Is Personal Responsibility an Inconvenient Topic in the Health Care Reform Debate?
62 Comments// Posted in Previous TTMYT Articles by jamie on 05.10.09.
During the recent presidential campaign, the Obama/Biden team issued a white paper describing their plan to provide affordable, accessible health care to all. In it they promote preventive care as one tactic in a multi-faceted approach to improve health care delivery. The plan further states, “Preventive care only works if Americans take personal responsibility for their health and make the right decisions in their own lives – if they eat the right foods, stay active, and stop smoking.” The first time I read this, I thought, wow, finally someone at the top is plainly stating (albeit politely) that Americans have to get off the couch and engage in their own well-being.
Since then I’ve read dozens of articles, blog posts and books on the subject of health care reform. Most authors agree it is imperative we reform our health care system. Proposal solutions often cite similar tactics, the majority of them being within the control of industry. But seldom does anyone suggest how (or if) the individual’s role should also be reformed. When personal or individual responsibility is mentioned, it is usually in reference to an individual mandate to purchase health insurance. But having health insurance coverage doesn’t make a person healthy. It’s what you do with that coverage and your personal choices that make the difference. My impression is that there is an inconvenient truth within this issue of personal responsibility, and it’s for that reason we hear so little about it as we debate how health care delivery should be reformed.
If you have an opinion on how personal responsibility should play into reforming health care in the United States, I’d like to hear from you.
POSTED BY USER LCHERRINGTON
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62 Responses to “Is Personal Responsibility an Inconvenient Topic in the Health Care Reform Debate?”
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By N2H
You raise a lot of good questions here. How do you move someone to be RESPONSIBLE? Typically, people don't change and take responsibility unless they're really hurting. Health has to do with so many disciplines: exercise, wise food choices, attitude, emotional well being – which do you change first, especially when you're overwhelmed and stressed. And, why should people change when BIG BROTHER has been watching out for them their whole lives? How well they're actually being cared for is another topic. How do you change the mindset of the nation? The world image of the lazy American is truer and deadlier than we care to realize. Denial and blame seem to be an easier route.
The reality of the situation has to change. We're not just "fixing" Health Care, we're charting a course for ourselves, our bodies, our well being and our loved ones, to live meaningful lives. Yes, the emphasis must be on the individual's personal responsibility, but the pill is too sour to swallow. The feedback is: yes I want to change but I also want to keep on doing what I'm doing. We won't get the average American's ear if it doesn't' address the real motivation: WIIFM (what's in it for me!").
Personal responsibility is and will always be an issue in all aspects of life and reform. What % of the population ever consider responsibility as the real topic? I think that responsibility needs to be looked at 1st but it will not…
As far as health insurance… I pay my own as a small business owner and as someone who is responsible I really can't deal with the fact that my insurance has TRIPPILED since 2007 with no health change. In fact, my health is better!
Yes ,we all need to take responsibility for our health. The recognition that good health is such a gift. That it is impossible to regain it once it is lost. That it IS your 'responsibility' to do everything you can to maintain your health. That yes even if you do all this you will still get sick. That there is so much out of your control. All of this seems so logical and straightforward. However, just today I was riding to work with someone who is 80 lbs. overwweight, does not exercise, is 60, has been told repeatedly she needs to lose weight, and has just been told she is diabetic. Her response is that the pills will do the trick and if those pills don't work there are shots. It doesn't seem to register that it was within her power to prevent this disease. There are many people like this. I have been unsuccessful in convincing people of their personal responsibility.
Linda
LCherrington’s article voices what I have been saying too. As a professor teaching medical pharmacology I have designed a project for the fall semester called mindful living. All of my students are future health care workers. I will challenge my students to be leaders of preventive medicine, which is not expensive diagnostic tests as most seem to think, but instead is personal responsibility for health. I will tuck topics into my course about mindful eating and nutrition, physical activity during chores and exercise, increasing hygiene including nasal washing, eliminating substance abuse, improving mood, decreasing debt, caring for the planet through recycling and reducing drug waste in our waters etc. Once upon a time families and schools made life worth living for children. Communities provided neighborhood fun; children and adults played together. Teachers enjoyed recess as much as the students. Walking, biking and public transportation provided opportunities to say good morning to passersby for the shear joy of being pleasant. We need to eliminate traffic and roadrage. People should select homes near jobs and shops to reduce dependence on foreign oil but also as a preventive medicine to be active in a community. Air conditioning makes people overeat in hot weather and stay indoors. Turn off air conditioning and play in the shade. Likewise overheating homes in winter wastes energy and slows thyroid function to reduce fat burning to heat. Lower the thermostat and knit a sweater in a rocking chair for activity and a sense of accomplishment. Bring back crafts and do-it-yoursef projects and skip drugs for depression. Preventive care is equivalent to using common sense to make life worth living in a country on a planet that we take pride i and protect by not littering biohazards. Drug free living should be everyone’s goal. We like to honor American heroes. Please reward healthy people for being heroes for not burdening health care costs that threaten to drag this country towards bankruptcy. I wholeheartedly agree with LCherrington and I am thrilled that his/her comment was referenced on MSNBC news. This is precisely the direction that the national health care debate needs to go towards. Americans need to become mindful that it is not sufficient to live, and living “well” does not mean living high on the hog but instead means living vigorly and intelligently and kindly.
I just learned of this website. I’ve been pondering “personal responsibility” regarding health care reform. I’m retired, but worked for many years in the benefits area (human resources) of large and small corporations. I’ve seen efforts to encourage employees to keep health care costs down and attend wellness programs. We’d send out articles about good eating habits, quick and easy exercises, not smoking, etc. I found myself cringing when going through the employee cafeteria line and seeing an overweight person loading up on carbs and skipping the fruits and vegetables. I’d cringe when I’d see all the employees go outside on their breaks to smoke. My thinking: “You guys are affecting MY pocketbook!!” I don’t know how everyone will get along with each other as we become judgmental. We’re already now affected by the choices of others, we’re just not quite as aware of it — by that I mean my individual medical insurance premium will be affected by the overall costs paid out by Blue Cross for those who have sky-high claims. I wish I knew where to draw the line on judgment — what if a couple with two kids with cystic fibrosis keep having kids? What about skiers? What about motorcycle riders? This is very complex. But the government should DEFINITELY do what it can to eradicate smoking.
I read your comment about smokers. I am 5′9″ and weigh 143 lbs. I have been eating sparingly for 30 years. But I was surpised to hear last week that an obese person costs the health care system four times as much as a smoker.
