A Twist to the Individual Mandate in Health Care


On June 28, another milestone in health care reform occurred when the Supreme Court ruled on the Affordable Care Act (ACA). The Supreme Court of the United States (SCOTUS) stated their opinion concisely on the SCOTUS blog (conveyed on The Atlantic):

“In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional….”

The purpose here is not to offer another opinion on the law or the ruling. Several UT experts have already delivered some keen insights, in addition to many others. My intent is to emphasize the individual mandate and add a twist to it.

In the upheld law, the individual mandate refers to the need for everyone to purchase health insurance. The real individual mandate we need to embrace requires no legislation; it just demands our individual effort and fervor to live healthier.

As we enter our time for celebrating our nation’s independence, we need to live up to our individual responsibility. Our individual mandate needs to be this: Live healthier!

This is not about politics at all. It is about individual responsibility.

Some get upset when politicians propose laws to curb our intake of unhealthy substances. The latest proposal came from Mayor Bloomberg with his suggested ban of surgary drinks of more than 16 ounces. Of course, there was much debate about this ban, especially since it seems to be an affront to our freedom.

No matter if you have a conservative, liberal or independent view, we can agree that there is a cost to freedom. In this case, the cost of not making healthier choices results in higher costs and, ultimately, government action to balance the costs associated with obesity.

Let’s look at those costs. In a recent Reuters’ article (Sharon Begley, April 30, 2012) entitled As American’s Waistline Expands, Costs Soar, specific costs were outlined:

  • Absenteeism cost: “Obesity-related absenteeism costs employers as much as $6.4 billion a year, health economists led by Eric Finkelstein of Duke University calculated.”
  • Productivity cost: “The very obese lose one month of productive work per year, costing employers an average of $3,792 per very obese male worker and $3,037 per female. Total annual cost of presenteeism due to obesity: $30 billion.”
  • Health care cost: “Nationally, that comes to $190 billion a year in additional medical spending as a result of obesity, calculated Cawley, or 20.6 percent of U.S. health care expenditures.”

Total approximate annual cost equals $226.4 billion. If this doesn’t make the point, maybe this added angle from the Reuters’ article will:

“Hospitals, too, are adapting to larger patients. The University of Alabama at Birmingham's hospital, the nation's fourth largest, has widened doors, replaced wall-mounted toilets with floor models able to hold 250 pounds or more, and bought plus-size wheelchairs (twice the price of regulars) as well as mini-cranes to hoist obese patients out of bed.”

There is something wrong with what we are doing with our freedom in regards to our personal health! To restate, this is not a political issue; it is an individual issue. Our role needs to be understood, and our health literacy needs to be enhanced.

If the government and other institutions are going to bear the costs of our individual health care problem, then proposing to ban 32-ounce Big Gulps, which contain 91g of sugar and 364 calories, may be the wake-up call some leaders are trying to sound. If replacing toilets to handle our weight issue doesn’t sound the alarm, maybe a super-size ban will.

Political motives can be questioned, no doubt. Maybe the intent is to not enact new regulations or restrictions but raise awareness of individuals and their health.

So, whatever state our health care may be in, please adopt an individual mandate to embrace a healthier lifestyle and make healthier choices. We can chalk it up to being a better citizen. We can mark it down as a way to celebrate our independence from over-marketing or over-consumption. Most importantly, we can get on a track to bring down the costs of health care while bringing down our weight and raising up our health.

This should be our new individual mandate in health care: Live free through healthier living. Celebrate independence from unhealthy habits. Uncle Sam needs us!


The views expressed are those of the author and not necessarily The University of Texas at Austin.

About The Author

Jon Mertz

Vice President of Marketing, Corepoint Health

Jon Mertz is the Vice President of Marketing at Corepoint Health, a leading healthcare integration software company. Jon has extensive experience in...


#1 Health insurance is most

Health insurance is most necessary for everyone and this will be very much helpful whenever necessary. Health insurance will give the proper facilities of medical treatment with less charge or even free sometimes. So this is really helpful for the people. So, Proper Health Care is definitely needed for a good health.

#2 It's amazing to see how many

It's amazing to see how many proposed changes to healthcare legislation have been put forward over the past 18 months... It could lead to some really positive change and I hope it does!

#3 Since employers are feeling

Since employers are feeling the costs of overweight workers, there should be more thought put into restructuring the workplace and the work processes, which now seem to encourage sedentary lifestyles. The typical office, and the processes whereby we share information (emails and long sit-down meetings) virtually ensures that we will spend most of our day sitting on our big wide butts. Years ago there was a local technology company that had a beautiful health and exercise facility onsite. Unfortunately, the corporate culture was such that employees seen using the site were perceived to be slackers who weren't putting in the long (mostly sit down) hours put in by the truly "motivated."

#4 Great point, David. Every now

Great point, David. Every now and then, you read articles where some companies get it, and they are providing opportunities to exercise, eat healthy, and embrace a healthier lifestyle. The other interesting trend are standing desks. There have been several articles written about the health benefits of standing up and doing work, rather than sitting all day. In our offices, we have a few team members embracing this approach. Standing up may be the key. As individuals, we need to stand up to our healthy responsibility. For organizations, they need to stand up to fostering a culture of healthy working and living. Great thoughts! Thanks! Jon

#5 Jon, I completely agree with

Jon, I completely agree with you!! If only government and the medical industry would come up with ways (NOT laws) to facilitate this. For instance, make it possible for people to comparison-shop for both insurance coverage AND medical procedures/preventive care. Ever tried to price a colonoscopy? You can't. Get coverage for preventive and wellness care? Nope, though that's changing.

#6 Renee, Thanks for your

Renee, Thanks for your feedback and insights. I agree that greater transparency on costs is needed. Much of this would help raise health literacy across the spectrum - costs, options, providers, personal care, etc. Providing the platforms for engagement are happening, and there will be much more to come. Exciting times ahead in health care! Thank you! Jon

#7 Jon: You make some excellent

Jon: You make some excellent points in your article. The Academy of Medicine, Enginnering and Science of Texas held its 2012 Annual Conference earlier this year. Among the presentations was a keynote by William H. Dietz, M.D., Ph.D.; Director, Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention (CDC). A few data points from Dr. Dietz's keynote: Obesity causes more than 15 percent of this country's preventable deaths more than alcohol, toxins, care accidents, gun-related deaths, drug abuse and STDs combined and it causes a huge financial strain on the health care system. According to the Centers for Disease Control and Prevention, obesity affects approximately 34 percent of adults and 17 percent of children in the United States. The agency recently estimated the costs of obesity at almost $150 billion per year, attributable to the impact of obesity on other chronic diseases such as heart disease, diabetes and cancer.

#8 Kent, Thanks so much for

Kent, Thanks so much for adding to the conversation. Dr. Dietz's statistics add to the argument of the need to stand up to our individual responsibility of living healthier. Raising health literacy is a key way to get more people to adopt the real individual mandate, and statistics and threats of taking Big Gulps away may raise that awareness. Appreciate your comment! Jon

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