May 23, 2009

A cheese burger too far

One of the unhealthiest and costliest aspects of the US medical industry has always been the nexus between employment and health insurance.

The conflict of interest inherent in employers choosing and providing health insurance for their employees has significantly contributed to absurdly expensive, roll of the dice health care - or no care - that the majority of Americans seem to hold sacrosanct. None of that nasty socialist medicine for them, no siree! Yet they notice nothing wrong with their boss determining their insurance, ipso facto, determining their access to health care, which, in the US, means someone else is in charge of when, where, how or if they will receive medical treatment. Certainly health insurance in the US functions in that manner in any case, regardless of whether one is employed or not, all utterly fucked, in other words, but root cause goes way back in time to the quirk of history that married employment and health care, which also, in one blow, embedded medical inequality.

Given this history and ideology, it's no surprise that moves to legalize moral penalties and impinge specifically on employee's private lives ever deeper would most vigorously spring up in the US.

Other countries, other cultures, aren't too far behind - hello Australia, weighing all the little kindy kids and sending off letters to parents telling them their children are too fat - but the US embraces these insidious, pernicious forms of social / labor control with alarming gayness.

Personally, I don't and never will give a rat's arse if my colleagues eat nothing but pizza or can't walk more than 20 feet in one wearying session. I've worked with more than enough incompetent, lazy arsed, nasty little shits to know that being in tip top - by whose judgment? - shape doesn't correlate with being productive or effective in the office.

That's not to suggest that slovenly lard arses are darned fabulous, they aren't. I have no evidence to offer about any thing.

I do know that the most preaning and vain are very often the most useless employees, but that has nothing to do with the state of their health.

"In its effort to overhaul health care, Congress is planning to give employers sweeping new authority to reward employees for healthy behavior, including better diet, more exercise, weight loss and smoking cessation.

Growing numbers of employers have adopted wellness programs after finding that they can lower health costs and increase the productivity of workers.

Critics say that holding people financially responsible for their health behavior is potentially unfair and that employers have no business prying into their employees’ private lives.

Lewis Maltby, president of the National Workrights Institute, a research and advocacy group, said financial rewards and penalties were often a form of lifestyle discrimination. “You are supposed to be paid on the basis of how you do your job, not how often you go to the gym or how many cheeseburgers you eat,” Mr. Maltby said.

But federal officials insist that the rewards and penalties can be used in an ethical way.

Ethics experts at the National Institutes of Health have developed guidelines for assessing workplace wellness programs. In the current issue of the journal Health Affairs, the experts, Steven D. Pearson and Sarah R. Lieber, say the unhealthy behavior of some employees can affect co-workers by driving up costs for the group as a whole.

“The core ethical justification for penalty programs is that employees should be held responsible for voluntary actions that cause harm to others,” they write. But, they add, employees should be exempt from penalties when it is “unreasonably difficult or medically inadvisable” for them to meet a particular goal or standard."

Shall we measure and punish cholesterol levels?

There is no medical proof that cholesterol contributes to heart attacks or strokes. It's an assumption. Cholesterol is necessary for good health. The medical target of no more than a 5.5 reading in total cholesterol is arbitrary, it has no scientific basis. Some people have a naturally higher or lower baseline for cholesterol, yet the health standard is the same benchmark for all.

Some are now claiming that exercise contributes nothing to weight loss efforts or general health.

Should workers be required to use a supposed preventative medicine, even though we know wonder drugs can turn out to be dangerous, even fatal, and pulled from the market long after the pharmaceutical company has raked in billions in profits?

Things that we believe to be true today can later proven to be false.

Where do we draw the line? Where did this mass acquiescence come from?

If American's largely believe that government has no business messing in their lives, how the hell did they come to believe that a boss, a profit making corporation, has any business telling them what to eat, when to exercise, or how to live when they're not working?

There is a moral imperative here, which has nothing to do with productivity, or the potential "driving up costs for the group as a whole", nor anything to do with "voluntary actions that cause harm to others". Absolutely fucking nothing!

The moral imperative is to object to this
infantilization: vigorously, continually, without exception.

Grow up people. Take responsibility.

Don't be too stupid to decline to be treated as another commodity to be maximized during the production process. Don't be too stupid to tell the social engineers, no matter their guise, to just fuck off.

Congress plans incentives for healthy habits


  1. The US health system is a scary beast. I sometimes wonder why the American people accept it in its current form. I'm surprised that riots don't occur, but then it is difficult raising a ruckus when you have an untreated illness.

  2. I genuinely "feel their pain" when I read about the US health system Dan. Especially people who do or have suffered serious illness. Wouldn't want to have cancer over there, and be faced with a $50K insurance premium ... hell, I could buy an entire new body for that amount in Oz. All that tells you is that the cost medical supply is obscene.

    Why don't they complain? History and ideology.

    It quite beggars believe that Americans will write scathing articles about Canada, Britain and Australia, and how dreadful it is that we poor unfortunate folk have to "wait" for surgery. Better to have queues to ration the supply of medicine than charge people a million dollars for triple by-pass or cancer treatment.

    Medicine is and always will be limited supply but unlimited demand, it's the classic example of a good or service that by definiton is rationed. Rationing fairly, cost effectively, for the good of all is challenging, but not insurmountable.

    Our friends in the US haven't worked it out yet. Many of them are quite convinced that the US can't afford to provide universial cover, but the fact is that the US health budget is already many times great than what it would cost to do exactly that!