I would personally like to thank Congress and, most especially, President Obama, for finally passing a national health care package, as imperfect as it may be. National Health is not merely a social issue but a Constitutional one, to my mind, in that it begins to "promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity..." at the most fundamental level. [The words in bold are mine.]
I am, however, distressed at many aspects of the package, one of them being how Congress is looking at ways to curb costs, making "...it easier for employers to use financial rewards to promote healthy behavior by employees, like weight loss." (The New York Times, November 8, 2009)
There is so much to quarrel with in this legislation that I don't know where to begin. I'll start with the fact that "healthy behavior" comes in all kinds of packages and that being fat has the advantage of suggesting (without confirming) unhealthy behavior for the entire world to see, judge and make fun of.
This leads me to the question of invisible behavioral risks. In 2004, for instance, 1.26 swimmers died each day. In the same year, 42,836 people died because of automobile accidents, which works out to 117.3589+ people who, each day, engaged in behavior unhealthy enough to land them in a morgue. More than 2 million people are permanently injured each year in car crashes, making them a drain on health care, social security and various branches of insurance.
One can hide the fact that one smokes. One can hide the fact that one is a weekend drinker. One can hide the fact that one's hobby is snake-handling.
But one cannot hide being fat.
And the facts on most health problems aren't in on obesity. Is Diabetes 2 a fat thing, a food habit thing, genetic or a random occurance? Does the fat person control his blood sugar because he stops eating ice cream or because, as a consequence of not eating sweets, he loses some weight? For that matter, should the thin employee who eats a Snickers bar at her desk also be penalized for unhealthy behavior?
Let's get some jargon straight, Ladies and Gentlemen of the Congress: overweight and obesity are nouns and adjectives; "promoting healthy behavior" is a verb. Obesity and overweight are states of being, the outcome of almost exactly the same behavior as everybody else takes the risk of -- eating too much, hanging out in front of the TV, working twelve-hour days at a computer. (I say "almost" because there are a small number of people whose metabolisms add a pound for each carrot stick they eat.)
Promoting healthy behavior is an action that is vague at best. Does the boss decide healthy behavior is in what the worker-bee eats or what the worker-bee weighs?
Because we, bosses and worker-bees alike, admire thin people to the point that 8 million Americans are either bulimic or anorexic. Up to 30% of anorexics will die and the others, with their bulimic cousins, will suffer from such expensive complications as bone density loss, cardiac problems, tooth decay, kidney problems and high risks of addiction to alcohol, drugs and tobacco.
But they, poor, though enriched, souls are invisible.