Isn't our health care system so expensive because people don't take care of themselves? Why should I have to pay for those couch potatoes who smoke, eat junk food, etc.? What about personal responsibility?

Phew -- a tough and possibly hostile question! Let's see if we can answer it -- one point at a time. 

The first point is easy: The high prices we pay are not because of improvident people's lifestyles, but because of the obscene profiteering of the medical/industrial establishment, which includes Big Pharma, Private Health Insurance Companies, and Hospitals.

Yes, people do get sick, but to what extent, if any, are they to be blamed for their illness? It's an ancient question, and the answer, carried forward by artists and writers, is that, to some extent, people do cause their own illnesses.  For example, in  William Blake's The Sick Rose, we read:

Oh rose, thou art sick!

The invisible worm

That flies in the night

In the howling storm:

Has found out thy bed

Of crimson joy:

And his dark secret love

Does the life destroy.

In other words, as Blake would have it, the rose is sick because she is too beautiful, too seductive -- it's her own fault -- she has nobody to blame but herself! In addition to invoking the age-old trope of the woman being the cause of her own hurt, this poem not only lets us direct our prurient gaze at her, it also lets us distance ourselves from her suffering: We would never act like that, we think, so what happened to her is unlikely to happen to us.  When beholding suffering, our primal impulse is to see whether the sufferers brought it on themselves, so we can comfort ourselves with strategies to avoid the same fate. It's not a very attractive trait, but many of our primal traits are less than attractive. But they are human.

Also human is the resentment we feel when we are told, by such well-meaning people as Dr. Bernie Siegel that we have brought it all on ourselves. In an attempt to be helpful, he asks, "How did you need this illness....what was your body trying to tell you?"

Personally, I find such an approach distinctly unhelpful, but it doesn't help matters to see, in real life, what seems to be the result of very unhealthy behaviors. If people smoke a pack of cigarettes a day, does it surprise us if many of them contract cancer? Yes,  these people's behavior did seem to cause their illness, but does that mean that they are to blame for it?  What about the inveterate efforts of Big Tobacco to hook youngsters onto nicotine before they reach the age of discretion? It took years before this country was able to see through the cigarette industry's smoke screen of lies, and see that smoking was a matter of public health. We the people started to see that smokers deserved more to be helped than demonized. Their addiction was partly the result of a social ill, and to the extent that we acquiesced to this ill, the blame for it was partly ours -- so the expense of treating those afflicted by it should be partly ours -- including the cigarette industry, which promoted it in the first place!

A similar example of a public malady is soft drinks. It is sometimes forgotten that the brand name of Coca-cola was derived from one of its salient ingredients at the time of its creation -- cocaine. It was there to addict the drinkers. Cocaine is no longer there now, but a lot of addictive caffeine is, not to mention so much sugar that soft drinks are now considered one of the chief causes of obesity, and thus of diabetes, and all its attendant ills. Sugar, it turns out, is at least as dangerous cause of disease as is fat. In 2016, an NPR article stated that

50 years ago sugar industry quietly paid scientists to point blame at fat

Do the thousands of drinkers addicted to caffeinated sugary beverages deserve more blame for their ills than the industry which, knowing the ill effect of all that sugar, to this day still tries to addict them with the promise, conveyed through multi-million dollar advertising campaigns, that these drinks will make them appear -- and feel -- cool? 

New York has a law whose public health aim is to limit the consumption of such drinks in public places. The same aggrieved people who decry these laws as attacks on personal liberty -- folks, they claim, should be free to drink as much coke as they want! -- these same aggrieved people are the ones who are affronted when they are asked to to contribute to the treatment of those afflicted with the results of this social ill.

Yes, there are plenty of people afflicted with results of public policy allowing -- and nowadays even encouraging -- the pollution of air and water, and the consumption of ingredients tardily recognized as carcinogenic; people whose sickness is caused by medical treatments too late designated dangerous by the authorities -- or not yet designated dangerous at all! Should those victimized by such public failures be held responsible for their illnesses?

And there are those whose illness cannot be shown to be in any way linked to the environment, and whose only misfortune is that they have been born to parents carrying genetic predispositions to disease. If they become ill with these diseases, are they to blame? Of course not! In these cases, and in the cases where the physical or social environment encourages disease, folks can't be blamed for what happens to them.

But surely there must be people whose illness seems not at all attributable  to the social or physical environment, nor to genetic predisposition. Let's imagine one -- say that supine gentleman in the illustration above. Let's say he has plenty of money to eat right, and plenty of education to know the dangers of not exercising, and let's say that everyone he encounters is setting a good example for him, and let's say that at work his boss is very understanding and does not put too much pressure on him (I know this last requires a leap of imagination), so that mentally he is in reasonable health, and let's say his family loves him, and yet, despite all this, HE INSISTS ON BEING A COUCH POTATO! If he gets sick, must we contribute to his health care?

My answer is yes we must, for who is to judge him? Or put it another way, if you -- God forbid -- should get sick, wouldn't you want to be treated with compassion, and not abandoned because someone judged you as unworthy of care?

We humans are all in the same boat. And if someone falls into the water, do we let them drown? No, we help them, because they are human beings -- and so are we. If we don't help them, we are less than human. 

"But I am not less than human," I hear someone say, "I just want to keep from falling into the water myself."

"But if you did fall into the water," I reply, "wouldn't you want to be helped back into the boat?"

"Of course, I'm human."

I tell this person, and everyone: "Remember that."

Dio 

PS: If you'd like to leave a comment -- and I encourage you to do so -- simply click on the "number of comments" area, and share your thoughts in the "comment rectangle" that appears.

PPS: We know that there are plenty out there who have stories to tell -- stories of your trying to cope with our dysfunctional healthcare system. Trouble is, we don't know what these stories are! That's where you come in. If you have a story to tell, you can email me at indivisible12401@gmail.com. You can be as anonymous as you like. Thanks!