When I was in labor, 2 nurses said to me “I hate you, you are so thin”. I felt like a beached whale so you can imagine my shock but they were more than 300 lbs each. Later I asked them to clear the air from the iv line but instead they showed me how much air could be injected without killing me. I was terrified! Obviously they really hated me because I was a healthy size only carrying the extra weight of the baby. This weight problem impacts health care many ways. It worries me that many health professionals are so terribly overweight that their self image and professionalism is gone. Any advice they give about health falls flat because obviously they do not follow their own advice. Thin people should not be hated by fat ones. I complimented those nurses on everything I could think of just to try to win their favor and save my life. I would gladly have taught them how to increase their activity and eat sensibly if they had given me half a chance.
Like many others, I’ve come here as a result of an MSNBC story.
But, really, how do you determine who is engaging in healthy behaviors and who isn’t? It’s simple to say that we can tell what your behaviors are from, for example, your weight, but it’s not that easy. How do you differentiate between a fat person whose labs are in normal ranges and a thin person with high cholesterol? Do we refuse to provide medical care to a person who sustained a head injury while riding a motorcycle without a helmet, or who was injured in a car crash because she wasn’t wearing a seatbelt? Aren’t those areas where “personal responsibility” should be considered?
And why stop at health insurance? My husband and I chose not to have kids, but our school tax rate is the same as the rate of people who made a different choice. Shouldn’t people who have children pay more than me? Since I’ll be dead of fat long before I’m old enough to retire, shouldn’t my contributions to Social Security and Medicare be lower than those of people who will live longer because they are thin?
I’m sure that “personal responsibility” sounds like a great idea … until you realize that there are things that you’ve chosen to do that have a cost to those who make different choices. To you, it might be “fair” that I pay more for health insurance because I’m fat. But to me, it seems entirely “fair” that you should pay more for the items listed above because you have kids and will live longer because you’re not fat.
As for the repeated stories about fat people eating “junk food” while the virtuous thin eat nothing but the healthiest of health food … it’s called “confirmation bias.” You remember things you see that conform to your prejudiced view of the world, and not the things that conflict with it.
I certainly understand the complexity of this issue. What we are essentially discussing is the degree and manner of encouraging “virtuous behavior”, however defined. While there is likely no one good solution to grab hold of, there are employers who recognize the value of rewarding behaviors that will likely encourage better health among their employees. I’m thinking of employee incentive programs that reward people – with money or other useful incentives – for swimming laps; walking miles; getting regular checkups; adopting nutritional programs; changing unhealthy behaviors. These programs are voluntary, but clearly provide a tangible benefit to the person who participates. The problem with these sorts of employee incentive programs seems to be (for the most part) that they may not seen as practical or affordable by most employers. But if we could find a way to make them more practical or affordable, and to systematically incentivize behaviors that would likely reduce an individual’s use of the health care system, we could bring down some of the costs of providing care – regardless of the actual individual impacts. Personally, having watched two parents die of two very distinct (and painful) smoking-related illnesses, I’m convinced enough of the benefits of a healthier lifestyle and try to follow one. But I recognize that change is hard for some, and lifestyle is not the only factor in use of the healthcare system. Still, I believe I understand well enough that substantial benefits can come to anyone who cares to live a healthy life – just as I know that my insurance premiums help to pay the costs of care for everyone who couldn’t care less about doing so. Surely this is an idea worth pursuing.
It is time that personal responsibility is put into all of these bail outs and plans. If you bought a house you couldn’t afford and were “tricked” into a mortgage that you couldn’t afford, you should lose your house. If you are obese because of your diet and are stricken with Type II Diabetes later in life, Medicare should not pay for it. These are just a couple of areas, but I think the discussion needs to get to real plans. If we say personal responsibility is important fine, but what are the hard choices we are going to make if people don’t take that path. I know I for one am tired of paying for someone else’s choices.
I find it amusing that people are talking about personal responsibility here about healthy lifestyles, and yet, no one correlates that to the entire discuss of health care reform. I have been uninsured. I have bought individual coverage. I have been covered under a group policy. At every stage of those times I knew what I had to do to cover myself, to protect myself. Honestly, the package they are putting together scares me. I know people that are from countries with socialized medicine. What people are asking for and what is going to be done is not going to equal any kind of positive outcome. Read the fine print. Why else do you think the program isn’t set to truly role out until AFTER the next election? We need change, but not like this. Yes, people need to be more responsible, but thin people who eat right get diabetes too! Genetics play a substancial role in the disease. If you want to play that card, then look at the food that we have available–all the estrogren, preservatives and pesticides/garbage that is put in to food that is “good” for us! Am I the only one that see’s how many people are getting cancer in relation to what it was 30-40 years ago? What changed? The ingredients. I would LOVE to have food that is bad for us at a higher tax rate than those that are good for us! Then maybe it wouldn’t be so expensive to buy vegetables and fruits–but lets get all the pesticides and preservatives off them! Inactivity isn’t the only reason kids are overweight! I agree we need to be more active and eat right–but that isn’t the only thing that makes people sick!
Personal responsibility is one of the reasons I do not believe in “univeral health care”. The government cannot provide us with all our needs in life; our needs, are our own Personal Responsibility. I do not expect the government to supply me a job, food, housing, or healthcare. Those are things that I am supposed to take care of myself.
If the government wants to help reduce the cost by allowing for greater compeitition or other means that industry know it all’s believe will keep costs under control, I am all for it. What I do not want to see is a government takeover of healthcare and a national system is the first step in that direction and like skydiving once you start there is no turning back.
Personal responsibility should definately play a role in healthcare reform; however, I am concerned with children that have not been taken care of becasue of poor upbringing, sexual abuse, physical abuse, emotional abuse, and mental abuse. These children suffer until the police or social services intervenes. I have seen children placed back into abusive homes through social services. I cared for these children for 5 years becasue their parents could not or would not care for them. Additonally, what about the homeless person that has a severe psychological disorder and cannot receive care due to lack of understanding, no money/insurance, or societal norms of degrading the homeless population. I have seen children turn eighteen and they have nowhere to go and some do not have the knowledge or resources to help them get the help that they need. Healthcare reform needs to take into consideration the severely psychologically challeneged children and truly helping these children.
I do believe in personal responsibility. I am a person who is going through the long process of undoing years of learned behavior. I am 30 years old. I have finally (after 12 years of reading) found that the only healthy way to eat is by eating unprocessed (excluding the cooking process) foods. To get to this conclusion, I have tried every healthy way of eating under the sun. There is so much misinformation out there. Even the FDA pyramid is inaccurate. How can they encourage us to get around half our calories from processed foods (e.g. ‘whole grains’ aka cereal, bread, pasta)??
I am a smoker. I come from a long line of smokers. Again, I have tried everything under the sun to quit smoking, from hypnosis to Chantix and nothing has helped me. I have also finally come to the realization that I either smoke or I don’t. Yes, it is a very difficult addiction, but my choice – I quit or keep going. I am going to quit, just stop.
I drink a lot of caffiene. Refer to smoking above.
So, I have the food licked. No more processed foods. I feel much better now and this is a reasonable way to eat. My next step is smoking then caffiene.
