personal responsibility

medical personal responsibility


The Sierra County Prospect strongly supports self-sufficiency and personal responsibility. Indeed, we are in favor a lot of things that are easily carried too far. We’ve heard "personal responsibility" taken way too far recently, in the health care discussion.

When used in a positive sense, "personal responsibility" is the key to happiness and success. It pays homage to the power and liberty each individual has resident within them. It implies the ability to do for one’s self, and is certainly a virtue. Self-sufficiency is the road to freedom, and dependence on others is the road to serfdom.

When used in a negative sense, it means "I’m not paying for you." That’s how it is being used in the health care reform discussion.

First it was trotted out by the neo-conservatives to mean "tough luck if you aren’t rich" and "it sucks to be you." The idea is that if you can’t afford health care, you don’t deserve to live. The whole neo-con worldview is a little hard to describe, but it has something to do with money being a measure of the person. If God loves you, you’ll be rich; if not, well, you’re just not quite as human as everyone else. While most people view society as a basically cooperative venture in which we all do well together, neo-cons have a "zero sum game," which means if you go forward, they have to go back, because life is like a pie and there is only so much. Neo-cons believe they could be even richer if you weren’t standing in the way with your hand out.

There is something to be said for the idea that there is only so much health care to go around, but nothing to be said for the idea it should only go to the rich.
No matter how you pound on the makeup to try to make it pretty, this approach is simply about selfishness and greed.

The first attack on "personal responsibility" was from the neo-cons, and that was a bummer, but to be expected.  The next attack is even more irritating, but it shouldn’t have been a surprise either, because it has its foundation in history.
It goes like this: we shouldn’t have healthcare reform because you eat beef. If you took your personal responsibility more seriously, you wouldn’t eat beef, or animal fat, and you wouldn’t smoke or drink alcohol (perhaps Chardonnay in moderation) and you’d be thin and ride a bike everywhere.
It was bad enough to be lectured by the greedy; a lecture from some skinny geek in colorful spandex is too much. "Personal responsibility" now means the thin don’t have to pay for the fat.

It’s founded on the same fallacious argument about wearing helmets on motorcycles and seat belts in cars: "Why should the rest of us have to pay for your bad judgement."

Here’s why:

  1. There is no real evidence that seat belts or motorcycle helmets lower anyone’s health care costs and no real life data on what it costs the rest of us for you to eat buttered bacon;
  2. Most people will die from diseases related to their ancestors and luck;
  3. Illness is misfortune, which can happen to anyone;
  4. People make the choices they do for complex ecological and social psychological reasons; that means that health is part of a milieu, a broad panorama which includes genetics, culture, history, class, geography, employment and the whole Pandora’s box of life. Way down the list is "personal responsibility."

Between the greedy and the skinny those who really need medical care the most are being squeezed out. It’s a bankrupt idea that we can remove "personal responsibility" from a virtue to make it a reason to deny healthcare; none of us are really islands of our own, our fortune is tied to those around us. Sure, we should all try to get health insurance, sure we should eat less fat and walk more, but if we don’t or can’t, that’s no grounds for social neglect.

There might be reasons to be against Obama’s health care reform plan, but "personal responsibility" isn’t one.

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