| Millions could be saved. Sweet words to a politician’s ear whether it's millions of lives or dollars. The experienced politician knows the words are usually followed by some human behaviour modifying prescription that people are not going to like, so they let a commission or government report deliver that news.
Last week, Canada’s media rediscovered that millions could be saved by dealing with the big four of health: smoking, drinking, fat and salt. Both lives and money could be saved if all the major consumption trends in Canada were countered with a strong dose of human behaviour modification, a dilemma for the conservative politicians running this country.
Twenty years ago, conservatives would have had no trouble dismissing this desire to change people’s eating habits as socialist claptrap. Conservatives, no matter what party they are running, are not in the business of modifying people’s behaviour unless the modifiers happen to be cops or the modified happen to be union members, the poor or protesters. Yet, the possibility of investing in a little brainwashing to save money and a few lives to boot must be more tempting than getting the government to pave the road to your favourite lake.
Our fearless leaders would love to reduce the money wasted on health care for smokers, drinkers and the diet-challenged. Unfortunately, the usual grab bag of half-hearted information campaigns and vice taxes are not doing the job, and more drastic habit-changing schemes smack of good old Liberal values or, worse yet, socialism.
Besides, once you take a cold look at the issue, all those vices are rather good for the economy. Not only does over-consumption create jobs, but dealing with the aftermath creates more, higher paying jobs. Sure, health care comes out of everybody’s pockets, but Regional Health Authorities are some of the largest employers with some of the best paying jobs in Alberta.
It is always about the economy, stupid. And being stupid is good for the economy. So, conservative health care reformers are stuck looking for ways to save millions of without hurting the health care industrial complex. So far, they have come up with making the rich pay for enhanced health care services and making the unhealthy pay extra for bad luck or refusing to change their lifestyle. Enter private health care that enhances the public system, and health care debit cards or "savings" accounts. The two changes will make health care look remarkably like another universal insurance scheme that has hit the wall: car insurance.
Last week, car insurance hit the headlines with the message that payouts and lawsuits are costing insurance companies millions. They are, as insurance companies do, passing those costs on to Alberta car owners through rapidly increasing insurance rates. In some cases, the companies have decided to stop offering car insurance policies to Alberta drivers.
Albertans are bad drivers, and we are becoming worse. Adding insult to injury, we also like to sue like Yankees when we have an accident. As a result, we all pay the price as car insurance premiums go up again and again.
At some point, the grand assumption of the car insurance industry that rising costs will cause drivers to behave has failed. The growth of photo radar and rising insurance rates have not improved our driving habits, and insurance companies are responding by not issuing insurance to new drivers.
Applying the same concepts to health care through medical "savings" accounts or debit cards will fail in the same manner. People are even less likely to change their lifestyle than their driving style to avoid a financial penalty. When the system starts to crumble, refusing to insure the unhealthy is not the sort of response Albertans would accept.
To the great consternation of policy makers, life, death and everything in between is not simply about money. Squeezing people’s wallets is not the way to change lifestyle habits whether it is a fat tax, gas tax or a medical "savings" account. Politicians must work harder to come up with solutions because the car insurance model is not working all that well for cars and it certainly will not work for bad bodies. |
