Proposed Health Plan Offers Little Reward

Tuesday, 04 Aug 2009 12:59 PM

By Ernest Istook

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Make up your mind, Congress. Should healthy behavior be rewarded? Or punished?

While so many on Capitol Hill want a big government Nanny State, their approach seems as schizophrenic as that of stressed-out parents who argue over how to discipline unruly kids. Do you get them to behave by using rewards, or with punishment? Or both?

For example, there’s talk of taxing sodas and other sugary foods and drinks, and applying the money to healthcare. That’s punishment.

Rewards would be lower insurance premiums for those with healthy lifestyles, which many companies offer already. Yet the proposed health bill expressly prohibits those premium discounts. No savings for non-smokers, non-drinkers, or the non-obese. Section 113 of the House version dictates that premiums can vary only by age and geography — and even then only to a limited degree.

That provision removes any reward for healthy behavior. Yet lifestyle changes are the darling issue of many politicians as well as public health advocates.

So if there’s no carrot available, will Congress turn to the stick? The Centers for Disease Control is a government agency, but is lobbying anyway for a tax on soda. The Congressional Budget Office estimates that a three-cent tax would generate $24 billion over the next four years. Those favoring the tax testified to Congress that it would lower consumption of sugary drinks and improve Americans' overall health.

Then there’s beer. Having bonded with suds lovers at the “Beer Summit,” might President Barack Obama now ask his fellow drinkers to pony up in the name of better healthcare? Since the president recently made CEOs pay for their own lunch with him at the White House, he’s obviously not shy about asking anyone to pay more.

Staff for the Senate Finance Committee have floated an idea to raise beer taxes by 48 cents per six-pack, wine taxes by 49 cents per bottle, and hard liquor taxes by 40 cents per fifth. Proceeds would help fund the healthcare overhaul.

Senators and Congressmen are reluctant to embrace these publicly, but the ideas are not dead.

Such taxes are a tough sell. Several states are already pursuing higher taxes on alcohol. Britain is seeing pubs close after it raised beer taxes by 20 percent over the last two years.

Would American bartenders and beer- and soda-delivery drivers join the unemployed if this happens?

If so, they might be accompanied by health insurance underwriters. They wouldn’t lose jobs due to higher taxes, but because the legislation effectively outlaws their work. If companies cannot rate health insurance premiums, and with the end of exclusions for pre-existing conditions (also promised by Obama and his allies), then what’s an underwriter to do? Maybe they could work in the life insurance sector instead — but don’t be surprised if Obama next announces that we need government competition for life insurance also. And property insurance. And auto.

Those are logical next steps since Obama and House Speaker Nancy Pelosi have unveiled their latest strategy of labeling insurers as immoral villains. To them, it’s apparently not wrong for government to take people’s money; it’s only wrong for people to keep it. Yet their attack is on the very thing that motivates people and business — the profit motive.

Obama actually started the attack before Pelosi did, with his recent statements that, “A whole lot of people are having bad experiences because they know that recommendations are coming from people who have a profit motive” and, “Maybe if you take some of the profit motive out . . . you can get an better deal.”

Fifteen years ago, during the last major healthcare debate, then-first lady Hillary Clinton said it was wrong for anyone to make a profit from treating sick people.

Things haven’t changed. Obviously, we’re being punished again.

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