Patriotism and Health

It was inevitable that the discussion concerning the social and economic costs of illness, injury and disease would become a political one. Under the economic casuistry now in fashion, virtually every aspect of personal and social behavior is quantified in terms of its costs and benefits to society. While smoking was initially the most salient behavior subject to this new economic calculus, it was only the first. Obesity soon was added to a growing list of behaviors and lifestyles found to be contrary to good health, and so harmful to the economy.

If health care becomes national policy, then keeping people in good health, and thereby controlling costs, would become a matter of national policy. Once the taxpayers become responsible for providing health care to the public, the obsession over healthy habits and lifestyles would only increase. The issue of public health would no longer be simply a medical matter, but a political and economic one as well. Every group with a health care axe to grind would seek to grind it in Congress. Reports concerning the costs and benefits of different "lifestyles" and "habits" would proliferate. There would arise a whole new industry dedicated to a new health care casuistry that would determine the economic costs and benefits of various habits and lifestyles. Habits and lifestyles that would save money; good. Those that cost money; bad.

There was a letter to the editor in this morning's "Dallas Morning News" that I fear presages the inevitable result of this new health care casuistry: that maintaining one's health is patriotic. Those whose behaviors and lifestyles would increase the costs of health care, or undermine productivity, would be considered as acting against the public good, ergo unpatriotically. True patriots would live lifestyles that saved the government money and increased productivity. Perhaps the day might even come when tribunals exist to evaluate the health habits of individuals to determine who was contributing, and who was detracting, from the public health and thereby decide who was acting patriotically, and who wasn't. Those found to exhibit counterrevolutionary lifestyles and behaviors would be consigned to ill health and public scorn.