What you get with a nanny state: A large, powerful nanny

posted at 4:15 pm on January 7, 2009 by Ed Morrissey

The pragmatic reason for opposing a nationalized health service arises naturally from the fact that they just don’t work well, as we have seen in Canada and in the UK.  Philosophically, opponents of single-payer health care worry that once the government pays for our medical care, it will have the authority to dictate lifestyle choices to its citizens subjects day-care denizens.  Paul Hsieh points out how this has already begun to happen in Japan for the Christian Science Monitor:

Imagine a country where the government regularly checks the waistlines of citizens over age 40. Anyone deemed too fat would be required to undergo diet counseling. Those who fail to lose sufficient weight could face further “reeducation” and their communities subject to stiff fines.

Is this some nightmarish dystopia?

No, this is contemporary Japan.

The Japanese government argues that it must regulate citizens’ lifestyles because it is paying their health costs. This highlights one of the greatly underappreciated dangers of “universal healthcare.” Any government that attempts to guarantee healthcare must also control its costs. The inevitable next step will be to seek to control citizens’ health and their behavior. Hence, Americans should beware that if we adopt universal healthcare, we also risk creating a “nanny state on steroids” antithetical to core American principles.

Do you still think that diet and exercise choices are no one else’s business?  Not when other people pay your medical bills.  If I have to pay for my neighbor’s doctor bills, I’m going to demand that he stops smoking, stops eating pizza five nights a week, and starts getting some exercise.  If necessary, I’ll find a way to make him stop.

Of course, I won’t have much power to enforce the Ed Morrissey Rules on him, except to not pay his medical bills.  Replace me with Uncle Sam, and suddenly we have the massive power of the state behind those rules.  How has that worked in other government-run systems?  Hsieh gives us a few examples:

  • Britain banned some egg advertisments from television because they promoted an “unhealthy lifestyle.”
  • New Zealand refused entry to a British citizen and submarine cable expert because of his obesity.  After he lost some weight, New Zealand finally relented — but his wife is still persona non grata because of her weight.
  • The German government has campaigned to brand those who don’t eat right and exercise as “antisocial” for burdening the nanny state with their problems — which has certain uncomfortable historical echoes.

Don’t think it could happen here?  Los Angeles and New York City have already banned restaurants from cooking with trans fats.  A few California communities have banned smoking in private residences, which should be a real joy to enforce, and some states have sugar taxes on soft drinks.  That’s without a nationalized health service.

He who pays the piper calls the tune.  When we surrender our responsibilities to ourselves in favor of a nanny state, don’t be surprised to be treated like children … or worse.


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MarkTheGreat on January 8, 2009 at 8:36 AM

I wonder how many different health care systems lexhamfox has lived under?

I lived in Japan and was enrolled in the system in the mid-80′s to early ’90s. This was from my early 20s to 31 and I didn’t have any significant health problems. But I did want to get my teeth cleaned a couple of times a year. I’d have to make 4 or more visits to the dentist for one complete cleaning, paying the standard visit charge each time. They would only clean one quarter of my teeth at a time and then schedule me for the follow-up. I thought it was ludicrous and asked my Japanese boss why this was necessary. He explained that in addition to the small charge I paid directly, clinics were paid by the government per patient visit, so by doing things this way they could increase their income 4x.

Now in China I have the option of private insurance and clinics. The quality is better than what I got in Japan (though not as good as the US), and things that can be taken care of in one visit are.

DarkCurrent on January 8, 2009 at 10:18 AM

Doesn’t Japan have the highest percentage of smokers in the world?

JeffinSac on January 7, 2009 at 7:29 PM

They do smoke…a lot in fact. This is somewhat mitigated by diet and lifestyle. Everybody bikes or walks at least a few miles per day and their diet is heavy on soy and fish.

Asher on January 8, 2009 at 10:19 AM

Asher on January 8, 2009 at 10:19 AM

It’s the tonkatsu and Asahi beer that are the real keys, not soy and fish.

