What Healthy Wisconsin Should Cost (And Almost Certainly Won't)

Not long ago, I was reading an online exchange between a male dating guru and one of his acolytes. The acolyte described the woman of his dreams: young, athletic, smart, beautiful, Packer fan, etc. The guru assured the acolyte that such women existed, and that he could help the acolyte meet them. The guru also, however, added this discouraging note: “When you meet a woman like that and make clear that you’re interested, the first thing she’s going to ask is, ‘What, exactly, do you bring to the table?’”

I have the same question when it comes to Healthy Wisconsin. The state intends to provide universal health care coverage—secure, affordable, high-quality coverage. It sounds like the health care equivalent of the dream girl. Naturally, it’s got me wondering: what, exactly, are Wisconsinites bringing to the table?

Fear not; I have an idea. When Wisconsin reformed welfare, it began spending considerably more on services to help participants find jobs. But it also began demanding more—in particular, universal participation in work. There was a fundamental idea of reciprocity here: we’ll help you, but only if you’re willing to help yourself.

Why shouldn’t the same logic apply to Healthy Wisconsin? Consider this scenario. You’re at an appointment with your Healthy Wisconsin doctor. She gives you a routine physical and finds that your weight is a potential health issue. So, she sets a body mass index (BMI) value that she’d like you to achieve within six months. She also gives you an exercise and nutrition regimen to help you reach your goal. But here’s the catch: if you don’t get within 10 percent of your doctor-recommended BMI in the allotted time, your coverage under Healthy Wisconsin is suspended. You can apply for reinstatement, but only once you’ve achieved your target BMI value. Until then, you’re on your own.

Again, you see the logic of reciprocity: we’ll help you, but only if you’re willing to help yourself.

Having bounced this idea off of a few people, I can share with you a couple of their (and possibly your) most passionate objections. Here’s the first one: “You can’t have government dictating people’s behavior like that! It’s a violation of their rights!”

But what rights are being violated here? Neither the state nor the federal constitutions include a right to hassle-free health care. (I checked. I even checked the emanations and penumbras.) Free health care is an act of beneficence by the state, and by the taxpayers who fund the state. It’s a gift horse. Accordingly, there shouldn’t be any complaining about its teeth. If you want the health care, you’re going to have to deal with the hassle. If you don’t want the hassle, don’t take the health care.

Here’s the second objection (which starts out the same as the first): “You can’t have government dictating people’s behavior like that! That’s Big Brother! I thought you people were all about small government, not government messing with the niggling details of people’s lives.”

“We people” are, in fact, all about small government. Healthy Wisconsin, on the other hand, is big government. If the state of Wisconsin is committed to practicing big government, then it might as well do so in the most constructive way possible. The most constructive way possible in this case, as in the case of welfare, is to insist on reciprocity.

You can relax, though; it’s really not as bad as it seems. I can even help you get started. This Friday, when you’re out enjoying fish fry, try this new approach to the old favorite: “Excuse me, waiter…could I please have mine broiled?”