It is well understood that the US health care system is full of administrative inefficiencies, inflated prices, improper care, waste and fraud. Pretty much everyone agrees on that. Unfortunately, one important - maybe even the most important - element is usually left out of the current debate on healthcare costs. And that is personal responsibility.
Every discussion tacitly assumes that Mr. Joe Blow is entitled to medical services, even if he cannot pay for them. And that is wrong. The result of that is the rest of Americans having to spend over $100 billion a year on the care of uninsured in the form of taxes, higher hospital and doctor bills (who have to cover the cost of services rendered, but not paid), and higher insurance premiums. Granted, $100 billion is not that much compared to the total healthcare expenditures, but it is still about $1000 per year per American family. And there is a lot of good things a family can do with $1000 dollars.
In addition, as the uninsured tend to use the limited resources of emergency rooms for their routine care, the quality of care for everyone in many facilities is falling.
A possible solution to that would be a stricter policy of not providing care for people that cannot pay for it. Even - or especially (as they are extremely costly) - in life threatening situations. Of course that would require also a law shielding the healthcare providers from liability in cases when they refuse to treat an individual that cannot pay.
This will put the responsibility for the healthcare back where it belongs: on an individual. After few well-publicized cases of someone dying because he/she was turned away from emergency room, people would get the idea that after food and shelter the next necessity is health care. People will better understand the need for living healthier lifestyle and taking better care of themselves. More will buy the insurance, which will become more affordable.
That would benefit everyone.
Some may ask what about these who are really unable to pay for the healthcare? We, Americans, are a generous people as a group. I have no doubt there would be charities and churches (even some minimal taxpayer-supported social services) that can provide assistance to those who truly cannot afford it.
But for everyone else, it is their choice: if they prefer to buy a doughnut than pay for a vaccine, they shouldn't complain when they get sick.
Thursday, February 28, 2008
Live or Die: it is your choice
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2 comments:
What about the theory that allowing people to choose for themselves harms society as a whole? For example, it is one's choice whether to drive drunk or not. However, in that decision, one is not only effecting themselves but indangers all of society when they get on the road. Many people in healthcare feel the same way. People will not choose healthcare when given alternatives and they need to be forced to pay for it and use it.
The concept of personal responsibility implies that people are held responsible for their actions. If they harm themselves, too bad -- let them suffer. If they harm other people -- there will be external consequences. In your example, if someone drink himself to death - that is his business. If he kills a person driving his car - he will be prosecuted as any other murderer. But not before, not just because of a potential harm he may cause, but only due to his actual deed.
The personal responsibility concept contrast sharply with the preemptive collective punishment concept, in which whole population (or a large section of it) is collectively punished (e.g., prevented from having a beer every now and then) to preempt potential undesirable behavior of some individuals. An example of a preemptive collective punishment could be The Prohibition, but this is a subject for a whole article of its own...
So to answer your question: people should be free to choose their actions, but they should not be free from the consequences of these actions. Both natural consequences that they will experience themselves, and external consequences imposed by the society as a punishment.
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