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Dueling Delusions in Health Advocacy: “Affordability” vs. “Personal Responsibility”

One side insists that we must have affordable health care for all.  

The other side insists that individuals must take personal responsibility for their own health.


For the “affordability” advocates, they mean that individuals should all be able to pay an affordable amount for health care--even if that requires government-funded free or highly subsidized health care for many, such as Medicaid & the Affordable Care Act.


For the “personal responsibility” advocates,  they mean that many people choose to do unhealthy things, so they become unhealthy.  Why should “responsible” healthy people with healthy habits pay for the "irresponsible" ones?  In fact, doesn't free and subsidized health care encourage unhealthy behavior, since unhealthy people pay little for the consequences of their choices?


What the affordability proponents don’t discuss, is whether the country can afford to pay for widespread free or highly subsidized health care--especially when 60% of adults have expensive chronic diseases, increasingly starting in childhood and continuing throughout life.  


Meanwhile, the personal responsibility proponents never explain, how someone who is never taught personal responsibility for her/his health is supposed to act responsibly. 


With American health care 1.5-2x as expensive as other countries, @$12,000/person cost compared to median income of $27,000/person in 2019, & half of federal spending going to health care--it turns out that national debt, i.e. our kids and grandkids (and great-grandkids+) are subsizing our health care.  Future generations, who will have to pay for their own health care on top of a big chunk of ours, certainly won’t think of this as “affordable”.


By the same token, our culture is changing rapidly, with epidemic seat-time at school & screen-time at home. Most children are not learning healthy habits, either at school or at home.  We have chosen to stop teaching physical & health education at school, we have slashed recess, and both school & home meals are often full of unhealthy, sugary, highly-processed calories (though meals at many schools improved somewhat 2012+, after new USDA standards were introduced).


Let's consider literacy. We insist that all Americans learn to read & write--and then we as a country take responsibility and pay to teach those subjects through the public K-12 school system--and we hold schools accountable for doing so.  Yet we have wantonly ignored health illiteracy, while health behavior has continued deteriorating...  


So here’s an idea:  how about teaching all children throughout their K-12 schooling to become responsible for their own health, in order to develop healthy habits for life?  Then we will have a much healthier population and actually be able to sustainably afford universal health care!

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