I have come to the disheartening conclusion that we will never control health care costs because we keep expanding the mission of medicine to include “consumerist” services that are primarily about facilitating life-style choices or fulfilling “identity” desires. For example, California now requires group health insurance to pay for fertility services for their gay customers–even though the insured isn’t physically infertile.

Sex change would seem to fall into this category. Now that Medicare is going to pay for it–meaning private insurance will soon be forced to follow–I wonder how we will prevent requiring society to pay for doctors to amputate healthy limbs of BIID sufferers.

What? Wesley, have you lost your mind?

Hear me out: BIID–body integrity identity disorder–is an anguishing condition in which the sufferer becomes obsessed with the belief that his or her true identity is as someone without a leg, or arm, or even, as a paraplegic or quadriplegic.

Advocacy has already begun to allow amputation of healthy limbs as a “treatment.” If that happens, there will be no way to prevent it from being paid for by insurance or society. From one of my earlier posts on the subject:

I fear the worst. Radical individualism is now the avatar with powerful forces urging that self identity become the be all and end all–no judgment allowed–perhaps even to the point that one day it will mean permission to chop off healthy limbs and other body parts. If we follow this path to its logical conclusion, it will mean using the medical system to surrender to serious mental illnesses.

Advocates for allowing amputation to be a treatment for BIID claim that there is no substantial difference between that condition and transsexualism, and that if surgery and other medical interventions are considered a proper treatment for the one, it should also be for the other.

Now that government insurance pays for sex change surgeries–including for imprisoned felons like Bradley Manning–what argument or principle would stand in the way? In these days of identity-is-all politics, I don’t see any.

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Wesley J. Smith, J.D., Special Consultant to the CBC
Wesley J. Smith, J.D., Special Consultant to the CBC