I recently stumbled upon a blog called Junkfood Science which stated this:
Do you ever wonder what kind of policy advice the leaders in your state get? The Wisconsin Policy Research Institute, which says it’s a free market think tank that advises government leaders on key policy issues and conducts regular opinion polls, produces a daily newsfeed that managers in Wisconsin read each morning.
Today, state administrators received in their inboxes recommendations for a “healthy Wisconsin.”
It’s a vision for the state-run healthcare program, providing universal healthcare coverage for all, modeled after the Wisconsin Works* welfare reform. It was written by political scientist, David Dodenhoff, Ph.D….
He is proposing that the state prescribe compulsory preventive health regimens on what you eat and on your lifestyle, regardless of their efficacy, through state doctors. Ideally, healthcare would be denied until you comply.
At first I was as offended as Ms. Szwarc, Junkfood Science’s author, appears to be, and had I taken the article at face value I would have continued to be. But then I started doing research on the Wisconsin Works program Dr. Dodenhoff references, and his own writings on that program in particular, and I realized that Dr. Dodenhoff was apparently writing to an audience who would be presumed to know his opinion of the Wisconsin Works program; specifically, that the “work or else” program was essentially a failure.
Dr. Dodenhoff’s commentary on the Healthy Wisconsin program can be found here.
In the article he says this:
When Wisconsin reformed welfare, it began spending considerably more on services to help participants find jobs. But it also began demanding more—in particular, universal participation in work. There was a fundamental idea of reciprocity here: we’ll help you, but only if you’re willing to help yourself.
Why shouldn’t the same logic apply to Healthy Wisconsin? Consider this scenario. You’re at an appointment with your Healthy Wisconsin doctor. She gives you a routine physical and finds that your weight is a potential health issue. So, she sets a body mass index (BMI) value that she’d like you to achieve within six months. She also gives you an exercise and nutrition regimen to help you reach your goal. But here’s the catch: if you don’t get within 10 percent of your doctor-recommended BMI in the allotted time, your coverage under Healthy Wisconsin is suspended. You can apply for reinstatement, but only once you’ve achieved your target BMI value. Until then, you’re on your own.
Dr. Dodenhoff’s previous reports on the Wisconsin Works program explain why the same logic shouldn’t apply (emphasis added):
When Wisconsin Governor Tommy Thompson introduced the Wisconsin Works (W-2) proposal in November of 1994, he described the foundation of the new program as follows: “For those who can work, only work should pay.” Work experience, rather than education and training, was thought to be an intrinsic good, and the only program activity that was fair to non-welfare families. If they could be paid only for working, the same should hold true for W-2 participants.
Subsequent years, however, have seen a major erosion in the “only work should pay” principle. Administrative data from the program indicate that participants being paid solely for work are a minority — about one-quarter of the W-2 population. And though a majority of W-2 participants are engaged in some sort of work activity, most are also engaged in education and training.
A similar reality holds within the community service job (CSJ) tier of the W-2 program. CSJs were originally intended to be full-time positions in which W-2 participants could work off their W-2 grant and learn the habits of day-to-day employment. As W-2 has evolved, however, CSJ positions have come to include education and training activities…
Finally, data in this report and other research indicate that attendance at community service job sites is poor, and that attendance monitoring is spotty. This means that for many participants, the CSJ experience does not replicate that of a regular, entry-level job; under W-2, chronic tardiness or absence from work is not necessarily met with a reduction in pay…
If they believe that work-first, work-only is an inappropriate model, then they ought to explain their position, revise the first principle of W-2, and communicate the policy change to all W-2 agencies. If, on the other hand, they believe that work-first, work-only is an appropriate ideal, as did the creators of W-2, they need to begin dismantling the infrastructure of education and vocational training activities that have become a part of the program.
Clearly, the doctor doesn’t consider Wisconsin Works to be a good role model for a similar health care program.
In the presumably facetious Healthy Wisconsin commentary you will read the doctor’s refutations to possible objections:
Having bounced this idea off of a few people, I can share with you a couple of their (and possibly your) most passionate objections. Here’s the first one: “You can’t have government dictating people’s behavior like that! It’s a violation of their rights!”
But what rights are being violated here? Neither the state nor the federal constitutions include a right to hassle-free health care. (I checked. I even checked the emanations and penumbras.) Free health care is an act of beneficence by the state, and by the taxpayers who fund the state. It’s a gift horse. Accordingly, there shouldn’t be any complaining about its teeth. If you want the health care, you’re going to have to deal with the hassle. If you don’t want the hassle, don’t take the health care.
He is certainly correct that there is to “right” to hassle-free health care. His next statement, though, illustrates a common idea that is simply wrong: “Free health care is an act of beneficence by the state, and by the taxpayers who fund the state.” “Free health care is an act of beneficence by the state” is true enough, although one could argue that beneficence is not the proper role of government in this country, but to call free health care an act of beneficence “by the taxpayers who fund the state” is just wrong. First, it isn’t free to the taxpayers because they are paying for it through their taxes, and it isn’t “an act of beneficence” by the taxpayers because they have no choice in the matter. The government decrees that their taxes WILL be used for health care, they cannot opt out, end of story.
“Don’t take the health care.” But he left off the part about how such people may still have to PAY for that health care they aren’t getting, through their taxes. Also, what’s the first thing we are told before starting a diet and/or exercise program? Consult your doctor! What’s that? Your doctor’s advice didn’t work within six months? Sorry, you’re on your own now, regardless of any physical conditions such as diabetes or back injuries that can affect one’s ability to exercise and/or lose weight.
Just more reasons why government-mandated universal health care is a bad idea. The Healthy Wisconsin bill, it should be noted, contains no such “lose weight or lose coverage” provisions that I can find, and it failed in late 2007. The evidence suggests, however, that if universal health care is mandated it is probable that some well-meaning person (or control freak) will add such provisions, which will inevitably be costly failures.
And Junkfood Science does have some interesting information. Check it out.
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