My point in sharing my story is that there is a lot of misinformation out there, including from our own government. Until our culture changes, we are going to be constantly undoing decades of learned behaviors and addictions. Our culture supports these things and encourages them.
Our insurance companies also support and encourage these things. Every time I go to the doctor for ANYTHING I am offered a prescription. I have yet to meet a doctor that will offer me sound advice and guidelines rather than a pill. In the doctor’s defense, 99% of the patients will never follow their advice or guidelines and will end up getting worse.
Our insurance companies do not offer preventative care. I have wanted to see a nutritionist for years, but since I am not overweight and have no medical condition my insurance will not cover it (HMO). There is no time to exercise due to long commutes and long office hours. Our culture needs to change.
I love the advice ‘bike to work’ or ‘car pool’ to help yourself or the environment. Right. My commute in the morning is 45 minutes to drop 2 kids off at different places and get to work. It is a total of 8 miles of driving and it takes 45 minutes. Who is going to car pool that? Or bike to work? Right. The advice is unreasonable.
In order for me to exercise daily or every other day I literally have to make myself a social outcast. ‘No, I can’t meet you tonight because I have to exercise’ or ‘Well, I can hang out if you want to go for a walk or something’. Many people think there is something wrong with me that I don’t want to sit around w/ them or go out to dinner. I sit for probably 11 hours a day. I don’t see what is so odd about wanting to exercise for 20 – 30 minutes a day – but it is foreign to most people!
So, us attempting to change our lifestyles to be healthier get NO support. Not from the government, not from friends, workplace, insurance companies, etc… We are freaks.
I am trying. I am not there. I have 2 more bad habits I need to address, the really hard ones. I will get there. I wish I had some support along the way.
Things need to change from a cultural level in order for the health care industry to change. In order for things to change culturally, individuals must change. Like I said, we are now undoing decades of learned behaviors and it is going to take time.
All my life I have not so much worried about what I eat (a lot of carbs but almost no red meat) and I have this advice: forget the debate about processed foods. For me, it’s not what I eat BUT HOW MUCH! I feel portion control is key. Good luck.
Wake up! This is already the case when you have to purchase your own individual health insurance. I guess chosing to be self-employeed could also be considered a bad personal choise??? You pay more when you are over 50 or overweight or smoke or female. You cannot get insurance when you are obese or have an illness such as diabetes, heart disease, cancer, neurological, etc., etc. The list is quite long! And while you may pay as much as your house payment, you get much less for your money! So, all the people who do not want to pay for someone else’s error in their ways, I hope that you can keep your job forever and don’t dream of being a self-employed entrapaneur. I hope that you don’t get older. And may you never have an accident or serious illness. One wheyword slip (by choice or beyond your control) and you could join the ranks of poor unfortunate people who find themself without health care coverage! I know you would not want someone to have to foot the bill for your bad choice(s). So, what do we do with you then?
Personal responsibility. Only in a perfect world. Should people take care of themselves and avoid “risky behavior”? Of course they should. Being overweight should be penalized. There are too many statistics to back up the fact that being overweight dramatically effects the health care costs in this country and the obsured arguments that thin people live longer healthier lives are “unfair” to the fat person who is going to die sooner make me want to puke.
Fat people, smokers, drug abusers should pay higher premiums/taxes/fees and be rejected care for their behavior. It is time to take a stand by people that “take of themselves” and this “politically correct” crap has to stop. Penalize in anyway you can the lazy & selfish and leave good health care to those that deserve it.
All is true – I know my insurance premiums go to pay for bypass surgeries and all the other things mentioned and it annoys me! But one thing not mentioned is STOP PAYING FOR PEOPLE TO REPRODUCE. One of the biggest drains on Medicaid is paying for people to have children. Children are a choice not something everyone should have to pay to bring into the world.
I pay my own healthcare and have a NORMAL BMI. I do NOT want to pay for a 300lb couch potato because they can no longer walk or work a regular job.
I have thought about this idea for sometime and it really resonates with people that are in their proper height and weight category. Of course if you are outside of the recommended weight for your height, you probably won’t like my suggetions.
kd posted above:
I pay my own healthcare and have a NORMAL BMI. I do NOT want to pay for a 300lb couch potato because they can no longer walk or work a regular job.
I agree with kd’s assessment. If you take your child to the doctor they tell you where they are on the ‘chart’. Why don’t we use that approach as 1 of several criteria for determining how much a person with a BMI within the range vs a person outside/above the range will pay in health coverage? I realize it’s NOT the only criteria and should be taken into consideration with other pertinent info, but it’s one way of leveling the playing field. Smoker vs non-smoker is another critical component, heavy drinking vs light-no drinking, etc.
We all know that excessive eating and in particular the wrong foods, along with smoking and heavier drinking make for a bad combo in terms of good health.
I heard a stat about a week ago related to this. An obese person has healthcare costs of approx. 4 times that of a smoker in terms of health costs. It has to be higher for a non-smoker, relatively healthy person.
I just think people should be compelled to take care of themselves if nothing more than for their family, even if they don’t care about themselves.
Finally!!! It’s about time this issue came up. I’m so glad it was doctors that said this because maybe people will start taking the idea of responsibility more seriously. I think everyone should get medical coverage in this country but I think Obama is pushing it through too fast without putting enough thought into it. This is one of the most important ingredients…I take personal responsibility for my finances, as well as, my health…so I really have a hard time bailing people out financially that don’t act responsibly with their money and just as hard of a time paying for people’s health care when they do the same thing.
Health care coverage should come with special incentives for people with healthy behaviors!! …And penalties for people who choose to smoke cigarettes, drink alcohol excessively, overeat, don’t exercise, eat too much junk food and sugar. It’s a free country and people can choose to live how they want but they should pay for that choice to abuse themselves and the inevitable health problems that come from those choices!
I’m sooo tired of all the free rides this government gives to people who can’t take personal responsibility for their own actions…we’ve become a country full of immature adults that want the government to be their daddy and expect to be taken care every time life gets too tough from their own irresponsibility.
I, too saw the link on MSNBC and, as a nurse for over 25 years recognize how important the topic is. Six of those 25 years were spent working in the Indian Health Service, run by the US Public Health Service. I started seeing the hugely obese diabetics in the 80es in the Southwest, it has since gotten more widespread. The drinking has always been there, other drugs have now joined the toxic mix on the Reservations.
The Native Americans receive totally free health care, medication, rehab, follow up and ect.and have since the 1940es. Contrary to popular myth the care is very good. They have preventive services the rest of us can only dream of, and health educators of all stripes.
Has it done any good? Yes and No. For those who chose to listen, walking, jogging and healthy eating are new ways of life for the smart, responsible people who ‘got the message’.
The rest eat, drink and live as if they are hell bent on self destruction.