DarkCurrent on January 8, 2009 at 10:27 AM

I heard on the radio this morning that the state of Massachusetts is planning health-related moves of this nature. They are, among other things, planning to require restaurants to list calorie counts on all menu items, and require schools to send diet-related report cards — called an O-card, for “Obesity” — home with school students.

Meanwhile, I just read on Drudge that world leaders are calling for a new world order in which an international board reviews government economic policies the way the UN now reviews military adventurism.

These are hard days for Liberty. It behooves every one of us who understands the fundamental necessity of human liberty to articulate the principles of liberty everywhere, as often as possible, so we don’t forget.

philwynk on January 8, 2009 at 11:32 AM

Although I know you were being facetious (or at least I hope you were), I really have to wonder where you Yanks are getting your info (or should I say, propaganda) from.
As a Canadian (and a Conservative one at that), I would not trade my ‘free health care’ for anything. I like knowing that if I, or anyone else in my family gets sick, I will NOT lose my house or life savings. And contrary to what you all might hear, No One in my family has ever had a bad experience with our Health Care system. That either makes us all the luckiest SOB’s in Canada, or the crap you are hearing is blown way out of proportion. Not sure which one of those I prefer…

pcbedamned on January 7, 2009 at 5:00 PM

You’re lucky then, I’ve heard horror stories of people with very serious injury being turned away from hospitals because they were full and couldn’t treat them.

With our system, if you have a life threatening injury, a hospital has to treat you, insurance or not. You or your family member might walk out of there with a hefty bill, but at least they have a chance of walking out of there. And I’m more concerned with still having my family than still having my house or money.

Sir Corky on January 8, 2009 at 12:15 PM

InCali – I agree with you. As I was growing up I remember that my family had catastrophic health care coverage and we paid for all the rest. With a few tweaks that could result in lower costs per person as well as more judicious use of healthcare.

My wife has leukemia and I am unemployed. Should she lose her job through which we get our group health insurance, she would essentially be stripped of coverage for her pre-exiting leukemia condition in any individual coverage private plan. Certainly we would invoke COBRA coverage at 3x/month in premiums but that runs out after 18 months. This is where I believe that some safety net coverage might be considered.

Do I recall that the nuanced language in the last debates about nationalized healthcare extended coverage to people here illegally? Presumably as a group they would not pay 100% of the premiums due through withholding since many work off the books. They also are reintroducing diseases to the US that have previously been rare or eradicated here. (LA now has infection rates like a Central American country for some infectious tropical diseases.) Would it be considered racist or xenophobic to close the borders or deport based on the incipient healthcare costs for said illegals?

Finally, would the nanny state also create a “progressive” premium scale to adjust premiums based on wealth rather than physical attributes like age and health status?

in_awe on January 8, 2009 at 12:24 PM

As a Canadian (and a Conservative one at that), I would not trade my ‘free health care’ for anything

Free? BWAHAHAHAH

Bevan on January 8, 2009 at 12:45 PM

They do smoke…a lot in fact. This is somewhat mitigated by diet and lifestyle. Everybody bikes or walks at least a few miles per day and their diet is heavy on soy and fish.

Asher on January 8, 2009 at 10:19 AM

The other aspect to consider about Japanese smokers is that they smoke charcoal-filtered cigarettes, which filter certain classes of carcinogen.

leetpriest on January 8, 2009 at 12:53 PM

And yet the same dumb-asses who are now clamoring for increased control over our lives will later be bitching about the intrusive state they helped bring about.

I just hate liberals sometimes. As smart as some are, they all seem to be afflicted with an infantile psychology that makes everything seem more important, dire, dangerous, etc., than it really is. Their only solution is greater external control, after which they falsely cry “Nazi” at everyone involved. Protect me, but not like that. Give me money, but without labels and milestones. Feed me, clothe me, help me, but then don’t be offended if I act like an ingrate. Me, me, me … it just gets really old.

Blacksheep on January 8, 2009 at 12:59 PM

in_awe on January 8, 2009 at 12:24 PM

I agree that the preexisting rule has to be fixed and think that your other idea is a sensible solution. Right now, the market in health care is pretty skewed. I’m not sure that many people even know how much a doctor charges the insurance company per visit and would be horrified to know that it’s generally at least $100 even if it is for a simple illness like a cold or the flu.

