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Personal Responsibility - are we ignoring that? Maybe just a little?

Posted by Cody Heitschmidt --Went Live: Monday, August 24, 2009
First off, let me be clear... I think health care needs some reform.

It needs to be more accessible than it is, pre-existing condition folks should have better access. I think portability from employer to employer is crucial, (really if we can make our cell phones portable from carrier to carrier, can't we do Health Insurance from employer to employer?) I have always been in favor of lending a hand to folks TRYING to get back on their feet. Ok so we are all clear... I think we need reform! Right!?!?

This post is not a counter to health care reform, it's not a "I am right and you are wrong" scenario. My thoughts in this post are an add-on, a "we need to address this too" statement.

"What do we do with all the folks who don't want to help themselves?"

What do we do with the folks who say they can't afford health insurance but smoke 3 packs a day at a cost of $5 a pack? (thats $450 a month, that covers health care)

What do we do with the folks who just don't choose to take part in their employers health care program, cause they WANT the money at home to pay for more neon glowing lights under their car?

What do we do with the folks driving $35,000 suvs from "cash for clunkers" with a $700 a month car payment, who "can't afford health insurance?"

What do we do with the folks who have $300,000 houses, that "can't afford health insurance?"

What do we do with the folks who are already on Food Stamp programs and have decided it's better than getting a job, so they just don't get one? They sure as hell "can't afford health insurance"

Don't come back with the ridiculous argument that health care should be like Police and Fire. It's not, those are public services that respond in a time of need, a very specific time of need. They are not personal services.

Health care should be treated like food and shelter, if you HONESTLY can't afford it... we have programs for it. (I know some of those programs need reform, remember... I stated that before and I am on favor of overhauling medicaid) but... If you want something better, if you want fancy meals and a nicer house... It's your own personal responsibility to improve your situation. I am all in favor of helping folks along the way, but if we don't force people to take some personal responsibility, we will go down the same path as welfare has before, incredible abuse and waste.

I swear if you come back at me with arguments about extreme cases (pre-existing conditions, handicap folks that can't improve their situation or kids, I will give you a wedgie... I wanna help those folks, I have said it a million times)

We as a nation need accept more personal responsibility... We need to prioritize things just a little differently I believe. We need to realize that health insurance is more important than fancy cell phones, cable TV in our homes, cool new cars, owning a home, flat screen TVs and designer clothes. If we as citizens don't believe its more important than that... Well... I don't know what to think.
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12 comments to read/post yours:

  1. First off, I'm with you. There's a lot of people who don't think it's important. If something goes horribly wrong (like they get shot or have a bad car accident), the hospital has to take care of them anyway, so why bother having insurance? The problem is, that leads to a very reactive medical system. ie. You don't know you have high BP or high cholesterol until you actually have a heart attack.

    I have a lot of random thoughts that I can't fit into a coherent comment:

    You say health care isn't like fire and police, but why can't it be?

    Flip side, I don't want people who are operating on my vital organs to get paid like police, firefighters, and teachers... :)

    Even if those people you spoke of who don't think it's important to have insurance were given insurance, would they ever go to the doctor in a preventative manner or would they just have insurance when they show up with their heart attack or gunshot wound?

    I think we all appreciate things more when they aren't just given to us, so i like the idea that you have to either earn insurance by getting a job, or pay for it, but let's go back to your fire/police analogy; particularly fire. What would happen if fire protection was more like the health care industry right now? If you can't afford fire 'insurance' from any of the private fire fighting businesses in town, and your house catches fire, it just burns to the ground. You can try to put it out yourself if you want, but you're not gonna get any help from professionals. Don't you think there would be a lot more outrage about that than there is about people who don't have healthcare? And that's just a house, not your actual body.

    Like I say, I don't know the answer. I don't like that what's happening right now is happening really quickly and I don't understand it completely, but I also don't think the current system is the answer. I don't want to end up like Canada, where you might die before you can find a doctor to take you, but I also don't want to get to the point where I have a good job and I still can't afford insurance. Who knows what the answer is.
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  2. Scott,

    Great comment and i agree it is a confusing and complicated issue.

    I also think its happening too fast here and now. I want things to get better, I just don't want us to make the situation worse by jumping the gun.

    I DO NOT have the answers for health care reform and have never claimed to.

    All I do know is that it would be a huge progressive step to get the folks that can take care of themselves to actually take care of themselves.

    Again... great comment. thanks!!
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  3. I feel that this personal responsibility argument repeatedly comes out on Codytalks…whether it is guns (“guns don’t kill people”), mortgage assistance (these people agreed to these predatory mortgages, so let them fail), minimum wage (why set this limit, let individuals decide what they will work for), and now health care.

