While employers can currently establish plans that incentivize weight loss, it’s not illegal and/or will not cause your taxes to go up to decide not to participate in such programs. Additionally, there is some measure of direct voting by employees — complaining about the plan, leaving the business to work elsewhere, not participating in the plan — that is much closer to the decisionmaker in the process and could ostensibly much more quickly repeal a plan decision than waiting for a large enough group of people to be voted in who commit to weeding out problems in legislation, which can take at its quickest years, and at its slowest, never (as the problems become too deeply institutionalized).
If the government forces everyone to buy private or public plans, then encourages (through subsidies to private plans, or directly in public plans) plans that create initiatives or penalties based on weight, then there is no escape. Even if it’s just verbal encouragement, it gives employers the sense that they can discriminate against unpopular groups and lower their own costs without the possibility of losing an employee that is a member of an unpopular group, since even if that employee was to leave, chances are the same discriminatory initiatives would be in place wherever else they’d choose to seek employment.
The choice to participate in health care should not be forced. Choice is sometimes the last check one has on a virtually universal discriminatory and unethical system with deeply rooted institutional bias. The ability to choose to opt out of healthcare, to have the choice not to participate, is essential. Those who want to argue about public costs are only doing so in the context of the current healthcare framework under which we suffer: though the nature of insurance re: pooling risks does mean that some will pay in and never take out as much as they pay in, while others will take out more than they pay in, it doesn’t mean that anyone’s health is technically anyone else’s business. That’s just the nature of insurance.
This would not be the case if health decisions and health behaviors and being a member of an unpopular health class literally become public business. By definition. One would have to completely trust the government not to fall in with popular Healthist sentiments that have a tendency to put a good deal of the blame for unaffordability and poor public health on fat people. In my humble opinion, placing such immense trust in a fickle, by nature ever-changing, populist, and power-hungry entity is foolish.
Those who are interested in freedom from institutionalized discrimination should always be concerned when choices are taken away, rather than offered up. The way to fight discrimination is to open doors, not close them. Many pro-fat activists are in favor of universal healthcare because they believe it will force insurers to cover those who are currently not covered, or allow the government to provide a plan that will cover them (they currently already have this power, by the way). But this is an example of closing doors, not opening them. Fatphobia is still out there, and it runs rampant in government — and is no less present in Progressive political circles than any other circle. If fat people can be used as scapegoats to save money in what is sure to be a very expensive system (TNSTAAFL*), that is what is going to happen.
And that is already what is happening, as the healthcare bills currently being proposed are overrunning their cost goals, even taking into consideration that every gimmicky scheme to shift money around has been called upon in order to make the bills look less expensive than they already are (frontloading payins, backloading payouts, political promises of savings that won’t be kept, etc). Since the government doesn’t have to worry about doing anything scientifically sound if their electorate cares more about money than science, they’ll pick groups to discriminate against (or promote discrimination against) re: insurance in the order that these groups are medically unpopular. Fat people and smokers are, without a doubt, the top of that list.
Universal or forced coverage is not good for fat people. What you gain in terms of being technically covered you will lose in the inevitable discrimination, higher costs, public shaming, fat hate and the wider spread of fat hate and focus on fat people as a “problem,” and so on.
Besides, I (and many others) know how to really lower costs, so that even groups that insurers put in a higher rate category would be able to afford insurance. But to lower costs would require less regulation, less control, more choices for individuals to buy care…in other words, a free market injection in a hopelessly overregulated industry. I’m certain that the cost of a plan for a “fit” family of four in Massachusetts currently would be the maximum of what you’d see for a non-“fit” family of four in a freer market.
The answer to the problem of fat people not being covered (or covered affordably) does not lie in handing over our fates to politicians and bureaucrats who are the ultimate barometer of public whims and misinformation.
If you have any questions, here is a bit of reading.
Do not give the public the ability to vote on your private health matters: No Fat People in Concentration Camps
Socialized medicine leads to more discrimination, higher costs, and fewer choices: Universal Healthcare and Fat
We should be free to do what we want, as long as that liberty doesn’t infringe on the liberty of others: Libertarians and Obesity, Take Two
A chain of back-of-the-envelope logic whereby involved government in healthcare in our current climate leads to dire consequences for fat people: Eliminate Fat People
Involving government in healthcare in our fatphobic environment can lead, and has led, to the breaking up of families. Additionally, it could lead to the state-sponsored eradication of fat children, by any means necessary: The Tide of Hate Rises
You should never give someone else the ability to make choices about your body: When Your Body is No Longer Yours
The state is not an objective third party with no profit motive, and will not operate as such in the distribution of health care: Why Universal Healthcare Should Be Opposed by Fat Activists
Junk science and fat unpopularity = the legislation of thinness: Universal Healthcare is Not Automatically Fat-Friendly
The Food Police are coming: “Lock-in” the Fatty Fat Fats
*There’s no such thing as a free lunch.