The False Distinction Between “Illness” and “Lifestyle”
There is a relatively new argument in the conservative arsenal of talking points as to why health care plans should not cover contraception: because pregnancy is not a “disease”, and so preventing it is not a medical issue, but a “lifestyle issue”. That’s right: conservatives have become so deranged, sex is now a “lifestyle”. Next thing you know, we’ll be hearing dire warnings about the “sex-haver agenda”.
But let’s think about the logical implications of this new conservative principle, that there should be no insurance coverage for “lifestyle”, only for legitimate “medical problems” over which the individual has absolutely no control. One obvious implication is that, since “pregnancy is not a disease”, there should be no insurance coverage for pregnancy, child birth or post-partum care. After all, having children is, like sex, a lifestyle choice, and pregnancy is “natural”. In fact, since there appears to be a sizeable contingent of moral conservatives who believe that all women who have sex — even within marriage and even for procreation — are irresponsible sluts who must be held accountable for using their lady-parts, I would not be surprised if there is conservative support for forcing women to endure painful and dangerous child-bearing, just as God intended. So I do suspect that in arguing that “pregnancy is not a disease”, conservatives are laying the groundwork for denying care related to child-bearing, not just contraception.
Another obvious implication is that treatments for erectile dysfunction should not be covered, either. Having sex is a lifestyle choice, not a necessity, remember? As for terming erectile dysfunction a “medical problem”, I am not so sure it’s objective. There is considerable variation among males in their ability to achieve frequent arousal; due to hormonal and other differences, some men are more sensitive to environmental factors than others. Besides, loss of sexual function is a normal consequence of aging. A strong argument can be made that the reasons for calling it a “dysfunction” at all are entirely cultural. And yet, you don’t see conservatives flipping over the fact that insurance plans cover Viagra much more frequently than contraception. Although GOP legislators have objected to having federal funds used to treat erectile dysfunction in rapists and child molesters, they apparently have no problem with funding those kinds of treatments for men who are not married, or those who are elderly and therefore not likely to be having sex for procreation. Keep in mind that unlike pregnancy and childbirth, erectile dysfunction is neither life-threatening, nor painful, nor potentially disabling. It merely prevents a man from having conventional penetrative sex — which, as we have already determined, is a “lifestyle”. So how come conservatives regard it as a medical problem that deserves coverage?
And then, of course, we have the issue of undeniable medical problems that are actually a consequence of lifestyle choices. Should those be covered? Looking at Rush Limbaugh, I bet you dollars to broccoli the man has what I call the Unholy Trinity, commonly encountered in portly men over fifty — hypertension, high cholesterol and diabetes. And I bet you further he has coverage for all those conditions. Why? The man smokes and obviously stuffs his face, yet no one bats an eye that his employer and his insurance carrier apparently pay the price of his deliberate lifestyle choices. Since they are so often caused by intentional chronic overeating, should treatment for cardiovascular diseases be covered at all? Or should coverage only be available upon proof that the patient spent at least 20 years on a strict vegan diet and worked out 3 hours daily?
Should there be coverage for treatment of drug addiction — a lifestyle in which people engage deliberately, at least at first? Hmm, Rush?
Should backpackers who contract exotic diseases while traveling off the beaten path get coverage for treatment? Or should they be expected to take responsibility for their choice of destination by paying out of pocket? After all, no one forces anyone to vacation in the Amazon jungle.
Should smokers, or people who vote down nuclear power plants, or people who drive Hummers, or people who have wood-burning fire places or coal stoves get coverage for treatment of respiratory diseases? Our affluent American lifestyle results in a hell of a lot of pollution, so why should employers or insurance companies really have to pay for our choices? It’s not like we need all these industries for our survival.
And speaking of industries, should occupational diseases — such as emphysema in miners — be covered? Keep in mind, people who are in dangerous jobs all knowingly chose them. If those miners thought emphysema was a bad thing, they’d all go and be classical musicians or something.
Or maybe we should just recognize that “illness vs. lifestyle” is a false dichotomy, and the principle that only medical problems for which the patient is utterly blameless should be covered, is arbitrary and inhumane. In modern society, health care is a basic human need. It should not be bound up with brutish and antiquated moralizing.