The USPHS does not have any programs, that I know of, to ‘tease out’ what works, or motivates, the success stories on the Res. In fact, the USPHS seems to have a policy of not mentioning the obesity or alcoholism except in the context of ‘victims’ of social forces.
I, personally, think that these overweight, alcoholic people are the ‘cash cows’ of the medical/pharmaceutical complex and woe to anyone who kills a ‘cash cow’-unless someone makes some ‘cash’ off the killing!
I am heartened to see that this topic, personal responsibility, is being brought up by the American people themselves. It is obvious that we would have to wait a long, long time for our government health care ‘watchdogs’, or the hospital industry to bring it up.
What about the millions of illegal immigrants, they cost this country billions more than Americans that quote “don’t take care of themselves!!! First lets tackle that drain our tax dollars!
Thank you! Thank you!
Yes we need more personal responsibility. It seems that as a culture we look outside ourselves for solutions instead of lifestyle. We spend more on cell phones and electronics compared to good quality food. Of course we have gotten used to fast and cheap food that is a one way ticket to pharmaceuticals and the doctor. I suggest that everyone see Food, Inc.
This also has to do with debt. It is a total lifestyle makeover.
Personal Responsibility — I am all for personal responsibility, however, I can afford to pay for health insurance, but, I cannot get it as an individual because I have a pre-existing condition.
People against healthcare reform have told me that I should get a different job that offers health care. So, it seems, my option is, cut my salary by about 80%, yes, 80%, so that I can get healthcare. Does this not seem downright dumb?
All I want, for example, is access to healthcare. The ability to get affordable, decent coverage and pay for it. Is that really too much to ask?
I couldn’t agree more with regard to personal responsibility. In addition, we also need to instill the idea of consumerism into the healthcare debate. Folks need to start asking questions such as “how much does “this” or “that” cost. Which provider does the best job of delivering quality & satisfaction for each visit. MRI providers need to be compared, labs & their services need to be compared, outpatient surgery centers need to be compared, prescription drug prices & generic vs. name-brand must be compared, etc. Once the idea of “going shopping” for healthcare is just as ingrained in our behaviors, similar to shopping for a car, a TV, or any other item in our lives, will we finally see a major downward trend in healthcare costs. We as a populace abdicate our personal responsibility to quickly to others in the healthcare setting. A major second hand benefit to “shopping” for healtcare will be the break-up of monopolistic practices of healthcare providers setting up “incestuous” relationships between doctor offices, labs, xray offices, MRI providers, etc. Maybe we will now hear the hew & cry for personal responsibility and have it finally stick.
I am a chef, and I have access to food all the time.
But I do watch what I eat, I exercise, and I live responsibly.
And, I am 53 !!!!!!!! So, why can fat, obese peopleget the idea and do the same?
My suggestion to pay for the health plan would be to develop a very accurate Body Mass Index set of measurements, and then, increase taxes/health premiums utilizing a 2.5% increment system.
In other words, if you are 10% above your ideal body weight, you pay extra.
Because, I am tired of paying extra for all the loosers/overweight/smokers/etc…that d not care about their state of health.
Fred.
If you think about it, the reason so many people fail to take personal responsibility for their health is that we are all insulated from the consequences. The immediate gratification of food, drink, caffiene and nicotine are far more potent that the fear of consequences sometime in the (distant?) future. The three big preventable diseases that run rampant through America are heart disease, diabetes and cancer. None of these diseases have side effects until the disease is quite far along. They are silently killing us and even though we know it, we ignore the consequences because of our mistaken belief that someday we’ll get around to undoing the harm we’ve caused ourselves; or we simply believe that we’re entitled to unlimited care from the best doctors and hospitals at someone else’s expense (this pretty much describes the current US health care system).
Until consequences become evident and more immediate, it’s unlikely people will take more responsibility. Employers who have offered significant incentives have demonstrated that it’s possible to get people to take more personal responsibility when the rewards are immediate and substiantial. Incentives alone won’t be enough though. Negative consequences for refusing to take personal responsibility are necessary as well and until we get to that point, large numbers of people will eat, drink, smoke and vegitate themselves to death, claiming it’s their right to do so, and someone’s responsibility to make sure that the health care “system” is still there to catch them when they fall victim to the inevitable diseases they have invited into their lives.
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I think the first thing to do is to mandate physical education in all schools for all grades every day…or maybe three days the first week, two the second, three the third, and so on. The alternate days could be spent on health education, including activities like shopping for healthy foods and cooking them, analyzing advertising and nutrition labels, etc. I think if physical ed and health ed were a given for every grade level every day, we would see improvement in one generation…and who knows, some of it might rub off on the parents.
Side note: I also think financial education should be mandated for all grades, starting with simple stuff like recognizing and understanding coins and dollars in kindergarten to investing in high school. Maybe if people left high school with good financial knowledge, they wouldn’t get themselves in the position too many do.
Back to health: At the same time, school lunches need to be healthy lunches (some schools do try, but I don’t think it’s universal yet) and NO vending machines with unhealthy snacks should be allowed.
All restaurants should be required to provide calories and nutrition breakdowns for items on their menus. They should be encouraged (maybe through some kind of tax break) to offer smaller portions for a lower price.
Organic rules should be enforced. They have become lax enough that too many non-organic ingredients are allowed to be in foods labeled organic. There should be a crackdown on food manufacturers to improve the quality of their ingredients AND to limit the advertising, especially to children, in much the same way limits have been set on advertising by cigarette manufacturers.
And I’d go for more public service advertising for healthy living…not just avoiding drugs and unsafe sex, but also for exercise and healthy eating. As a society, we’ve done a halfway decent job of making smoking unattractive and unacceptable. I see no reason why we couldn’t do the same for unhealthy eating and sitting on one’s butt!
