logic fail

Two comments taken from a blog called We Are the Real Deal:

"I would ask folks who think fat people are an unfair drag on the insurance pool, and therefore have a “responsibility” to lose weight, whether they jump to the same immediate belief about people who engage in risky extreme sports (or really any competitive sport–there are a lot of injuries, physical therapy, etc. that come up there). If not, why?"--spacedcowgirl

"And on the topic of “fat people make things worse for the rest of ‘us’ by costing more in health insurance”, if you take that line of thought (taking society’s assumptions about a marginalized group and using it to justify your own “righteous anger”) and apply it to other minority groups you can see why it is truly troublesome.

Women cause higher insurance rate because they’re more likely to have babies. Childbirth is really expensive.

Homosexual men cause healthcare to be expensive because they’re more likely to have STD’s.

Black people are driving up the cost of healthcare because they’re more likely to get that pesky sickle-cell anemia.

Are we going to start shaming procreating women for having the nerve to raise our healthcare costs?

Do we now live in a society when anyone who actually uses their healthcare for anything other than preventive care deserves to be shamed for their “poor choices”?"--Emily S.

Can I just say, I am so glad to see other people trying to articulate the same problem *I* have with all the "preventative care" hooha that's been all over the media in the past months. Some of you all have heard me try to articulate this in person and have given me, generally, the "WTF are you talking about,Andrea?" look that I know so well, or have seized on some minor point of my thesis, so I *know* I haven't been able to articulate my point. I'ma try again.

There's this weird and fallacious idea being bandied about and accepted as a True Fact without anyone looking at it critically or, indeed, applying (omg!) logic: that being, if we Americans just started Taking Care of Ourselves Right, eating right!, exercising!, drinking the one glass of red wine a day that's good for your heart and no less and no more!, getting our pap smears and mammograms and prostate checks and cholesterol screenings!, always using condoms!...and whatever else the public health wonks are pushing today, we will never get sick, never develop cancer or any chronic disease or condition, never need expensive medications, never need to see a doctor except for That Preventative Care, stop being a drain on the economy of this country, and then somehow magically die in bed at age 95 without ever having to spend a night in a hospital. Um, logic fail.

Let's take a hypothetical example. Let's say there's a woman named Andrea who is 46 and she's been getting her mammograms faithfully since they first told her to get one at age 39 and those mammograms usually show something like calcifications or cysts, which require coming back for extra films and/or an ultrasound or a follow up in six months instead of a year, such that instead of the six mammograms Ms Andrea "should" have had at this point, she's probably had ten and an ultrasound, all to tell her her boobs are just fine in the end. Now suppose Ms Andrea finds out at her mammogram at age 48 that she *does* have something that isn't just a cyst or a calcification; it needs biopsing. Then perhaps the biopsy comes back malignant. Then Ms Andrea needs surgery and radiation and maybe chemo, all of which is very very expensive. But she is cured and goes on to live another forty years full of preventative care and various other maladies that happen even though she's a Good Person who eats her vegetables and walks everywhere.

Now suppose Ms Andrea has an evil twin, Isobel. Isobel never gets her mammograms. Isobel never checks her boobs in the shower every month like she's supposed to. Isobel never goes for a physical. Isobel develops a lump in her breast the same time Andrea does, but because she's not looking for it, she doesn't notice it until she's 49. Then she goes lalalala, and ignores it. Eventually at 50, it spreads to her brain, she has a seizure in the bathtub, and dies from drowning. Or maybe she has a seizure on the street, gets taken to the ER, admitted, and told she's got 3 weeks to live, and ends them in the ICU.

Whose healthcare costs more over the course of her life, even *if* Isobel gets taken to the ER? The good twin, absolutely.

You want to *not* be a drain on the healthcare system of this country? Live unhealthily, never go to the doctor, and most importantly, DIE FUCKING YOUNG because of it. Or, y'know, just have good genetics like my dad, and live to be over 80, only taking one pill a day and going for your physical only when dragged, demanding cupcakes and CheezIts to the very end.

Either works. But Living Right, as a panacea? Uh, nope. Really. The logic doesn't pan out, sorry to say.

So maybe we ought to stop talking about How Much Money Those Horrible Unhealthy People Are Costing Us All, and instead, look at good health as a complex matter that is not under our control in a whole lot of circumstances and healthcare as a right in a civilized country and, y'know, take fucking finances and morality out of it.

xoxo