    I honestly don’t know how many people, like you suggest, simply pass on health insurance because they want fancy things (I kind of suspect that this is a small number people and somewhat a myth). Like Cody, I won't get bogged down in health care reform details, but will try to respond to the general question he asks…”What do we do with all the folks who don't want to help themselves?”

    Short answer, we pass laws to protect people and/or promote ideals, national interests, etc., whether or not the same people benefiting want to help themselves. We pass laws to limit and contain harm-to-others, to promote justice, etc. all the time.

    We (Americans) pass laws that require drivers to have auto insurance even if the owners want to roll the dice that they won’t hurt someone else. We pass laws that don’t let people work for below minimum wage even if they are willing to do so. We regulate safety conditions of workplaces to protect workers, even if they don’t mind the danger. We provide subsidized school lunches even if parents could afford to pay more or could pack their kids a lunch. We provide public education even if parents could afford private schools (and we require kids to go to school or get educated, regardless of what those kids or parents want). We don’t let communities have high levels of arsenic in the public water supplies, even if it would be cheaper otherwise. We pass laws criminalizing certain drugs, even if it is an individual’s choice to use drugs. We provide social security payments to older Americans whether they are millionaires or destitute, and regardless if they have saved every dime and have a big retirement nest egg or if they frittered away every dime on boats and plasma TVs.

    Indeed, we Americans passed a law that provides single payer health insurance coverage to every U.S. citizen that is 65 years or older, whether they want it or not, whether they could afford to pay for their own or not, and whether these older Americans have cable TV or designer clothes.

    Surely you aren't suggesting means testing for medicare, or social security, or public school, etc.

    Here, we will (hopefully) do something similar, and ensure health care coverage for all Americans (as well as other much needed health care reforms), which will benefit those currently with medical coverage, those in need, as well those who simply don’t want to help themselves. By passing health care reform (and in turn perhaps benefiting some who could help themselves but for whatever reason choose not to), will hopefully lead to a healthier, more economically viable nation, reduced health care costs across the board, an increase in preventive care, a clamp down on insurance company abuses, tax credits for small business to assist in compliance, health care subsidies for poor and middle class families, etc.

    How we get there, and/or what the final proposal includes/requires, however, remains to be seen.

    We pass laws for folks “who don't want to help themselves” all of the time. Not everyone agrees with or likes these laws, and not all of these laws are perfect, but you can’t deny that we have tons of them.
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  4. I would be remiss if I didn't add one more thing. Cody, fire fighting used to be a wholly privatized system, paid for by insurance companies.

    "[t]he United States did not have professional firefighters in the sense of government-run fire departments until around the time of the American Civil War. Prior to this time, amateur fire brigades would compete with one another to be the first to respond to a fire because insurance companies paid brigades to save buildings."

    http://en.wikipedia.org/wiki/History_of_firefighting
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  5. Dave as usual comes with well educated and intelligent comments and as usual, pretty much contrary to mine.

    Dave, if you use car insurance as a metaphorical example... are we going to pay for everyones car insurance? Car insurance kinda seems to be working privately huh?

    I would be in complete favor of similar laws requiring health insurance.

    If you can find anywhere that I said "let them fail" concerning predatory mortgages... please provide me a link. I do think folks have to take some responsibility, but man I dont remember saying let them fail.

    Do you not think a system that allows folks that could pay for lunches to get free/cheaper lunches needs reform?

    Do you think its ok that we pass laws criminalizing drugs that it is a person right to take?

    Minimum wage can just as easily be looked at as forcing an employer to pay someone more than the work they are doing is worth.

    As far as testing for SS medicare, public ed. Of course i am not suggesting we test for that. I tried to make the point COMPLETELY clear that I am not 100% against Gov. involvement in things. But I do think there has to be compromise.

    Are you suggesting that the Gov should feed and house all of us? (of course your not, thats why I am not putting words in your mouth)

    If people choose to be homeless as oppossed to having a job, why try to create a Social program to just give them a home.

    Now... I will try again... "If someone, due to circumstances, needs tax dollar help getting a home or food or HEALTH CARE... I am all in favor of lending them a hand" I will work towards and campaign for a system that does that better.

    Where would fire fighters be today if it was still Private???

    I don't know but they may be getting paid what they deserve to charge into a freaking burning building that some joker lit on fire for fun to save folks.

    Just a thought!?
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  6. Cody, this is a worthwhile debate....I didn't mean to put words in anyone's mouth, and just kind of paraphrased earlier arguments that I recalled. Sorry.

    To answer a few of your questions…no, I do not have a problem with subsidized school lunches—right now, all school lunches are subsidized by the government to an extent—with those in need getting greater subsidies or even “free” lunches.