Illinidiva on January 8, 2009 at 12:59 PM

Asher on January 8, 2009 at 10:19 AM

It’s the tonkatsu and Asahi beer that are the real keys, not soy and fish.

Well you probably are more correct, and that is coming from a Mormon. If they ate as much soy as everyone thought there is reason to think their health declining in a disastrous way.

But then one of the favorite myths of our culture is that exercise and a veggie diet will save you.

So that pretty much leaves your fish and the beer :)

Noelie on January 8, 2009 at 1:08 PM

As a Canadian (and a Conservative one at that), I would not trade my ‘free health care’ for anything

Free? BWAHAHAHAH

As a Canadian born, but one that fortunately is smart enough to see why you are laughing so hard, just remember if they don’t “see” the bill, in their little land of denial, it’s free.

The other thing you know about this poster is that they haven’t gotten really ill yet. When they do, they might not like their “free” health care quite so much.

Noelie on January 8, 2009 at 1:10 PM

National Healthcare means a 10 month wait for space in the maternity ward.

tarpon on January 7, 2009 at 4:33 PM

Don’t scare me! I just preregistered at my regional hospital’s maternity ward. And I’m due in February.

newton on January 8, 2009 at 1:11 PM

Well Capt’n Ed, I think this one quote definitely applies to all of this:

Of all tyrannies a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies, The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for own good will torment us without end, for they do so with the approval of their own conscience. – C.S. Lewis

newton on January 8, 2009 at 1:14 PM

As a Canadian born, but one that fortunately is smart enough to see why you are laughing so hard, just remember if they don’t “see” the bill, in their little land of denial, it’s free.

The other thing you know about this poster is that they haven’t gotten really ill yet. When they do, they might not like their “free” health care quite so much.

Noelie on January 8, 2009 at 1:10 PM

My sister (who, coincidentally, works in the health care field) once told me that nothing in this life is free. Every thing has a price, even when you don’t see it.

Just look at Cuba. Look at the hell they have endured for fifty years (!). But hey! They’ve got “Free Health Care“!

newton on January 8, 2009 at 1:21 PM

I just can’t wait until it dawns on the health nazis that two of the largest and most expensive of health care costs come from two of their favorite activities. Drug abuse and unprotected sex outside of marriage (especially those who engage in anal sex).

Yup!

The costs to treat the medical effects of those two “lifestyle choices” are astronomical and the effects of the diseases and other complications arising from them are so destructive for both the participant and their loved ones.

It will be interesting to see how they handle this. Because if their true intent is to make everyone be “healthier” thus reducing health care costs they will have to impose stiff sanctions against any and all who participate in these destructive behaviors. If they refuse to do anything about them then it shows their hypocrisy and is absolutely the worst thing you can do to any of these sanctimonious idiots. It sends them shrieking for cover like a 7 year old girl who got caught with no clothes on.

Nahanni on January 8, 2009 at 2:18 PM

Noelie on January 8, 2009 at 1:10 PM

I guess you like the other poster failed to notice the ‘ ‘ around ‘free health care’. More time needs to spent on reading and comprehension skills. I, as every other Canadian, know that our health care is not ‘free’. As for not yet being seriously ill, I personally have been fortunate in that area (aside from only 1 life threatening issue), but have had family members who have been or are. And I have yet to visit their grave sites while still visiting them in their homes. (P.S. – condescension does not = smart)

You’re lucky then, I’ve heard horror stories of people with very serious injury being turned away from hospitals because they were full and couldn’t treat them.
Sir Corky on January 8, 2009 at 12:15 PM

Remember what you ‘hear’ may not always be a fact. I wonder if those stories you ‘heard’ came from Toronto news right about the time of Mike Harris (a Conservative) where every union was screaming horror stories from health care to education. I personally have never heard of anyone getting turned away from a hospital in an emergency situation to die on the street. Just as in the States, if a hospital is to busy to treat a patient, you are transferred to another that can.

