on November 6, 2009

    When healthcare is 20% of GDP and a 1/3 of that is waste, healthcare reform is economic reform. Every American car costs $1,500 more you amortize the big 3’s healthcare costs.

    It behooves any pragmatic person like me why we allow such right-wing self-aggrandizement and low expectations to stand, chockful of excuses for why it’s acceptable for America, a supposed superpower with supposedly such grand manifest destinies, to be the only industrialized nation without accessible, affordable healthcare or are 37th in healthcare outcomes according to the OECD.

    it is ludicrous though not surprising if not all too human. like the British, Spanish, French, Chinese empires before, we have gotten too fat and complacent, allowing the minority that profit from the status quo to prosper at the expense of everyone else.

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