Thursday, June 18, 2009

Acting White: Personal Responsibility Aside and Health Care

This morning I hauled my sleepy butt out of bed at 5:15am for a 6:00am spin class, “Terrible Thursday”. Why? Take your pick, weight management, cardio-endurance, endorphins - whatever. It really does not matter; I just do it four times a week, come hell or high-water.

The exact plea that lent the title of this post was, “But personal responsibility aside, absence of adequate health care is crucial.” The words came from Mary Frances Berry, in an article for Essence Magazine entitled “What Obama’s Health Care Reform Means for Black America” (here). Who would argue that adequate health care is not crucial? Only a calloused idiot, which I believe I’m not. On the other hand, I wonder how personal responsibility can exist as an ‘aside’ in the discussion.

It seems to me that responsibility is the heart of the health care issue. Our entire health care system, including all its woes, is predicated upon people abdicating their personal responsibility to their health. If it taste good, eat it. To her credit, Professor Berry acknowledges in her argument that blacks exercise less than whites, seek out grease, starch, and sugary foods even when income makes this avoidable. She goes on to talk about how blacks suffer hypertension, strokes, and other maladies at disproportionate rates to whites. But in between her cause and effect offering, Berry slips in the personal responsibility aside escape-clause. Not so fast professor!

Me thinks that the cart has been placed ahead of the horse. I contend that a health care system that demands that people are their own first and best line of offense in taking healthy care of themselves would cost nickels and dimes against today’s borrowed dollars. The prevalent emergency room treatment Berry speaks of, among the under/uninsured, is the absolute most expensive/least effective way to delivery health care. Astonishing ER expense is just the logical end-point of a health behavior mentality/system wholly derailed.

We treat our bodies like crap from the earliest age and then look for the government to deliver a humane and affordable, or free, ‘get out of bad-health jail’ solution. Slight-of-hand arguments, like Professor Berry’s, put willing politicians and our empty pocketbooks on the bailout hook. This can’t go on! There is no reform for a system that is morally, ethically, scientifically, and economically bankrupt. It must be dismantled and rebuilt. We are now trying to reform a system that spends hundreds of billions of dollars each year searching for and delivering responses for avoidable ailments. As a start, smart people, like Berry, should begin by not using those words ‘personal responsibility aside’.

James C. Collier


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lincolnperry said...

Now Mr Collier, I'm not making excuses for my poor and working class brethen, in this whole heathcare debate. No one is talking about the problems in poor health have a direct link related to the food chain.

The Republicans dont want to talk about corporate Agri-business putting HFCS in everything in the center aisles of the grocery store...where most poor Americans shop and one of the leading causes of type II diabetes, which is driving healthcare cost up!

I say tax the crap that makes people sick, soft drinks, and snacks, and other non nutrient value carbs and junk food in the center aisle! Tax the fast food restaurants as well. Use that tax to help pay for universal healthcare!

Anonymous said...

I say deny treatment to those who abdicate personal responsibility. Doing otherwise has clearly destroyed the incentives for self-preservation.

Of course, our society has become far too namby-pamby for this. How dare I suggest that the 400-pound 30-year smoker with AIDS doesn't deserve the best possible medical care?

Darwin is rolling over in his grave.

lincolnperry said...

@Anon 9:02pm
Do you suggest putting Proctor & Gamble, RJ Reynolds, out of business...Corporate Agri-Bus and Big Pharma are the culprits in our healthcare crisis as well!

Anonymous said...

Linc, those companies will go out of business as soon as people stop liking their products. I believe we all have a right to smoke, or eat junk food, or ride motorcycles without helmets so long as the government (and therefore our fellow citizen) isn't picking up the tab for the side effects.

Unfortunately if the government does end up with that responsibility (as it appears they will), then it becomes "in the public interest" to shut down any business that the government thinks is unhealthful.

Michael in LA said...

Preventative health care includes annual physicals, twice yearly dental exams, as well as prudent diet and exercise regimens. Getting a physical and seeing the dentist are pretty expensive when you don't have insurance. I know what folks are going to say - just buy your own insurance.

To make most private insurance affordable to working and middle class people - the deductable is set pretty high. That high deductable kills the "$10 copay only" visit to the doctor and renders the policy pretty much a catastrophic illness/injury policy.

There needs to be an alternative private health care policy that regular people can buy. It should have an affordable deductable and co-pay, prescription medicine coverage, and not exclude coverage for trivial pre-existing conditions.

If the private sector can figure out how to sell other goods and services on the cheap and turn a profit - why can't the medical/insurance industry figure it out for theirs?

The idea that good insurance has to be tied to a good job stifles entrepreneurship. How many people are out there with a good business idea, but are afraid to make the leap and leave themselves exposed to bankruptcy via a medical emergency?

Anonymous said...

