Update on the Health Care Trojan Horse

On several occasions, I have warned that government funded health care is becoming a Trojan horse for increasing government micro-management of your life.  The logic is that by paying for your health care, the government can argue it has a financial interest in your not eating fatty foods, not smoking, wearing a bike helmet, exercising, etc, decisions that would otherwise only affect the individual themself.*

For those who often accuse me of exaggerated paranoia when it comes to government intervention, check out this from the UK:

People who are grossly overweight, who smoke heavily
or drink excessively could be denied surgery or drugs following a
decision by a Government agency yesterday.  The National Institute for Health and Clinical Excellence (Nice) which
advises on the clinical and cost effectiveness of treatments for the
NHS, said that in some cases the "self-inflicted" nature of an illness
should be taken into account.

Sorry, but I told you so.  What's next?  Is an unwanted pregnancy "self-inflicted"?  How about an STD from unprotected sex?  The rulers of this process in England might argue that "Oh, we would never include those things" but technocrats in the US have seen parallel things happen as they have lost political control of their similar institutions in the US.

It gets me to wondering whether the Solomon Amendment may be the new template for government control of individual lives.  In both Universities and state governments, the Feds use the threat of withdrawal of federal funds to coerce actions (think 55 mile speed limit, title IX, military recruiting on campus) that the Constitution nominally does not see to give them authority over.  Now, there is the distinct possibility that federal funds to individuals (Social Security, Medicare, unemployment) could be used to increase federal authority and coercive micro-management at the individual level.

*Update: Yes, I do know that "themself" is probably not correct grammar.  I sometimes use they, them, themself as a grammatically frowned-upon but I think less awkward substitute for he/she, his/her, and his-or-herself when trying to be gender-neutral.  Sometimes I just use the traditional male pronoun, sometimes I use the female pronoun generically since women will complain about "he" used generically but men will not complain about "she", and sometimes I mix them up.  There is still some consensus building to do in coming up with gender neutral pronouns, though this person defends the singular "they".


  1. Frank:

    This is unquestionably true. My employer presently offers a comparatively lavish set of health care benefits, including an onsite doctor and medical staff. I was interested to note that during our recent HIV training session, the doctor announced that they have little kits containing certain medications that might prevent an HIV infection if used within 36 hours of exposure. However, the kits would only be issued to people who had been exposed by occupational hazard or sexual assault. If you chose to engage in risky behavior, this benefit was not available to you.

    Not exactly a government policy, but it illustrates the power of the payer to dictate the terms under which the benefit will be provided.

  2. Doug Murray:

    Re the Update: I grew up here in the South and knew very well that more than one of "you" is "y'all", so I had a tough time in my early school years with the idea that "you" could be either singular or plural.

    If "you" can go both ways, why not "they"?

    By the way, did I get the right number agreement in the first sentence with 'more than one of "you" is'?

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  4. Bill:

    In the original article, two paragraphs down from your quote, you find NICE stressing that:

    "Its ruling should apply only if the treatment was likely to be less effective, or not work because of an unhealthy habit."

    I doubt Doctors will oppose being able to tell patients to buck their ideas up...

  5. Dave Neis:

    I ran into the singular pronoun question while writing the rules for my game, Doin' D.C. (TM) (Shameless plug!) As explained in a footnote:
    '[I]t is...inconvenient and unsightly to continuously type "he/she", "him/her", "his/her", or "his/hers"... [T]o expedite writing, new words have been created and used within these rules. So it is that you will find "heesh", "himmer", "hizzer", and "hizzers" used, respectively, wherever appropriate in this booklet.' (And yes, I know the commas should be inside the quotation marks, but that's another rule I don't always agree with and necessarily follow.)

    I used these words as needed on my website--another shameless plug coming--www.niceideas.com, too.

    I'll conclude the same as I end the footnote:
    "Feel free to use them in your own writings."