Additional suggestions, some of which do not require complicated legislation. First, encourage the insurance industry to permit the deductible year to be the PLAN YEAR. For example, if I have an individual policy that I purchased effective May 1, my deductible year would be, every year, May 1 – April 30. The medical community goes bananas in December as people try to get in procedures because that was a year they’d already met the deductible. January is a busy month because people think they MIGHT meet their deductible, so they want an early start. This jams up the system. And believe me, the system is going to need DOCTORS and health care practitioners and there will be a shortage. We have to space things out. Companies who provide group benefits could be encouraged to go with plan years that are NOT the calendar year, and the deductible year would be that particular company’s plan year. Claims would “spread out” more. Secondly, get rid of insurance plans that mean that every doctor’s visit must have a claim filed, with the patient paying a co-pay. That’s like having your car insurance pay for oil changes and flat tires. Offer only high deductible plans for the catastrophic. The “oil changes” and “flat tire” fees would work towards that high deductible. This would mean lower premiums. The difference would be put in a Health Savings Account (HSA) with preventive procedures paid for with those saved dollars. Health Savings Account contributions should be permitted for Medicare participants who enroll in a high-deductible supplement plans. Right now they are not permitted. Bag the concept of “in network” and “out of network.” The insurance company will pay “$X” dollars for specific coded procedures, tests, etc., anywhere it’s obtained. The consumer can find a doctor who might just settle for that “$X” amount, or …. as a choice one can use a more expensive doctor, and you pay for it out of your HSA or your pocket. Develop a quick skin test for presence of nicotine. If present, the claim submitted would yield an $X-minus reimbursement. Even if one is on a patch or gum, eventually you’ll want to wean away from that. Sorry, until that happens, you’ll pay for it. Maybe your pre-teenagers will hear this and think twice about taking up the habit. Illegal immigrants — difficult to deny help when you have a bloody person on a stretcher. But many illegal immigrants are in having babies who will automatically be citizens. NOT!! Give automatic citizenship ONLY to those babies born in the USA with at least one parent a native/naturalized citizen (not just a permanent resident). The baby/eventual young adult will eventually need to get in line with everyone else for citizenship. The uninsured — whether illegal aliens or citizens — can’t really be denied critical care, but bill them. Put liens on their houses. Garnish pay checks — anything to get that care paid for or prevent a total free ride. I’m sorry, but the next generation should not be able inherit a house from someone who left this world with sky high medical debts for society to absorb. When I think of more ideas, I’ll write again.
It’s me again. Forgot to mention another prohibition — no more prime time TV advertisements of prescription drugs!! Those spots are expensive. In order to avoid claims of censorship, the drug companies are welcome to use PRINT ad — or time slots between 2:00 a.m. and 4:00 a.m. at most. The cost of drugs is getting ridiculous.
AMEN TO THAT SUGGESTION!! Used to be your doctor would suggest medicine to you, know we see on the TV “if you think this is right for you, talk to your doctor”. If the pharmacuetical companies budget for marketing was slashed due to limited advertising, perhaps it wouldn’t cost so much for the actual pills!!! Let’s leave it up to the doctors to decide what works best for us and that way we don’t have people lining up for medication that has such bad side affects!
I don’t think you’re really suggesting limiting a company’s right to advertise, but I get what you’re saying. Drugs are hard to produce, and in order to make them profitable they have to advertise. I believe the root problem is a system with low personal liability for trying so many drugs. If you can go to your doctor and get a prescription for Latisse (eye lash thickener) and only pay a $15 co-pay and also pay the same co-pay for your heart pressure medication, therein lies the problem. The expense of the eye lash thickener is being passed on to the general group just as the heart pressure medication. I believe most of us don’t mind sharing the burden for heart disease, but I don’t think very many of us want to share in the cost of some beauty queens eye lash growing problem or subsidize some guys four hour erection.
Thank you. Finally someone is talking about personal responsibility in health care. We have become a society of abdication of personal power. No wonder we get bamboozled by the loudest voice out there.
I beleive this is the central piece that will reverse the health care condudrum. The rest are details that will fall in place.
It’s not surprising that the government doesn’t want to talk about individual responsibility, because so many government programs are predicated on the notion that citizens are basically incapable of taking care of themselves and need the government to take over for them. I worked through a ministry with a family that was getting virtually everything the government was giving. The mom’s sister had applied for disability because she had developed type II diabetes, which is a disease related to lifestyle choices and which is largely manageable with lifestyle changes. She was quite heavy, and her disease had progressed to the point she had some neuropathy. She was turned down twice, hired those attorneys on tv, and got on disability, retroactive to the first time she had applied. Our government sent her a check for $16,000, with which she promptly bought her boyfriend a pick up truck. She convinced her sister, who was also obese and had diabetes, to apply, which she did, and she was put on disability as well. She died two years ago at the age of 37 from uncontrolled diabetes. Her death was horrible and she was in and out of the hospital for several months as all her organs began to fail and she left behind two boys, ages 14 and 11. She;’s dead because we have a system that doesn’t encourage people to take care of themselves but instead rewards people for staying sick. If you take care of yourself and your symptoms disappear, so do your checks! The government has become the enabler-in-chief. Good luck to the president trying to change this mindset!
Everyone should also remember that although exercising would really help everyone a bit, I think educating at an early age would also help. Keep in mind that buying “healthy” foods is not always an option, when you go to buy food, how much money do you spend, and how long does the food last? When your very poor, how you eat and what you eat isn’t that big of a concern as not going hungry.
That, and a lot of comments and ideas lean towards controlling other people, and controlling how others live. I don’t like like that, somehow, it sounds a little selfish and evil to me.
I agree that education is key. I grew up in a single-wide trailer very poor. The difference for my and my family was that my mother had learned from her mother meal planning from basic ingredients. It’s amazing how much more food (and therefore how much longer it will last) you can buy that way. The problem is education and convenience. It is healthier and cheaper to eat this way – but it requires more time and effort. Too often the very poor are subsisting on Coke,Mac & Cheese, and fast food. My sister works at WIC – it’s amazing how few people know how to meal plan and cook.
It’s not that we want to control someone, but for how long should we subsidize their poor health decisions. It’s not good for them or us.
I do not believe that it is more expensive to buy healthy foods than it is to buy non-healthy ones. I woke up to that fact one day when I was hesitating to spend several dollars for some out-of-season fruit, then realized I never balked at spending that same amount for a half-gallon of ice cream! Things like beans, brown rice, potatoes (good for you if you don’t lather them with butter or gravy), peanut butter, popcorn, eggs, milk, oatmeal (not the individual packet kind, but the kind that comes in a big box), carrots, broccoli, and many other vegetables are NOT expensive foods. They are good for the body and they go a long way. And they are usually ALL cheaper than soft drinks, ice cream, cake, and the like.
It’s not a matter of wanting to control another person. If a person wants to destroy their own health without infringing on others, then go to it. But just like we make laws against drunk drivers because they infringe on others, people who refuse to wake up and eat the oatmeal, followed by a brisk walk, ARE infringing on others by the increased cost of health care. Plus it’s not good for them either. Call it an intervention. If a loved one was destroying himself through alcohol or drug addiction, most people wouldn’t hesitate to do whatever they could to get them to stop. How can destroying yourself with a food addiction be more acceptable?
FINALLY, SOMEONE IS MAKING SENSE. I work for a small company and pay for my own personal health insurance for me and my small family. We have a high deductible plan and are required to foot the bill for the first several thousand dollars. This PERSONAL RESPONSIBILITY makes us much pickier about our services. Do you know you can save a bundle negotiating prices with your doctor – without any reduction in services or quality of care? What about preventative care? I have to do it, it is too expensive not to. I can afford the $70 for the annual checkup, I can’t afford to ignore it and pay $2500 next year out of pocket. You can try convincing people of the responsibility that they do and should have about their health, but until it affects them financially, what’s the point? They won’t do anything. What if you tell someone that if they lose 10 lbs they can save $500 a year? TAKE CONTROL OF YOURSELF, you won’t like it when the government does it for you – we all lose with that scenario.
