Wednesday, January 10, 2018

You’re Sick. Whose Fault Is That? - The New York Times

On my pediatrics rotation in medical school, several residents told me they worked with children in part because they sometimes found themselves judging adults: Did they do drugs? Were they fat? Why did they drink so much?

The idea that Americans should take personal responsibility for their health has recently received renewed attention. Vice President Mike Pence has argued for "bringing freedom and individual responsibility back to American health care."

Mick Mulvaney, director of the Office of Management and Budget, expressed a more punitive view, saying, "That doesn't mean we should take care of the person who sits at home, eats poorly, and gets diabetes."

The call for personal responsibility is not new, nor just conservative. Barack Obama said, "We've got to have the American people doing something about their own care."

Many Americans think it's O.K. to ask people with unhealthy lifestyles to pay higher insurance premiums and deductibles. Efforts to inject more personal responsibility into health care, however, have not consistently been shown to lower costs, improve outcomes or save lives. Effectiveness — or lack of it — is often in the eye of the partisan beholder.

What does it actually mean to take personal responsibility for health?

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