What about these men he saw last weekend at the Woodward Dream Cruise?
...a trio of well-fed spectators wedged into identical lawn chairs on the public right-of-way. [...] Each held a beer in one hand and a cigarette in the other, and all three sported pendulous bellies that spilled over their beltlines and glistened in the midday sun."Why shouldn't those men be entitled to health care? Obesity and obesity related-conditions like hypertension have been blamed for our rising health care costs, but other major factors include spending on prescription drugs and new medical technologies, longer life spans, a greater prevalence of chronic illnesses, an aging population, and high administrative costs. Poverty, stress, air pollution and environmental hazards affect our health too.
And healthy habits do not necessarily translate into lower costs (via Economix blog/NYT).
Vermonters have the healthiest behaviors, including less smoking and more exercise, according to the latest Gallup-Healthways Healthy Behavior Sub-Index numbers. [...]Dickerson believes everyone should enjoy access to some minimum level of preventative and acute care, but he wants to add stipulations, i.e. "reimbursement for the cost of treating many chronic health problems should depend, at least to some extent, on what steps the patient has taken to avoid them."
The states with the unhealthiest behaviors were primarily located in the Midwest and the South; the worst were Kentucky, Arkansas, West Virginia and Indiana.
How do these healthy behaviors factor into health spending in each state? Not a whole lot, or so it appears on its face. ...
The Western states showed both healthy behavior and lower health costs, but the Northeastern states spent a lot per capita on health care despite their relatively healthy habits. Vermont, for example, spent $6,069 per person on health care in 2004, the ninth-highest level out of the 50 states and the District of Columbia.
I'm in favor of personal responsibility too, although I'm not sure how possible it is to accurately measure a person's efforts. And in the case of drinking, smoking and overeating, there are often underlying emotional and psychological problems that make quitting extremely difficult. Is it fair to penalize them for falling off the wagon?
Fortunately, helping people live healthier lives is being addressed by President Obama whose principles for health reform include prevention and wellness initiatives. They're also included in the Senate HELP Committee and House Tri-Committee plans. (See a side-by-side comparison of all plans here.)
We need to get health care reform passed and make available to Americans the tools and information they need to live healthier lives today. Nitpicking about personal responsibility and unhealthy habits only serves to slow down or sink reform.
(Cross-posted at Blogging for MI.)