Reader May sent a question regarding wider social applications of The Underpants Rule, specifically as it relates to how much fat people “cost”. Here are my thoughts. (The block quote may be triggering although I don’t believe that was May’s intention. You can skip it and you’ll still understand the blog. I choose to leave the actual question because I think that it makes it easier for some people to relate since they may be asking the same questions themselves.)
As much as I want to fight for the rights of the big beautiful folks (myself included), I do realize that there does come a point when some personal choices do cost others money. Did you know hospitals now have to have much wider beds and chairs (politely called “bariatric chairs”) for their very large patients? More hospitals also have electric lifts and slings to move a patient. And that ambulances have had to get specialized equipment to be able to move the obese? So my honest question is : who do you think should pay for these upgrades?
First, I think that those who take on the job of providing healthcare for the community should be looking for ways to remove barriers to healthcare, not trying to justify them. The hospital needs equipment for all kinds of reason – to work with premature babies, to have an intensive care unit, to work with children, to work with people who use wheelchairs, and to work with people of size. They signed up for this when they agreed to provide healthcare to the community. The idea of “blaming fat people” for being fat as a way to justify not having the equipment that they need to give us healthcare is simply not-very-thinly-veiled bigotry. Just like they should provide the equipment that people who use wheelchairs need – not ask them why they are in a wheelchair and then deny them help if was “their fault.” Also, just for the record, they don’t need a “polite” name for a chair that fits my fat ass, they can just call it a chair – that’s what we call it at my house.
There is a sentiment here that body size is a choice and that it is changeable, and that people can choose whether or not to “accept” fat bodies, with which I disagree. It is absolutely true that bodies come in many different sizes for many different reasons, there is evidence that weight is as heritable as height and research suggests that body weight is almost impossible to change long term. In the end, it doesn’t actually matter why someone is fat – the hospital has taken on the job of providing healthcare to the community and they knew that the community included fat people when they took on that job, and so my question isn’t should they get the equipment they need to treat fat people. My question is why wasn’t this factored into their business plans and cost of doing business in the first place? I believe that they are responsible for having equipment to treat their patients of all sizes and needs.
I think that any time we try to identify a group of people based on how they look and then calculate their “cost” on society and/or figure out what we can blame them for, we are going the wrong direction. Our culture has taken to attempting to calculate the cost of individuals and figure out what we can blame people for as an excuse to deny healthcare or services in order to create the highest possible profits, even if that means that some people are completely unable to access healthcare. Next will they refuse to treat people whose issue can be considered their fault – they didn’t follow proper ladder safety, they were thin but sedentary, they tried to do their own electric work etc.
I think our time and energy would be better spent working on access - helping make sure that everyone has access to food options, safe movement options if they want them (that includes physical and emotional safety – if every person can’t go to the pool in a swimsuit with total certainty that they will not be shamed or bullied then we are failing to provide safe movement options,) and access to evidence-based healthcare that is affordable for each person. At the end of the day, I think it’s important to remember that if equal rights and access seem to inconvenience others then it’s typically safe to assume that those other people have very likely been benefiting from the current situation, and that includes hospitals that have higher profit margins because they simply didn’t purchase what they need to serve patients of all sizes.
Healthcare should be about health not about finding ways not to provide healthcare.
Happy HAES Holidays Teleconference Workshop – Registration is Name Your Own Price – Nov 13 and 15
Normally I get between 100 and 200 e-mails a day. During the holiday season that climbs to 200-300 from people asking about everything from how to set resolutions that aren’t about weight loss to how to deal with the family food police. I’ve put together a group of speakers to give you information to support you through the holiday season and into the new year. Details and registration are here, registration is name your own price.
Like the blog? Check this stuff out (and you can help support my work which I would really appreciate):
The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here to order
The Dance Class DVDs: Buy the Dance Class DVDs (hint: Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)! Click here for the details
Become a Member and Get Special Deals from Size Positive Businesses
I do size acceptance activism full time. A lot what I do, like answering over 4,000 e-mails from readers each month, giving talks to groups who can’t afford to pay, and running projects like the Georgia Billboard Campaign etc. is unpaid, so I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.