I agree with the original and subsequent comments-the question is what should congress put in the health care bill in this regard to promote personal responsibilty.I say ther eis only one way-take health care out of the hands of Doctors and give it back to the individual,as health cannot be “prescribed”,only learned and practiced.There is a plethora of information on health,diet ,nutrition,supplements,herbs,drugs,tests,procedures and surgeries-but how does the individual know what is the most effective,and even if they know there is no incentive to practice good nutrition,exercise and take natural supplements to prevent disease and to treat the majority of conditions which are treatable by individual use of judicious supplements.The first step is to start rewarding the good people in this scenario-those who look after themselves-yes the government should MANDATE health coverage for natural products ala freedom of choice in Bills offered up by Congressman Ron Paul.The second step is to make all of the pertinent information on diet,nutrition,exercise,supplements,drugs,treaments,tests and surgeries available in one place and accessible to the individual online in a giant interractive database.The online health information is sorted by medical condition,supplement,biochemical pathways,gene,drug,symptoms and tests and is interractive with the patient medical records.At any point in time,the individual can access the online database by multiple devices,incuding cell phones,which provides the diet,supplements and exercise needed for that person based on their age and condition.Further,at the touch of a key or screen,the individual can get an immediate diagnosis along with the name of the condition,treatment and any tests.Natural means alongwith any drugs,or procedures would be included.Everything mentioned is covered by the individual’s insurance plan-the choice(s) are there and the costs to get an accurate diagnosis and treatment are greatly reduced, health is improved and it provides a National Standard of care along with universal coverage for all,freedom of health choice and individual responsibility.It is all there and all within current technology-do we have the will to take health and put it where it belongs,in the hands of the individual,or will we just gum this thing to death and allow Congress to do what they see fit which is spend more of our money on solutions to problems the Government cannot help?-all the government needs to do is MANDATE the freedom of choice insurance,and the online health management system with stated outcomes and stand back and let industry and individuals do the rest.Keep it simple, like the clunker program, and it will work.EVERYBODY is ready for the right solution with no Town Hall Meetings needed.Fred
I sent a note to the White House suggesting that people who pay for premiums should get a discount if they DON’T have to use their health care. They should do like the auto insurance safe driver program. If you don’t have accidents, you get a discount. If you stay healthy, why should you have to pay the same premium that someone who doesn’t take care of themselves?
I completely agree. Rewarding people for “good” behavior through their pocketbook is the only way to truly get the public’s attention. Similarly, lifestyle choices could impact the cost of your insurance when you first start with a plan.
I do have a problem, however, with increasing a worker’s insurance premiums based on preexisting conditions. Some people have medical issues they will need the insurance for; simply increasing their premiums the more they use is simply takes us to a more extreme version of fee-for-service than we currently see. Over time, a certain amount of this is to be expected; but base-level insurance for all workers, regardless of their existing medical conditions, should be the goal.
Anyone have a thought on this dilemma?
Sadly that is the nature of insurance. You pay more for car insurance if you have a lower credit score – this happens because statistically people with lower credit scores get in more accidents. Same thing with young males 18-25. I paid more for my insurance because I was in that category – even though I never got in an accident or even a speeding ticket. I believe we do need to address this issue. Someone with cancer or who has undergone fertility treatments (try getting private health insurance after using Clomid) should still have access to affordable health insurance. I believe, however, that lifestyle choices that lead to health problems e.g. obesity and smoking, should pay more.
If people ate foods in which Nature intended, we’d have a $1 MILLION healthcare bill instead of $2 TRILLION. We ARE what we eat and the American public is a poison ridden group of humans who are basically lazy and stupid.
Stupid since they won’t learn how to eat right, and lazy because “It takes too much time to cook and then clean up after.” PURE BS. It makes me sick to no avail. They all deserve the short painful sick lives they live.
If they want to learn more about my credentials and some FREE health-enhancing information, anyone can visit http://www.healthwellnessfitness.com. We need to take MAKE all Primetime television stations show one hour a night (Like a Presidential Address interrupting all stations) to show the public about healthy lifestyle, not STUPID shows like King of the Hill, and Family Guy and Simpsons… while they eat their junk food.
It’s pathetic. THEY ARE THE CAUSE OF THEIR OWN DEMISE. One great way for population control… bad for economics though.
Wayne Victor Dennis (Google THAT)
I have worked in health insurance and health care technology for the past 15 years, with the goal of reducing health care costs for the American society. Folks, nothing has worked in the long run. And the sobering truth is that nothing can contain health care costs in today’s society. As long as people desire to live forever and drug and medical technology companies can make it possible, health care costs will continue to soar. Most Americans (and probably most of the world) would rather wake up each morning and take a handful of pills and continue to eat massive amounts of fast foods each day and buy new clothes each year in a bigger size rather than control their weight by diet and exercise. How is it they can afford new cloths each year but not health care insurance? Funny, isn’t it?
I am 52 years old and still have the same weight and body measurements that I had at 16 years of age. It isn’t that hard! Fat people are lazy and grotesque and should be held accountable for the error of their ways, just like criminals. They steal from all of us every day. They are much more harmful than smokers!!!
Sad to hear, but I understand what you mean about the costs. The problem as I see it is that there is currently no “cost” to this way of thinking. Want to live forever? Fine – pay what it costs to do so. There are the upfront costs of living a healthy lifestyle; or there are the back-end costs of popping miracle pills or extreme surgical choices. I have 3 friends who have had the gastric bypass surgery – all of them primarily due to unhealthy lifestyles (which sadly continued after the surgery, leading to further complications, I might add). Healthcare certainly costs money, but those who are reckless users of the system should not be shielded from the bulk of this cost. This is where the effects of personal choice should be clear.
Personal Responsibility for your own health!What a concept “NOT”,WOW.We all know what is bad for us yet we all keep doing it over and over again.We eat different now than we did back in the 50’s & 60’s.But smoking & drinking have been around forever,drinking is an addiction & so is smoking no kind of moderation on these two can help.The decision to improve our own health is a personal responsibility.If our government is to give health insurance to all then great.My idea is to qualify for government health insurance we must show we are in good health if your are not in good health then you won’t qualify for this type of health insurance and must buy your own health insurance. Anyone reading this please add what else can be done. Rafael
Because of the field you’re in, I’d be interested in your reaction to a post I made above — about changes in how insurance is done.