    You also ask if I think it is ok to pass laws criminalizing drugs that it is a person right to take? I am not familiar with the right to take drugs—medicine or otherwise—but no, I do not have a problem with laws criminalizing drugs, so long as the laws are reasonable. In theory, we could make aspirin illegal, but I think that would be stupid and unreasonable. We could also legalize heroin, which I think would also be stupid and unreasonable. The gray areas in between , however, is where reasonable folks can differ.

    I guess lots of times on this blog I focus on whether we “can” pass these laws; and others focus on whether we “should” pass these laws.

    I think some of the proposed health care plans do mandate coverage (similar to auto insurance requirements) but then also require employers to share in the cost. This would be coupled with certain exemptions and subsidies for people who cannot afford insurance and for small businesses in general.

    For the most part, I think we all agree that we can/should help people, we just disagree on how much help to give and who and how they should receive it.

    I do think the hypothetical homeless man who doesn’t want a home (and let’s be honest, usually has a mental disease); the mom who would rather live on food stamps than work; and the person refusing to co-pay for health insurance he or she could afford to instead live a jet-set life are hyperbolic. The vast, vast majority of people do not want to be homeless, or live on food stamps, or go without health insurance Here, you agree reforms are needed, and no offense, focus on hyperbole like these alleged jet-setters foregoing insurance rather then focus on working towards common sense reform..

    Instead, can’t we focus on ways get the most out of reform, by expanding Medicaid coverage to include more of the working poor and those in need; cut down on insurance company abuses (like denial of coverage); require insurance companies to spend more of the premiums they collect on care rather then profits; implement sliding scale assistance subsidies to help middle class and working families get coverage; put caps on “out of pocket” expenses for individuals covered by insurance that otherwise frequently lead to bankruptcy; tax credits for small businesses to help them cover their employees; guarantee insurance for all children; and implement health care modernizations; etc.

    BTW…I am glad to see you back at Codytalks with some politics.
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  7. Ohhh, private fire fighting was horrible and basically like organized crime, with rival fire fighting brigades fighting other brigades to prevent them from responding to each others calls, setting fires in buildings where the owners didn't contract with their brigade, etc. They were thugs and corrupt. Making fire protection a public service was a huge step forward.
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  8. Ok, time for a "mom" and Human Resource person to step in here for a comment - first of all to say "hi" to all three of you and then to say I watched an excellent, informative (probably very one sided) health care dvd this week at a staff meeting regarding this issue - it really opened my eyes. It stated how the pharmaceutical companies are always saying they are spending most of their money on research and development when in truth it really is on marketing and profits - now all I see are "TV ads" - it also did show the misuse of how insurance companies administratively are not efficient. It was mainly put on by Harvard and Princton doctors - but they really were pleading - they felt they did not want to be "business people" any longer - they want to go back to saying "no" you don't need those tests - "let's wait and see if you'll get better" - but have been either afraid of attorneys in the end or their administrators for not being able to "charge" for procedures. They really want some "overall control" and felt the VA was pretty much doing a good job just not being given enough money to do it. I, by no means, am knowledgeable enough to talk about this - but in my profession it does break my heart when my employees come in and from the very beginning tell me "oh no, my parents tell me just get my kids on a medical card - that's what they did and it's lots cheaper" - when I know the same employees, making the same money have our insurance - again, I don't know all the situation - but it seems just be somewhat of a generation thing that sometimes scares me.
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  9. Now my Mom is involved I gotta mind my manners!!

    Dave as always fun to discuss/debate with you.

    My Mom is coming from the trenches of Human resources and coming from a company that works hard to provide good, affordable Health Care and MANY of the employees don't take advantage of it.

    My only standing argument is that to some extent personal responsibility has to play into it.

    I am starting to think that just passing a law requiring health insurance may in fact be the answer... along with massive reform in the Insurance industry. Also reform of Medicaid to make it possible to not make people who genuinely can't afford it not become criminals.

    I would completely in favor of that.(with the knowledge I have in my head right now)
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  10. I thought this little gizmo was helpful in seeing how the health reform proposals would affect you, wherever you fall. It specifically addresses those uninsured by choice.

    http://www.npr.org/templates/story/story.php?storyId=111499109
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  11. When I became pregnant at 32, I could not get health coverage at any price, with any company, well, because I was already pregnant. I could not get any care subsidized by the state or gov., well, because I was above poverty level. Something was wrong way back then, and it's still wrong now. Health care is in need of MASSIVE reform, above and beyond my own personal experiences.
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  12. Anon,

    I agree... and i sincerely hope that you have made it through the crap and are doing ok now even with what you were dealt.

    thanks for comment.
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I love the discussion in the comments.. so... GO FOR IT!

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