Healthy Behavior No Longer A Personal Choice

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It’s a strange state of affairs when the comedy channels break more important stories than the news shows. Just last week a report by Wyatt Cenac, from the John Stewart show set off a firestorm of discussion on the blogosphere.  HR 3472, a bill proposed by former Congresswoman Kathy Dahlkemper, would have offered incentives (insurance discounts) for healthy behavior (not smoking, losing weight, controlling cholesterol) was defeated in committee not by partisan politics (both parties were in favor of the bill) but by intense lobbying efforts from the American Diabetes Association (ADA), the American Heart Association (AHA) and the American Cancer Society (ACS).

Why would the big three associations, which are supposedly for health and prevention, oppose legislation that rewards improved health? According their perfectly jumbled released statements:

The impact of these provisions would have been to penalize people with pre-existing health conditions and certain health risks who could not meet these targets by charging them more for their health care. In addition, the legislation would have applied to health plans sold in the individual market, where people do not have the support of a formal workplace wellness program to help them achieve these goals.”

This bill might open the door for discrimination of people with pre-existing conditions, and also those who are genetically predisposed to these conditions. Most importantly it would restrict access to healthcare to those who need it most and research has shown that this has a negative effect on health.”

In fact, the bill would have enabled employers to reduce the health care premiums of people who met specific health targets (such as not smoking or maintaining low blood pressure), but also penalize people with pre-existing conditions who could not meet the targets by charging them more for their health coverage.  The Society supports comprehensive wellness and health promotion programs that utilize incentives, such as discounted gym memberships, for employees. But we oppose restricting access to health care for those who need it most.”

If their stated opposition is understood correctly, it boils down to, unless everyone benefits from these discounts, no one can benefit. Aside from the absurdity of this argument for the essentially capitalist endeavor that is our insurance industry, in what strange twist of reality did smoking and eating junk food cease to become choices?   And how does offering incentives for eliminating said activities, equate with penalizing those who choose not to partake? Even those with genetic predispositions to high blood pressure, high cholesterol or diabetes would benefit from not smoking, from eating healthier and exercising more.  What do you think?

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Chandler Marrs MS, MA, PhD spent the last dozen years in women’s health research with a focus on steroid neuroendocrinology and mental health. She has published and presented several articles on her findings. As a graduate student, she founded and directed the UNLV Maternal Health Lab, mentoring dozens of students while directing clinical and Internet-based research. Post graduate, she continued at UNLV as an adjunct faculty member, teaching advanced undergraduate psychopharmacology and health psychology (stress endocrinology). Dr. Marrs received her BA in philosophy from the University of Redlands; MS in Clinical Psychology from California Lutheran University; and, MA and PhD in Experimental Psychology/ Neuroendocrinology from the University of Nevada, Las Vegas.


  1. I’m actually against the discounts, but for an entirely different reason.

    Who is to decide what is “healthy”? And how do you prove it?

    What if they decide all people over 40 have to take statin drugs to be healthy? Or have a flu shot? Or that all adults have to get up-to-date on all their booster shots? Or what if they penalize people for being higher than 24.9 on the BMI scale? BMI gives some info, but certainly not the full picture.

    All those things above (which i personally would not do and consider unhealthy) could be coerced by the lure of “lower health care costs.”

    Other people may disagree with my idea of healthy choices vs. not healthy choices, but really, who makes the decision? That is my concern. Many people out there know first hand that the doctor doesn’t always “know best.”

    • Kat, you are correct. Who determines health? The most recent example is the widening of criteria for statin use. A set of drugs totally unnecessary for most of the population are now, and will increasingly be, prescribed to more and more people who don’t need them, under the auspices of ‘health’ in cases like that, individuals who refuse these unnecessary drugs will be considered unhealthy.

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