I have been an RN for 26 years, my husband a physician for 30. I have been in the field of health education and now yoga therapy for most of those years. I am THRILLED to hear this discussion about Personal Responsibility! It’s about time. When a part of the proposed health care reform is based on “payment for outcomes” we should all be filled with fear. If doctors are going to be paid (or penalized) for how well their patients do taking care of themselves, they will be forced to “fire” those who are not meeting the goals. The unforeseen consequence of this will be an even bigger problem of health care access. Who will be able to afford to take care of the 350lb smoker with diabetes, hypertension and high cholesterol??? Being able to spend our lives destroying our health and having the expectancy that someone else will fix us is OVER. It’s time we stand up as American Citizens and Demand more from ourselves and each other and stop relying on others to fix our problems.
I believe being responsible for our own health is imperative.
It is interestiing that “polls” indicate that more people support smokers vs people with weight issues, paying a higher price for healthcare. why is that when we have less smokers in the US and more people with weight issues? We seemed to do a great job to make people “responsible” for their smoking habit and we “helped” by not allowing them to smoke in lots of places but with food choices and exercise, we are less inclined to push too hard. That is personal!
Why not have a higher tax on unhealthy foods and a more reasonable pricing model for exercise equipment, exercise classes and gyms?
Why not charge the food industry higher taxes if they insist on using ingredients that they know are not good for their customers? Ah, the almighty dollar. Do you know that vending vendors complain if you ask them to stock healthier choices? Well, the majority of them do complain and fight THE CUSTOMER they serve by making it so difficult that many more timid souls, just give up. Why would they not support an employer wanting to offer healthy vending choices. Ah.. it is the almighty dollar again, not enough profit in those healthier choices.
how about looking at delivering healthcare differntly? Ever been to a doctor’s office where all you can watch is the latest on the talk show circuit? the reading material is something you use to carve a pumpkin on or to train your dog? we often spend longer in the waiting room then we spend with the doctor. Why not take advantage of that down time, docs? Why not have health education playing on the television? Why can’t the doctor utilize the free resources that are out there to stock his waiting room? Hey, CDC has tons of educational material and they are free! Why not have the receptionist make an appearance and get the room up and moving, instead of putting up signs that tell us, not to tap the glass, ring the bell or ask when your turn is coming.if you can’t stand up, then sitting exercises are also an option. Anything would be better than having a room full of anxious and annoyed people who’s only exercise they get is looking at their wrist watch every 15 minutes!
Understanding they what and why is another missing link in our current system.
My spouse recently saw our PCP who ordered the same lab work he ordered 3 wks before and in all honesty, he did not need to order anything at that second visit. Now, did my spouse ask why? Nope but I asked him why and he had no explanation… well except “the doctor asked me if I had insurance”. Like that made any sense! However when I reviewed with him what the lab tests were for and that his were normal 3 wks before and how much these tests were going to cost, he suddenly became an educated health care consumer. he understood that there wasn’t any Insurance Fairy or Insurance God who would pick up the cost. Hello, WE ALL PICK UP THAT COST! Being a good consumer, he called up the doctor’s office the next day and spoke with the medical director. This doctor told him – his patient – that he should have questioned why these labs were needed and then refused if it did not make sense! Well, if the doctor had taken the time to rationalize WHY he thought thes tests were needed, he would not have ordered them and my husband would not have to be the one determining what his treatment plan should be! Not all doctors are like this one but there are a lot more that are like this then are not.
So responsiblity is a medicine we all have to pucker up for and swallow with some of us needing a much bigger dose then our others. if your dose has to be bigger, then your cost should be bigger.
We have to stop thinking about what’s in it for ME and start thinking about what is in it for US! I do not want to have to tell my grandchildren that Grandma’s generation just ate too much, sat too much and complained too much, so no healthcare for you!
Let’s throw annual check-ups into the bag of personal responsibility. I’m American but I’m currently living in Poland where we have public health care and a parallel private system. It is quite common here for older women to just simply not visit the gynecologist. My mother-in-law hasn’t been to gyn. since her last child was born 35 years ago and there’s no regulation forcing her to go. A once a year visit here is paid under the state’s health plan. After the passing of several relatively young female friends and family members, she still could not be persuaded to go to the dr. Certainly, it would be to the a state’s advantage to force people to have check-ups than to pay for their cancer treatment. Also how would dental and eye care be treated under the proposed reform?
Chris´s last blog ..New Hairdresser! Yikes!
On personal responsibility: I’ve practiced General Dentistry for
30 years and educate everyone of my patients about proper oral health care. About 90% of what we do in dentistry is PREVENTABLE. Do patients listen???? Yes. Are they compliant—maybe 15%. Behavior is a difficult thing to change—we counsel teens on the amount of sugar in sports drinks (we tell them to divide the number of grams of sugar by 4 to get the no. of teaspoons of sugar in a drink eg. A 12 oz can of Coke has 12 gms of sugar—i.e. 3 teaspoons of sugar). Do they change their habits—-maybe 15% do. With this as a micro model for the medical problems I’m not very confident that people will change behavior. Schools compound the problem by having unhealthy products for the kids—BUT then schools are PAID by the venders to have these unhealthy foods.
Perhaps the best model in the blogs above is to reward good habits (i.e. proper weight etc) with lower premiums—–BUT then the greatest percentage of health care costs are used by a small percentage of patients—-who make poor choices to begin with; in turn they are usually poor and cannot afford insurance anyway. Sounds like we’re going in circles doesn’t it??
Alot of good suggestions in the above blogs. Obama is trying to solve a VERY COMPLEX problem with a magic bullet. Simple approaches sometimes work best with complex issues.
Probably the best model for change is to reward behavior through reduced premiums—but then if the care is free why should they change? This is the problem with all welfare and medicaid programs.
The people who have submitted blogs here show more intelligence than 90% of our representatives (exceptions are Tom Coburn,M.D. Oklahoma, Orrin Hatch of Utah). A Congressman on CSPAN the other day didn’t even KNOW there was a problem with insurance companies going across state lines (each compnay is licensed to do business in each state). Such ignorance is frightening when they don’t know the core issues in the health care debate. And they want to reform the WHOLE SYSTEM????? Lord help us if they try to cram this thing through in a rush to “do something”.
JEC-My dentist in the US used to say, “Don’t floss all your teeth – just the ones you want to keep”. That made such an impression on me as a kid that I am a devout flosser.
Chris´s last blog ..New Hairdresser! Yikes!
Years ago I saw a tee shirt on someone at a golf tournament. It said, “If you’ve got ‘em, floss ‘em.” I thought about all the money my parents put into braces to give me something to “floss.” I’ve done so ever since. Lesson: tee shirt messages can work!!
Let’s all just face the predominant facts folks.
We Americans for the most part are overweight.
And it’s all because we eat more calories than we burn.
We’re lazy. We watch too much TV. We eat too much garbage food.
And we blame everything and everyone else.
For those reading this that are overweight(and you know who you are) ask yourself these questions.
Are you really, truly doing anything to lose that weight?
Did you join a gym on January 2nd, go for a few weeks then quit?
