Thanks, Glenn

Links from Instapundit:

Combat reads.

Strength to Strength.  Introducing (to me at least), Mark Rippetoe's Starting Strength website.  The first link is to a speech in which statements are made along these lines by an expert not (yet) familiar to me, John Sullivan:

• Aerobic exercise builds conditioning, quickly established once one begins, and quickly diminishing, once one leaves a program built on it.  Strength exercise, on the other hand, builds "architecture," an enduring result.
• Doing strength exercise is like a deposit in one's health 401(k) plan.
• It is important not only for the individual, but also the community for one to build his strength: less morbidity in the future (that part of the future near to Carol and me), less demand on the community for medical and other support services related to bad health. (As to the community, I not only think of demands for government services, but certainly I think of demands on the healthier people in one's family.) I want my death to be a good one, far distant but, when the time comes with very short ramp up, very cheap, and then quickly out of here.  

We know this, we vegan/Crossfitters.  We know what we are up to.  Sullivan however, while not exactly Winston Churchill (but who is?), says it well.

22-year Old Smoker Drops Health Coverage at Wal-Mart

"I really can't even afford it [the employee part of Wal-Mart's health coverage] now, so for it to go up even a dollar for me is a stretch," said Colby Harris, who said he makes $8.90 per hour and takes home less than $20,000 per year working in the Walmart store's produce department in Lancaster, Texas. 

Harris, a 22-year-old smoker, was set to see his cost per paycheck rise to $29.60 from $25.40. He says he has decided not to sign up for coverage. Given his low income, as Harris foregoes coverage any major medical bills could potentially fall to taxpayers through the government's Medicaid program. 

-from a CNBC report entitled "Wal-Mart Employee to Pay More for Health-Care Plans."

According to this link, the average cost of a pack of cigarettes in Texas was $6.00 in 2011.  Other internet links indicate that it could be as high as $7 per pack.  The amount of the increase in Mr. Harris' "cost per paycheck" is, according to the article, $4.20.  If he cuts back one pack per pay-period, he covers the insurance increase and has change left in his pocket.

As the story indicates, Harris will get medical services of some sort, if he needs them.  The government will pay for it, although, if he doesn't buy insurance, he will be "fined" or, as Justice Roberts would put it, "taxed" an amount for not having his own coverage.  I don't know just how the government will levy that fine - the IRS is assigned that task in Obamacare.  (I don't think government is all that good about taxing people with low incomes, however.)   I do know we will have more bureaucrats and more regulations to catch the Colby Harrises of the country, if we have the political will to collect that tax.  How that will really work out for Mr. Harris economically is too complicated for me to figure out on the fly.  If he keeps healthy, he will win for awhile.

Another point is obvious: his future health costs will likely be far higher than those of non-smokers, so the risk he assumes by dropping his insurance and smoking the cigarettes increases as he gets older, disproportionately in comparison to his non-smoking peers. Yet he is young right now and healthy.  As I said, he will win for awhile.  Our culture is all about the short term.

We subsidize bad choices, one way or the other.  Meanwhile, many people will fault Wal-Mart for increasing the employee cost of its health-care.

"Convenient Care"Clinics

The 8/2 issue of the WSJ carried a column entitled "Health Care When You Want It" by Web Golinkin on the "convenient care" clinic network that is developing in such places as Wal-Mart, CVS stores, and Walgreens. (From that link, you can access the WSJ article on a "free preview" basis, if you register for their 2 week free subsctiption offer.) Golinkin is the president and CEO of RediClinic, LLC, "One of the nation's largest convenient care providers, and is a director and co-founder of the Convenient Care Association."

These centers are manned by nurse practitioners, and Golinkin has this to say about the quality of such care:

Research over the past 30 years has consistently shown that the primary care provided by nurse practitioners is comparable in quality to that provided by physicians, though nurse practitioners are still required to collaborate with local physicians in most states.

I'm not sure that "comparable" means the same as "the same as", but this growing service is surely a big piece of the free market response to the health care crisis, and it may be a good one. (I would venture that "comparable" care from a nurse practitioner is better than no care from a physician.) Golinkin also writes that 97% "of the more than 4,000 RediClinic patients surveyed this year said they would recommend RediClinic to their relatives and friends."