Even though we may be reluctant to pay a premium for our insurance because of others who engage in irresponsible behaviours (for example: smoking, overeating and health insurance), Sandeep Jauhar, M.D. reminds us of some pertinent results from the health care field.
Jauhar provides evidence that “punitive measures to force healthy behavior” do not work; reminds us that we all undoubtedly engage in some form of comparable, irresponsible behaviours (e.g. using a phone while driving); and that the issue of personal responsibility in health care is a lot more complex that we imagine:
Personal responsibility is a complex notion, especially when it comes to health. Individual choices always take place within a broader, messy context. When people advocate the need for personal accountability, they presuppose more control over health and sickness than really exists.
Unhealthy habits are one factor in disease, but so are social status, income, family dynamics, education and genetics. Patient noncompliance with medical recommendations undoubtedly contributes to poor health, but it is as much a function of poor communication, medication costs and side effects, cultural barriers and inadequate resources as it is of willful disregard of a doctor’s advice. […]
Healthy living should be encouraged, but punishing patients who make poor health choices clearly oversimplifies a very complex issue. […]
‘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.”
No mention of moral hazard.
Comments
2 responses to “Personal Responsibility and Our Irresponsible Behaviours”
On a related note, I think along these lines you would appreciate Marc Ambinder’s nuanced and sophisticated piece in the Atlantic on obesity.:
http://www.theatlantic.com/magazine/archive/2010/04/beating-obesity/8017/
Good, representative paragraph:
“This jumble of circumstances and effects is what Thomas Frieden means when he says that just being an American can naturally lead you to be obese: obesity is an almost inevitable consequence of living with our cultural norms, our history of agricultural production and subsidies, our long-standing socioeconomic inequalities, and the impact of technology on our behavior and bodies. Against this formidable dynamic, America has erected two lines of defense: name-calling, and hectoring about diet and exercise.”
Thanks, Cedar. Sounds about right and right up my street.
I’ll check out the item and write another comment here or write a short post.
Thanks.