Sandeep Jauhar: No Matter What, We Pay for Others’ Bad Habits

Posted by Kendall Harmon

“It’s the context of people’s lives that determines their health,” said a World Health Organization report on health disparities. “So blaming individuals for poor health or crediting them for good health is inappropriate.”

I must admit I often feel like my colleagues who grouse about spending all day treating patients who do not seem to care about their health and then demand a quick fix. I do not relish paying more taxes to treat patients who engage in unhealthy habits. But then I remind myself that we all engage in socially irresponsible behavior that others pay for. I try to eat right and get enough exercise. But then I also sometimes send text messages when I drive.

The whole point of insurance is to reduce risk. When people inveigh against the lack of personal responsibility in health care, they are really demanding a different model, one based on actual risk, not just on spreading costs evenly through society. Sick people, they are really saying, should pay more. Which model we eventually adopt in this country will say a lot about the kind of society we want to live in.

Read it all.

Filed under: * Culture-WatchHealth & Medicine--The 2009 American Health Care Reform Debate* Economics, PoliticsThe 2010 Obama Administration Health Care Bill* TheologyEthics / Moral Theology

3 Comments
Posted March 30, 2010 at 6:00 am [Printer Friendly] [Print w/ comments]



1. BlueOntario wrote:

Sick people, they are really saying, should pay more.

Once upon a time late in the last century there was a community that had a community-rated system supported by its large employers that pooled everyone and made health insurance affordable even for small business and the unemployed. That included wellness initiatives such as employer-supported recreational activities. 93% of adults were under an insurance plan. Then it fell apart: the large employers started to self-insure or look to national insurance agencies with “good deals” and pulled people out of the pool, younger people figured they could save a buck and not buy insurance… Coverage is still in the upper 80% range, but government has stepped in to provide, especially for retirees, where employers have stepped out.

Two phrases come to mind when I look at how this system fell apart and consider how we gamble with affordable health care: there ain’t no such thing as a free lunch, and you can pay a little now or a lot later.

March 30, 9:21 am | [comment link]
2. Br. Michael wrote:

I would also add that there is always someone who wants to live other people’s life for them.  It’s always for their own good of course.

March 30, 9:45 am | [comment link]
3. Bill Matz wrote:

The author ignores the uniqueness of health “insurance” in this regard. Other forms of insurance (e.g. auto, property/casualty, life, etc.) ALL compute rates based heavily on risk factors. The author fails to explain why health insurance should be different. It is one thing to overlook non-controllable factors. It is another to ignore controllable ones. Without some form of risk weighting either health insurance will become cost prohibitive and/or there will be severe rationing of more costly procedures, as reported for many countries.

March 30, 11:55 am | [comment link]
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