Some years ago, I designed a bumper sticker with a picture of AFLAC's white-feathered foul mascot and the following text: "The Second Amendment-It's Not Just about Duck Hunting".
Too bad the NRA wasn't interested in my idea-apparently unwilling to be associated with any of Thomas Jefferson's "tree of liberty" concepts. But the phrase structure has some transfer value: consider, for example, the current malaise (excuse the semi-pun noun choice) about government health care plans and the unpublicized program of one of the nation's largest supermarket chains to provide health insurance for its employees.
What I refer to is popularly called the Safeway Plan. It's partially based on the politically incorrect notion of individuals being held, at least somewhat fiscally responsible, for the personal-health consequences of the behavioral choices they embrace (like smoking, drinking, snorting cocaine, etc.).
Because the conventional wisdom is biased in a far more collectivist direction-the community rating system, whereby everyone pays the same health insurance costs irrespective of how prudently (or not) he/she conducts his/her own affairs (pun intended)-Safeway is now better recognized for its niche at the retail end of the farm-to-consumer food chain than it is for its remarkable foray into rewarding personal responsibility in an era when political correctness calls for just the opposite. That's why I say, Safeway isn't just about groceries.
Historically, the supposedly unique Safeway Plan-insurance premiums vary according to risk assessment-is actually more the norm than the typical community rating.
From the venerable Lloyds of London to domestic fire insurance to auto insurance, statistically-based risk assessment has always been the usual practice. The concept of community rating is a newer, left-leaning, ideologically driven concept. Contrast it to Safeway's statistically driven principle.
It's based on two insights, according to Safeway CEO Steven Burd in a 2009 Wall Street Journal interview.
"The first is that 70 percent of all health care costs are the direct result of behavior. The second insight, which is well understood by the providers of health care, is that 74 percent of all costs are confined to four chronic conditions (cardio-vascular disease, cancer, diabetes, and obesity).
"Furthermore, 80 percent of cardio-vascular disease and diabetes is preventable, 60 percent of cancers are preventable, and more than 90 percent of obesity is preventable," Burd said.
The Safeway CEO went on to explain that "...Safeway has done nothing more than to borrow from the well-tested automobile insurance model."
I might add that the automobile insurance model doesn't countenance delaying insurance purchase until after a pre-existing condition has been created and then demanding free or low-cost coverage on compassionate grounds.
I don't have the column-inches to review the multiple problems in state or federal programs in place (or proposed) to service everyone by insuring everyone-an excellent summary requiring nearly a half-page of print is in the March 31 Wall Street Journal; its header includes two words that say it all: "...Containing costs..." Not reallocating costs to different sets of taxpayers, who can't refuse but can politically object, or to different sets of providers who can (and do) refuse to service some sets of customers, or to quit entirely, or to set up fictitious budgets and try to hide the ensuing deficits.
I note that TennCare, of the State of Tennessee, tried and pretty much failed to contain costs. ShumyCare of Vermont seems to avoid the subject altogether although it offers one medical care organization (TennCare has a dozen, for example) with some sort of gate-keeping function.
Neither approach comes close to touching the political third-rail of the Safeway Plan; it's the only one that offers the only route to real cost containment.
It isn't the Safeway Plan formula which enrages the politically correct left (who could object to incentives for healthier behaviors?). Plus it isn't the above average-healthwise constituency which the Safeway Plan services because they're all Safeway employees.
Consider, TennCare versus ShumyCare in Vermont:The latter is 96 percent white, has a Median Household Income of $52,000, and a poverty rate of 10 percent. The former is 80 percent white, has a MHI of $44,000, and a poverty rate of 16 percent.
It's interesting that the percent-in-welfare state rankings aren't all that different. Vermont is no. 5 and Tennessee is no. 4 in the nation, both at a fraction over 2 percent for reasons subject to the usual speculations.
But it's the obesity rates that tell the real tale/ Vermont is at 23 percent, Tennessee is at 32 percent. The most obese state is Mississippi while the leanest is Colorado. And the diabetes stats report the expected: Vermont is under 7 percent, Tennessee is over 11 percent.
Out of sheer cowardice, I won't attempt to correlate with minority percentages in this column. But as the Safeway Plan recognizes-and both TennCare and ShumyCare don't-rewarding your customer base to lose weight can save a lot of money.
Even so, the above statistics suggest that Vermont should be spending less per capita on health care than Tennessee. Yet, it isn't. More on this topic in the coming weeks.