metalman said:
The article's headline is misleading. The author's unwillingness to subsidize other people's risky behaviour essentially applies to
any health insurance plan, irregardless of whether it is offered by a single-payer universal system or a privately owned for-profit corporation.
Considering the content, "Why America Hates Health Insurance" would be a much more fitting title, except that very few people would agree with that premise.
I can only assume that the author believes private health insurance plans involve no redistribution of any costs and every insured person has to pay for their own treatments only. Of course, this is completely and utterly false. If you pay for a private health insurance plan, you are in fact subsidizing the treatments of other people of whom some are fat, some are smokers and others might engage in unsafe sexual relations.
If you cannot stand the idea of paying for the treatment of a fat person, then there is usually no other option but to not buy any health insurance plan and pay everything out of pocket. Of course, the problem with this approach is that you will likely get overcharged because you have no bargaining power compared to a large insurance company that buys care services for a large amount of clients, fat or not.
So, whatever amount you save by not "subdidizing" other people's risky behaviour is likely going to be outweighed by the fact that you simply cannot buy services as cheaply as a large insurance company.
I am also puzzled by the author's glowing remarks about Dr. Sunderhaus. He praises him for telling a patient that she is too fat and then complains about oppressive nanny states that suggest citizens what to do. I do not mean to be insulting, but this seems to be rather schizophrenic to me. (Also, you can actually buy a private insurance plan in the UK, which he cites as an example, so you can escape the freedom-crushing tentacles of the NHS if you really want to.)
One thing to consider is that, if there is universal health care coverage in a country, it does not matter whether it is offered via a public single-payer system or a competition-based privatized one, the chances are much higher that people with unhealthy habits will not be punished, but informed by doctors such as Dr. Sunderhaus about better ways to live their lives. And yes, informing patients and making recommendations is actually a very important function that doctors fulfill. Being pointed in the right direction by a doctor early on can most certainly save a lot of health care expenses in the long run, not to mention increase someone's quality of life dramatically. Of course, if you have no health insurance coverage (because of pre-existing conditions, etc.), chances are much, much lower that you will ever talk to someone like Dr. Sunderhaus until your health has already detoriated greatly...