Illinidiva on January 7, 2009 at 8:46
PM

Thank you for taking the time to explain your system in a non-condescending way. Although it does seem that America is already paying for a socialized system that most can’t use. So in essence, you are paying for Health Care, twice (please correct me if I am wrong).

Yes, I do prefer the Canadian system, but it is what I am used to. I would imagine that if I were an American I would feel the same as many of you do. We bring to the table what we know. A difference of opinion is just that – a difference of opinion. Time to bring on an intelligent and respectful debate – keep the insults for the playground…

pcbedamned on January 8, 2009 at 3:08 PM

Remember what you ‘hear’ may not always be a fact. I wonder if those stories you ‘heard’ came from Toronto news right about the time of Mike Harris (a Conservative) where every union was screaming horror stories from health care to education. I personally have never heard of anyone getting turned away from a hospital in an emergency situation to die on the street. Just as in the States, if a hospital is to busy to treat a patient, you are transferred to another that can.

pcbedamned on January 8, 2009 at 3:08 PM

I can appreciate your skepticism about what people “hear,” but I’m not talking about something I heard on a news report, or read in a blog. I’m referring to a personal story I heard straight from someone’s mouth. And I wasn’t referring to Canada when I said that either, maybe Canada has a better policy regarding serious injuries even when their hospitals are full.

Sir Corky on January 8, 2009 at 5:03 PM

In Oregon, a woman covered under the Oregon Health Plan was told, in the same letter, that they both wouldn’t cover her cancer drug because it was too expensive, but that they would pay for her euthanasia. In the same letter, we won’t pay for you to live, but we will pay for your death.

Two doctors in California had the California Supreme Court rule that they couldn’t turn down a lesbian wanting artificial insemination from their offices, even though both doctors referred her to doctors that would do it.

When the government is the insurer, they can tell you what you have to do or not do, no matter what your religious or other moral/ethical objections you have. Private insurance companies don’t do this because if a doctor refuses to accept their insurance they become less desirable to consumers and lose on the premium end.

PastorJon on January 8, 2009 at 5:10 PM

newton on January 8, 2009 at 1:14 PM

Love that CS Lewis quote.

Ernest on January 8, 2009 at 5:21 PM

Thank you for taking the time to explain your system in a non-condescending way. Although it does seem that America is already paying for a socialized system that most can’t use. So in essence, you are paying for Health Care, twice (please correct me if I am wrong).

Yes, I do prefer the Canadian system, but it is what I am used to. I would imagine that if I were an American I would feel the same as many of you do. We bring to the table what we know. A difference of opinion is just that – a difference of opinion. Time to bring on an intelligent and respectful debate – keep the insults for the playground…

No, I’m not double paying; everyone receives Medicare and Social Security regardless of their income. Medicaid is seen as similar to food stamps and welfare, aid to the poor and not something that you want to be on. It is actually quite awful. The gov’t is notorious for not paying doctors enough, and many doctors will not accept new Medicaid patients. I do resent the fact that families making more than me are getting some of the other assistance programs, but it is not because I want that health care. It’s because they should be paying for their own healthcare!! I’m paying taxes for someone to freeload.

Frankly, if a single payer system was put in place in the U.S., I’d actually be worse off. Hillary Clinton tried to socialize healthcare in the early 1990s, and I remember that the “gold” plan was $200/ month. I currently get the gold plan for $55/ month. I make $42K/ year which is really stretching to make ends meet in Chicago where I live and cannot afford to pay $200/ month on insurance. I’d be forced into a crappy basic plan that all the poor people would receive, so it would really diminish my current level of care. It’s basically a socialistic type of system.. taking from the haves and redistributing it so everyone’s equal.

Illinidiva on January 8, 2009 at 11:39 PM

jim m on January 7, 2009 at 6:26 PM

OK, this is an old thread now (sorry, I was at an IOM conference all day yesterday), but jim m, what you’re showing is not that the U.S. pays all the R&D costs for Pharma, but that the authors of the table you excerpted for us normed U.S. costs to 100.

Now, your post may not have been intended as a response to my point (I couldn’t really tell), but just so you know, you haven’t answered my point.

DrSteve on January 9, 2009 at 9:25 AM

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