Should I, a healthy 45 man, who eats well, exercises regularly, does not smoke, drinks moderately and on weekends only, pay for your health costs if your uninsured?
If you say yes then I will pay my government mandated amount.
But then will you be willing to fess up and pay for 2 months of my gym membership?
If you land in the hospital with heart disease due to your weight and I have to help foot the bill, can I send you my bill for a new pair of biking shorts, new tires, a couple new shirts and a water bottle?
On the other hand maybe we should let this whole health care happen and give Obama what he wants and then mandate those naive folks who put him in office in the first place to pay for the whole thing.
Those same folks who statistically don’t have insurance to begin with – the 19 – 25 year olds – you know – those vibrant, healthy, non smoking, texting, twittering, know it all’s out there that think Operation Desert Storm is a Wii game.
They’ll learn a valuable lesson in politics; they’ll be forced to get insurance and pay for something they won’t benefit from (like us babyboomers and Social Security).
Yea, I like that idea! Anyone else?
Hmmm, socialized medicine is not a new concept…It seems to be working in other countries….I don’t hear them complaining about it. IN FACT, the people I know in other parts of the world are GLAD that they’re NOT Americans. They cannot believe we live this way. My friends and I have from time to time discussed what we would do if we found ourselves with an illness that could potentially bankrupt our families like cancer. We all agree the most sensible thing to do would be to go over the border to Canada where treatment is free. Americans are true to the notion of putting money ahead of people. I think I’m in the minority when I say people should come before money and that everyone should be entitled to the same level healthcare as everyone else. It’s so sad that some think of themselves as more deserving than the next. Let me add to that that I feel we should not have to pay for education (college/ trade schools). Education should be accessible to all EQUALLY.
Personal responsibility? How about “personal” responsibility for the insurance industry, the pharmaceutical industry, and the fast food industry — all of whom are deeply invested in perpetuating behaviors that are harmful to our health. Obese? The insurance company will pay for expensive gastric bypass surgery, but will not pay for 6-months of education with a certified dietician. Diabetes? The insurance company will pay for amputation of an infected limb (and a lifetime of disability and further medical complications), but will not cover (again) the services of a dietician/nutritionist. Hypertension? Big pharma pushes the pill-popping quick fix, and discourages changes in lifestyle. And the fast food industry continues to push their “drugs” on our children — with cheap and easy access to the foods that will make us the sickest. (They have even discovered ways to make a salad a high calorie, high cholesterol, high fat meal.)
This whole discussion of “personal responsibility” is a joke until we take into account the powerful industries (and lobbies) that deliberately mask their activities in order to turn a profit. There’s a reason that “unhealthy” stuff is cheap, easy, and readily accessible — because someone, somewhere, is making BIG money off of it.
Give people the opportunity to make reasonable and equitable choices and THEN talk about personal responsibility.
This site has the most interesting discussion on healthcare costs that I’ve yet read, because this issue of personal responsibility vs. personal freedom is truly the heart of the whole problem we are facing as a country. It goes far deeper than just our body shape –bodies are just a physical manifestation of our mental/spiritual condition, which is one of passivity and lack of self-discipline. Truly, there one can find the connections between our out of control health issues (obesity, smoking, etc.) and our out of control spending issues (credit card debt, mortgage foreclosurers,the government’s budget in general, etc.) I believe we must address this issue head-on, and then the rest will follow. As a nation, we have allowed ourselves to be manipulated by others (advertisers, government officials, etc.) into believing that we are incapable of doing anything for ourselves. We need to instill the quality of self-sufficiency back into our national character. All the problems being discussed at this site trace back to a lacking in this area, such as the comment earlier about an overweight diabetic woman who was content to just pop a pill (an external control) rather than control her problem herself by eating properly (an internal control). In the end, control must happen. If we don’t do it ourselves, it will be imposed on us from the outside in the form of oppressive government regulation. This can only happen if, once again, we choose to not be self-sufficient and instead ask the government to take care of us. If you want someone to pay your bills, then you have to face the fact that they have a right to restrict the way in which you acquire those bills. The fact that so many people are willing to lose their personal freedom in order to be taken care of by the government is indicative of how far we have traveled away from the quality of self-sufficiency, a quality that was once the defining quality of what it meant to be an American.
I really do not care for the “state” to tell me what is healthy and what is not. It can easily turn into what I should and should not do. Obama – Communism you can vote for.
It is just assumed that “obesity” is personal responsibility. That obese people, if they had the willpower, should be able to control their bodies.
Whether we like it or not, it simply isn’t true. There are so many overlapping mechanisms that humans have to keep us from losing weight, that it is impossible that there is one “solution”.
Obesity is not a health problem. Other than orthopedic problems, being “overweight” has no correlation to any health problems. The truth is, obesity is a “cultural” problem. It is a problem of style – what is stylish now is to be thin, whatever the cost.
Unfortunately, many people believe that thin is healthy – many studies have shown that being underweight is much more dangerous than being overly fat (and by overly fat, I mean people above 40 BMI)
The truth is, people who have BMI’s 30-35 have the lowest mortality rate.
And if obesity is such a death risk, why haven’t mortality rates skyrocketed? After all, it is commonly said that 60% of Americans are overweight or obese. Then why are we all living longer than ever before?
Audrey (aka Auð)´s last blog ..Tyr Painting…A look back
Um, has anyone thought of one of the other “personal responsibility” topics, one of the definite 3rd rails? People who have 8 or 10 or 12 (or in the case of one of my neighbors, 21) children?
The “pig in the python” is approaching Medicare. Let’s say that we are still debating this subject (and I do not consider shouting speakers down at town meetings “democratic debate), say, 10 years from now. By then we’ll have a large number of babyboomers on Medicare. Most will have purchased Medigap Plans. Medicare and Medigap (Medicare Supplements) — is this arrangement that not a blend of the government being a payor, with private carriers (by choice of the subscriber) handling part or all of the rest (depending on whether a non-mandated supplement was chosen)? Maybe we should extend Medicare coverage to everyone. Employers can select which Medicare Supplement (there are 10 or so plans, A – J) to provide as an employee benefit. The payment of the premium of this supplement is taxable to the employee. High deductible supplements would permit the participant to have a Health Savings Account. Everything is portable when one terminates employment….. the individual can either stick with the supplement at time of termination (and pay the premium to the carrier), or go with the A – J plan offered by the next employer. In 10 years anyway we’ll have LOTS of people looking to the government for Medicare and veterans looking at the VA. In the meantime, we’ve GOT to do something to increase the number of health care providers. I’ll be motivated to stay healthy to avoid LONG waits for appointments and spending hours in a waiting room. It’s already bad.
[...] “Seldom does anyone suggest how — or if — the individual’s role should be reformed,” argued Lisa Herrington, 46, a former health industry administrator who launched a discussion of the topic in May on the blog “Thoughts that Make You Think.” [...]