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Question 1: Health Care Benefits and Lifestyle Choice Responsibility
For the case study “You Play, We Pay”? A Matter of Personal Choice on pages 121 and 122 of our text, there are three questions to answer. The first question asks, should individuals be made responsible for their lifestyle choices regarding health care benefits? Absolutely, contrary to popular belief this type risk analysis of lifestyle choices for health insurance deductibles is thriving and growing today. Let’s first start with the argument that was presented for passing the Affordable Care Act (ACA), a premise that optimal health care reform would not only ensure that people receive medical care when they become sick, most importantly it would also reduce the need for medical care by promoting healthier behaviors (Orentlicher, 2014).
According to Orentlicher (2014), experts have recognized that health outcomes depend on the choices that people make about diet, exercise, and other daily behaviors.
Well, unfortunately it seems as though creating an environment of health insurance premiums and deductible affordability has not solved for the rising costs of certain population sectors unhealthy lifestyle choices.
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An imperfection of the ACA is that some of the important ACA requirements for encouraging healthier lifestyles has become unproductive. The law has come up short when it tried to improve individual decisions about nutrition, exercise, and other important personal health choices by encouraging better dietary decisions with its menu labeling requirements (Orentlicher, 2014). There have unquestionably been some positives that has come from the ACA, such as the positive legal right mandating the coverage of pre-existing conditions.
A law that provides welfare rights, calling for the provision of goods and services (Edge and Groves, 2018). As we are all aware, regardless of lifestyle choices there are certain diseases that are genetic in nature and cannot be reduced or eradicated by how we choose to live. “There are basic needs that we all share, recognize and respect as a person’s just due” (Edge and Groves, 2018, pp. 84).
Today, a health care benefit responsibility favoring the risk analysis of lifestyle choices for insurance deductible amounts is being sponsored by employers and growing in popularity. There is mounting evidence that enrollment in high‐deductible health plans is associated with reduced health care utilization (Abdus, 2020). So, following the logic of the ACA, a high-deductible plan must be having a negative effect on the health outcomes of individual’s since they are faced with health care costs that are leading to less care utilization. Not so fast, yes enrollment in a high deductible plan does result in less care utilization because these individuals do have to pay more in initial coverage costs, however these plans have relatively healthier people.
Abdus (2020) explains, individuals expecting low health care utilization may choose a high‐deductible plan over a traditional plan. Studies that examined the impact of offering high‐deductible health plan options to employees found employees who chose high‐deductible health plans over traditional (low or no deductible) health plans were more likely to be healthy, less likely to have any chronic health problem, and/or less likely to have had any doctor visits (Abdus, 2020). I contend that these individuals are conducting their own risk analysis based on their lifestyle choices. I feel that the ACA has failed to increase healthier lifestyles resulting in healthier people because of the positive legal right mindset. A mindset that requiring goods and services to be provided, such as nutrition labels, will cause others to take more responsibility. If anything, providing health care regardless of personal decisions might cause more irresponsibility. The reason that these individuals pick the high-deductible plans is that they have analyzed their risk of health care utilization and costs based upon the lifestyle choices they are making. What if the mindset was changed in alignment with auto insurance rates?
Over the years the auto insurance industry has realized that threatening the cancelation of an insurance policy or increasing the premium rates for poor driving did not result in better accident claim outcomes. What they have found of recent is that if you apply the loss aversion principle from the science of behavior change, outcomes become more favorable. Auto insurers will give you part of your premium back if the results of your driving habits result in less claims. I am not an advocate of health insurance companies doing a risk analysis of everyone’s lifestyle choices to categorize their level of deductible amount, it will only create inaccuracies. Just because you are a heavy drinker, smoker or participate in behaviors that typically lead to divorce, doesn’t necessarily mean that you will utilize more health care, regardless of statistics. However, I do believe that heavy drinkers, smokers and those creating an unstable family life that typically leads to divorce will make better lifestyle choices if they know there is a monetary reward waiting for them if they do not need to utilize health care. The auto industry changed the mindset of drivers with the introduction of safe driver rewards. Why couldn’t the healthcare utilization mindset of everyone be changed with something like the introduction of, wise lifestyle choice rewards.
Question 2: Curbing Alcohol, Cigarette and Drug Use
The second case study question on page 122 of the text asks, what prohibitions would you consider putting in place to curb alcohol, cigarette and drug use? My short answer is none. My long answer has its roots in the Libertarian Theory. The theory emphasizes personal rights to social and economic liberty (Edge and Groves, 2018). I am not a large advocate of prohibiting someone from doing something just because I believe it is wrong. I don’t believe my human right, the welfare of one is the responsibility of all (Edge and Groves, 2018), allows me the authority to prohibit others from personal decisions. The over usage of cigarettes, drugs and alcohol can certainly have a negative effect on someone’s future health. My more libertarian view is that everyone has the liberty to choose something that may or may not cause health care utilization. I don’t believe I get the right to prohibit their actions, I do and should get the personal right of helping them or allowing them to suffer the consequences of their choice to use drugs, alcohol and cigarettes.
Question 3: Incentives Considered to Promote Stable Families
The final question asks what incentives might be considered to promote stable families, as stable families have a positive impact on health care costs? I believe an incentive that is tangible and intangible will help increase the percentage of stable families. A tangible approach that is being tried by several states is to give extra benefits to Medicaid enrollees when they follow the healthy lifestyle orders of their physician. Some states are putting monetary credits into Medicaid recipients accounts for getting suggested immunizations and for following preventative care recommendations. These credits can be used for co-payments, weight-loss activities and smoking cessation programs. I think it can be taken one step further. It seems that a sense of self-identity around a set of moral values has created the strong stable Mormon family communities in Utah. As I see it, those of stable families identify themselves as a stable person.
They just happen to be in a family with other stable people. In other words, they choose to refrain from smoking, drinking and drug use because they identify as someone who doesn’t participate in those activities. Not as someone who is prohibited by their religion or family to participate in unhealthy lifestyle choices. Individuals all making similar decisions aligned to a common set of moral values in a community. I don’t think it is any different than those living in the state of Nevada. Individuals all making similar health decisions aligned to a common set of unhealthy moral values creating unstable families. The difference is that one community has a common moral value of having a healthy life-style the other doesn’t. I think the Medicaid credits should be used to pay for personal life coaches for those in unhealthy communities.
Though the life-coach is tangible, the processes of promoting an individualization, pushing people to imagine and live their own healthy identities is intangible. This urge runs counter to a fundament of sociology, which proposes that identities are social products that must be validated through social relations (Pagis, 2016). Life coaching feeds into the desire for self-creation. It brings together the need for help and the joy of accomplishing a positive image of oneself. According to Pagis (2016), three mechanisms are involved: creating an independent social space where identities can be crafted away from significant others; deliberately deemphasizing the coach and intentionally underwriting personal authorship; and encouraging clients to root identities in the social world while promoting an instrumental view of sociality. I believe life coaches can be the tangible incentive that brings out the intangible desire of people to live a healthy life-style overcoming the influence of unhealthy socioeconomics.
A Matter of Personal Choice. (2021, Dec 09). Retrieved from https://studymoose.com/a-matter-of-personal-choice-essay
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