The richest country in the world should not have 20,000 people dying a year because they can't afford healthcare.

Maybe some people should take more responsibility for their health. At the same time America needs to take more responsibility for its most vulnarable citizens.

And race isn't relavent, as there are vulnerable people of every race.

James C. Collier said...

To clarify - I support universal healthcare, but not under the current system, a system that attempts (and fails) to provide for people that which they are unwilling (through behaviors) to provide for themselves. Universal healthcare will accelerate the economic collapse of the whole system, and this looks like the only way we are going to get onto the right track. Unfortunately, the our whole economy may go down as well. It ain't going to be pretty!

Anonymous said...

I agree, James.

Another big culprit is the lack of doctors and the factors that contribute to it.

Malpractice insurance can be upwards of $100,000 per year for individual doctors, particularly surgeons and specialists. This is due to aggressive malpractice lawyers and civil juries which, increasingly, have no concept of what a reasonable award is. Even for low-risk specialties, it can often account for a third or more of a doctor's salary. Call them greedy if you will but, for the years of school and the hours they put in, doctors are getting a raw deal.

It's a simple issue of supply and demand. If we really want more and better medicine, we need more and better doctors. Making doctors tax-exempt, subsidizing medical education, and weakening the stranglehold of the AMA would help. But these do not have the quick-fix populist appeal of "universal health care".

Anonymous said...

I don't know that things will ever be fixed to everyone's total satisfaction, but at least we're having a discussion to talk about the issue.

The other issue that the author raises, though, is an important one as well. Far too many Americans are chronically over weight due to poor health choices and a lack of adequate exercise. Consumerism and the drive to make money on the part of food/snack companies add to the chaos, as many of the products they make are designed to taste good (to keep you coming back) but not necessarily to impart a health benefit at the same time.

Add to this the not-so-oft mentioned likelihood that all the additives and preservatives in our foods impede the body's ability to burn calories through natural metabolic processes, and you have a recipe for disaster.

I guess the best advice to give folks is, to the extent their budgets and circumstances allow, make the healthiest selections you can in the supermarket, trim back on counterproductive dietary habits, and get out and exercise!

Anonymous said...

"James C. Collier said...

To clarify - I support universal healthcare, but not under the current system, a system that attempts (and fails) to provide for people that which they are unwilling (through behaviors) to provide for themselves. Universal healthcare will accelerate the economic collapse of the whole system, and this looks like the only way we are going to get onto the right track. Unfortunately, the our whole economy may go down as well. It ain't going to be pretty!"

Okay, thanks James point taken.

Anonymous said...

You cannot have equal outcomes on health care. I just bought 6 unhealthy donuts and a bag of chips pigged out on both but I am not going to blame anyone for my bad choices. Omaba is not my God nor is the government.
Lastly the US is not the richest country in the world. It is on its way down. Hopefully it will be broken up in different regions: white, black, Hispanic, etc.

As a white male I am tired of caring so many lazy people.

Mr Biggs said...

"I just bought 6 unhealthy donuts and a bag of chips pigged out on both but I am not going to blame anyone for my bad choices. "

No but we will blame you for taxing the system, gee thanks for making my insurance premiums stay high by contributing to the risk they will have to pay out for triple bypass surgery or whatever it is that gluttons need when they've gorged themselves on too many twinkies.

Anonymous said...

Actually I am HWP and take no meds. I will not require tripple by pass but thanks for caring.

Lastly I didn't eat the six donuts all at the same time nor the chips in fact that was all I had for a day and a half.

Anonymous said...

66% of U.S. adults were overweight or obese in 2003-2004.
Women 20–34 years old had the fastest increase rate of obesity and overweight.
80% of black women aged 40 years or over are overweight; 50% are obese.
Asians have a lower obesity prevalence when compared to other ethnic groups. However, Asians born in the United States are four times more likely to be obese than their foreign-born counterparts.
Less educated people have a higher prevalence of obesity than their counterparts, with the exception of black women.
States in the southeast have higher prevalence than states on the West Coast, the Midwest and the Northeast.
16% of children and adolescents are overweight and 34% are at risk of becoming overweight in 2003-2004.
White children and adolescents had the lowest prevalence of overweight and being at risk of overweight compared with their black and Mexican counterparts.

If you just isolated the white population from all other groups this would be a great country on par with Sweden but of course Sweden is now going down as it accepts more non whites.

The scary thing is that liberals are going to try and force equal outcomes in health care. How they are going to do this is not easy to understand other than rationing health care.

James C. Collier said...

Anon 11:09, no argument with your stats, but from my visits, Idaho ain't Sweden, and Sweden ain't heaven (though you seem to believe it is). Diverse invitation is the root of this country. Your dreamy clinginess to your whitesness, as the solution to our problems, is unimpressive, but stick with it as it seems to be all that you have to offer.