Obama Health Plan Omits Personal Responsibility //
Ignores Largest Single Unnecessary Medical Expense
President Barack Obama's just-posted health reform plan omits any element of personal responsibility, despite his own professed support for the concept, and virtually ignores the largest single easily-controllable and totally unnecessary cause of ballooning medical expenses, argues public interest law professor John Banzhaf.
Recently Obama reminded Americans that "we've got to have the American people doing something about their own [health] care." www.msnbc.msn.com/id/31929715/ns/health-health_care/
HHS Secretary Kathleen Sebelius repeated the refrain: "personal responsibility extends to lifestyle; that in order to have a healthier America, a more productive America, we need to make some basic changes in what we eat, how much we exercise, getting our kids up off the couch, turning off the video games." http://www.realclearpolitics.com/articles/2009/07/19/secretary_sebelius_and_leader_mcconnell_on_meet_the_press_97534.html
Yet, despite the fact that smoking costs the American economy almost $200 billion every year in totally unnecessary additional expenses -- about twice the amount necessary to fund all health care reform with no Medicare cuts or new taxes -- and although study after study shows that increasing the cost of smoking reduces the number of smokers and slashes health care costs, Obama's plan -- unlike many states -- doesn't impose any personal responsibility on smokers for these costs.
The prestigious and liberal-leaning Brookings Institution's analysis of health care reform shows that simply making medical care marginally more effective at treating major diseases -- through electronic records, evidence-based medical practices, etc. -- is far less efficient than preventing the diseases in the first place with economic incentives. The National Association of Insurance Commissioners has recommended a plan originally proposal by Professor Banzhaf to charge smokers more for their health insurance, something already done in at least ten different states.
"We could completely reform medical care, and make health insurance available for all Americans without any Medicare cuts or taxes on any innocent Americans, simply by imposing a surcharge on health insurance premiums paid by smokers large enough to reduce smoking by 50%. Although that's probably too ambitious, even a modest surcharge would raise more money than many competing funding mechanisms and also help slash health care costs by reducing smoking."
As MSNBC has reported, this method of funding health care reform is virtually the only one favored by a majority of voters. Moreover, voters by a margin of almost 2-1 say they would prefer a candidate who favors a $1/pack tax increase on cigarettes -- roughly the equivalent of a $60/month surcharge for 2-pack-a-day smokers -- which would bring in about $33 billion annually; about the same as the proposed “millionaires’ tax” estimated to yield about $35 billion/year.
"There's still time during the health reform summit and the deliberations thereafter for someone to stop just talking about the need for personal responsibility, and actually incorporate it into pending legislation. It's the single biggest and most important step we can take to rein in ballooning health care costs, and stop forcing the great majority of Americans who do not smoke to pay higher taxes and inflated health insurance premiums to cover the costs of the tiny minority who do," argues Prof. Banzhaf, Executive Director of Action on Smoking and Health (ASH), America's first antismoking organization.
A copy of ASH's smokers' surcharge proposal -- including additional arguments for it, why it would not logically have to be extended to include the obese, and a more detailed financial analysis -- may be found at: http://ash.org/proposalsurcharge
PROFESSOR JOHN F. BANZHAF III
Professor of Public Interest Law at GWU,
FAMRI Dr. William Cahan Distinguished Professor,
FELLOW, World Technology Network, and
Executive Director and Chief Counsel
Action on Smoking and Health (ASH)
America’s First Antismoking Organization
2013 H Street, NW
Washington, DC 20006, USA
(202) 659-4310 // (703) 527-8418
http://ash.org/
