May 22, 2008 What Healthy Wisconsin Should Cost (And Almost Certainly Won't) By David Dodenhoff, Ph.D.
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.
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©2008 Wisconsin Policy Research Institute, Inc. P.O. Box 487 Thiensville, WI 53092 |
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