Thursday, June 14, 2012

Bloomberg, Broccoli, Smoking and Health Care

As we wait for the US Supreme Court to rule on the constitutionality of the Affordable Care Act (popularly and derisively known as "Obamacare" ) it might be useful to remember the slippery slope/limiting principle argument against the mandate to purchase private health insurance.  This was often referred to as the Broccoli argument. Opponents invoked the spectre of an empowered and leviathan Federal government ordering everyone to eat their vegetables. The law's supporters thought that this argument was completely ridiculous, not worth a response, and prima facie evidence that the mandate's opponents either had damaged amygdalae or had spent too much time surfing libertarian websites looking for pictures of S.E. Cupp.

I am not a fan of NYC Mayor Lord Michael Bloomberg because I think his bland corporatist persona is the cover for a raging power mad nutter who seeks control over other people just because he knows what's best for everyone. He may not have Sauron's One Ring but he certainly acts as if he does. This is most evidenced by his out of control NYPD that on his orders has effectively disregarded the Fourth Amendment for Black and Hispanic citizens in Gotham, especially if they happen to be young and male. Bloomberg says it's for their own good of course. But his need for control over people is not just limited to continuously stopping and frisking every single black male within the city or spying on Muslim citizens in other states. No, Bloomberg is convinced that he knows what people should be eating and how they should be eating. So his health department is poised to ban 32oz sodas. Of course that didn't go far enough and his health department, no doubt emboldened by the impending soda ban as well as the current trans fat ban, publicly mused about the desirability of banning milkshakes and popcorn as well.
The 11-member health panel met on Tuesday in Queens and approved the plan. A public hearing on the issue on July 24, with a final vote is scheduled for Sept. 13. If approved, the new regulations would go in effect on March 2013.Certain members spoke up, however, saying that the proposal should include other items. Board member Bruce Vladeck questioned why large tubs of popcorn were not included in the ban, according to the New York Daily News. Another member, Dr. Joel Forman, pointed out that even 100 percent juice and milk-containing beverages have large amounts of calories and should not be excluded.While Dr. Kenneth Popler, board member and president of the Staten Island Mental Health Society, recognized that it would infringe on New Yorkers' rights, he felt that the health benefits were worth it, the Wall Street Journal reported. Obesity has led to 5,800 deaths a year in New York City and costs taxpayers $4 billion, according to statements presented at the meeting.
So, while the kommissars in NYC were deciding how next to extend their personal preferences under color of law, one of the largest employers in the Metro Detroit area decided that it would no longer hire people who smoke. Period. 
Job seekers who smoke aren’t welcome at the Detroit Medical Center. The health system on Wednesday joined a growing number of companies to require new applicants to be tested for smoking.The policy does not apply to current smokers, though they are encouraged to stop smoking and participate in cessation programs, the DMC said in an announcement. In Michigan, the DMC joins the Lansing-based Sparrow Health System, the Oakwood Health System in Dearborn and the Crittenton Hospital Medical Center in Rochester to adopt the no-smoking policy for applicants. “I think it’s becoming a pretty common practice across the country, especially in hospitals and (other) health care” employers, said Paula Rivera-Kerr, spokeswoman for Dearborn-based Oakwood Healthcare System, which adopted a similar policy Oct. 1. 
Dr. A. Mark Fendrick, a University of Michigan physician who is director of its Center for Value-Based Insurance Design, said that because businesses spend significantly more on health costs for smokers than for non-smokers “it’s no surprise to see various types of screening and benefit-design changes” to discourage smoking, among current and future employees. “Projections about increased health costs are a major concern to employers right now,” he said. While several states have passed laws banning such hiring policies, Michigan has not, leaving smokers without legal grounds to challenge such a hiring decision, said Tim Howlett, an attorney with Detroit-based Dickinson Wright law firm and acting chair of the State Bar of Michigan Association’s labor and employment law section.
Now just to get the obvious out of the way I don't smoke. I don't permit smoking around me. I try to eat right. I fully understand that if you don't eat well and exercise you're more likely to live a sub par existence. I have little patience for fat people that try to protect their ego by trying to pretend that fat people don't have health issues. I get that large agribusinesses and food interests often push poisonous products onto consumers.  I think that everyone should minimize or eliminate things like sugar, fat, salt, blah, blah, blah from their diet.  And I actually LIKE broccoli. But those things are individual choices. Should your employer be able to discriminate in hiring based on lifestyle? Well if your lifestyle is related to your job, I would say yes. You won't find too many overweight cheerleaders or bodybuilder jockeys. But if you're doing something that is unrelated to your job on your private time, what business is that of your employer's? And if we say well it's because of health costs, then how far do we want to go? You may have a family history of chronic diseases. Should your employer be able to not hire you because of that? And if we allow discrimination in hiring because of smoking why not obesity? But that's in the (semi)private marketplace so the rules may be different.
In NYC though we have the city government seizing the ability to tell you what you can eat and how much of it you can eat. Again, they claim to be doing so because of health costs. This health cost argument was the same reason the federal government claimed the right to be able to force you to purchase health insurance. Now if you don't bend the knee to Lord Bloomberg and accede to his latest caprice, then you, as a business owner will be fined. Of course if you decide to ignore the fines and tell Lord Bloomberg exactly what he can do with them, sooner or later large serious men with guns will magically appear to either shut your business down or take you away to some place unpleasant. But it's for the public good.
Now can someone tell me again why the broccoli argument was so outrageous?
What's your take?
Should private companies be able to refuse to hire smokers? Obese people?
Is Bloomberg out of control or is this (considering rising obesity rates) a necessary and good decision? Should the government be involved in determining portion sizes and food choices?
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