By Sean
Perhaps my conservative disposition biases my life motive, but through my personal experience I have always learned that no one is ever entitled to anything. Personal responsibility and accountability are two attitudes that any citizen in a free country must possess for that country to prosper. It is unfair and irresponsible to reward individuals who deny accountability – those who consciously choose ignorance over responsibility. The potential reality for universal health care for all citizens disregards justice and equality to those Americans who are making an effort to live a healthy life. Simply stated, if tax supported, universal health care were to pass, healthy people should not have to pay the same price as those who will undoubtedly require more attention and expense. Health care reform should subscribe to the car insurance approach – safe drivers pay less for car insurance due to the fact that they are less likely to use it.
Approximately seventy-five percent of U.S. health care costs are a result of personally preventable chronic illness (Center for American Progress, 2007). Two specific, voluntary, and absolutely preventable behaviors are responsible for over $220 billion of health care costs in the United States: obesity and smoking.
In 2009, the United States of America has been statistically classified as the fattest country in the world, with over 30% of the population defined as obese. Two-thirds of the population is also considered overweight (Associated Content, 2009). Obesity kills over 100,000 Americans per year, and has been the most significant threat to life expectancy since the Civil War. Obesity leads to preventable chronic illnesses, including heart disease, diabetes, stroke, and colon, breast and prostate cancers, among many others, whose treatments routinely cost hundreds of thousands of dollars. In 2008, $147 billion was spent on such obesity-related medical expenses in the U.S. How could Congress ignore these numbers? No matter how efficient any form of health care reform is, at the end of the day a country that has unhealthy citizens who accrue such medical costs will inevitably require sky-rocketing expenses.
“Rising obesity rates are increasing health care expenditures per person in a way that is going to be very difficult to finance,” said Jay Bhattacharya, a doctor and health economist at Stanford University’s Center for Primary Care and Outcomes Research. “Unless there is some vast improvement in the efficiency of the health care system – and I mean vast – we’re going to be spending a lot more just because a lot more people will have diabetes and other obesity-related diseases,” he said. So the question still remains: we know a large part of the problem, so why aren’t we making those who are causing it accountable?
Another voluntary and completely preventable habit costs the health care system over $72 billion a year – smoking (Barendregt, Bonneux, Maas, 1997). In 2008, over 168,000 Americans died from smoking (American Cancer Society, 2008). The health care costs for those who regularly smoke are 40% higher than those who do not. “You expect a figure of this magnitude for the impact of smoking on health care, when you consider that one in five deaths per year is due to cigarette use,” said Leonard Miller, an economist and professor in the School of Social Welfare at Berkeley. So again, not only have we identified yet another drain on the health care system, it is a drain that could be completely prevented.
An emphasis on eliminating preventable health problems can go a long way for the common tax payer. A simple yearly, mandatory physical (for those who are legal citizens; illegal citizens do not pay taxes and should not qualify for any form of government health care benefits) can evaluate one’s obesity and smoking behavior, among other preventable health risks. Those who choose to live healthy lifestyles will be evaluated as such and will receive health care coverage at a fraction of the price than those who lack accountability and responsibility regarding personal health. Those who are obese and/or smoke have a choice – quit your addiction to pursue a healthy lifestyle, or pay for your irresponsibility. In the meantime, healthy American’s will not be paying for the elevated medical costs of those who abuse the system.
As an afterthought to this argument, I realize that the health care system is not as cut and dry as I have presented it to be. I also realize that there will be citizens that require serious medical attention due to disease and illness that are not preventable (including genetic complications that may lead to obesity). Finally, I understand that such an approach does not nearly eliminate the $2.26 trillion that was spent on health care in 2007, nor would this ever come close to becoming a reality (due to the complications with effectively evaluating unhealthy obesity, as well as the adamant opposition from mainstream tobacco companies); this perspective is simply a start to innovative and progressive thinking on the issue.
References:
1. American Cancer Society. (2008). Facts about smoking in America.
2. Associated Content. (2009). Top 5 fattest countries in the world.
3. Barendregt, Bonneux, Maas, (1997) The Health care costs of smoking. The New England Journal of Medicine. 337(15), 1052-1057.
4. Center for American Progress. (2007). Health care by the numbers.
