As the healthcare debate rages on, so do the many blog posts, interviews, and letters to the editor decrying the unfairness of potentially being forced to pay for other people’s “lifestyle choices.” The argument goes something like this, “Why should I, an active, thin person who eats nothing but bok choy and tofu, have to pay for the healthcare of my fat neighbor, in whose grocery cart I once saw Ho-Hos and whose television glows blue in the evenings?”
For brevity’s sake, I won’t get in to the problematic assumption that fat people never eat bok choy or engage in physical activity and that thin people never eat Ho-Hos or watch television, or the notion that weight—a state of being, not a behavior, by the way—is a good proxy for health. Because even laying those issues aside, there exists another significant problem with this idea. Namely, where does it stop?
There are all kinds of lifestyle choices. In Montana, we like skiing, hiking, hunting, fishing—all of those wonderful activities that take us outdoors and into our beautiful state. Unfortunately, if we follow the lifestyle choices argument, we would have to question the fairness of paying for the knee surgery of a skier after an accident or the resuscitation of a swimmer who gets in over her head. After all, skiing and swimming are voluntary activities that no one is forced to do.
Running marathons is great for your heart, but it can also put a lot of strain on your joints. If a marathoner needs a hip replacement, shouldn’t he have to pay for it? He did choose to do all that running.
I have many female friends who have chosen not to have children, or who have postponed childbearing until later in life. That’s all well and good for them, but if the studies are true that never having children or waiting until after age 30 to do so raises the risk for breast cancer, is it fair that we must pay for their treatment if they get breast cancer? Because, you know, they could have had children to help decrease their odds. (You say you’re infertile? Well, as long as it’s not caused by something preventable, like a sexually transmitted disease, then maybe you’ll get a pass for not having kids.)
And then there are women who have children but don’t breastfeed. Breastfeeding has been shown to help lessen a woman’s risk of diabetes and breast cancer, not to mention providing positive health benefits for babies. Should we resent providing treatment and care of women who choose not to—or are not able to—breastfeed? What about their (arguably less healthy) kids?
Men, don’t think you’ll be immune. Married men live longer and are healthier, so bachelors could be costing taxpayers more by choosing to stay single. Men also are less likely to seek preventative care. Does that make them undeserving of care when something goes wrong? Truth be told, men in general have higher risks for everything from cancer to heart disease than do women. And while they didn’t choose to be born male, most of them ultimately decide to stay male.
Slippery slope arguments always end up sounding a little absurd (or a lot, in the case of mass sex changes for men to reduce health risks), but the point is this: If we start categorizing people as worthy or unworthy of taxpayer dollars based on their lifestyle choices, we could all end up in trouble. Although I try to eat right, exercise, drive safely, sleep well, and floss my teeth every day, my lifestyle choices aren’t perfectly designed to minimize my risk for every possible health condition and injury. Ask yourself what you do every day that raises your risks and you might see that a rush to judgment doesn’t benefit anyone.