Monday, June 22, 2009

A Missing Element in the Healthcare Debate: Personal Responsibility

The healthcare debate that the Democrats have been wanting since 1994 is in full swing, and we can expect the political headlines of the next few months to be dominated by it. Unfortunately, this being modern American politics, most of the rhetoric will consist of childish ad hominum attacks and ridiculous straw man arguments rather than thoughtful discussions about public policy.

It's difficult to say what Thomas Jefferson would have thought about the current healthcare debate. In his time, a sick person would simply be cared for by other members of the household. Only in the event of a very serious illness would a doctor be summoned, and the fee would simply be negotiated between the doctor and the head of the household. The very concept of a "healthcare system" would have been confusing to Jefferson, or any person from the 18th Century.

On the one hand, he believed in small government and low taxes, so he would likely have strongly disapproved of a healthcare system run by the government. On the other hand, he would have believed that the fruits of the advances of medical science that have taken place since his time should be equally available to all citizens, irrespective of income. Let us not forget that "life" is among the natural rights to which he believed all human beings are entitled.

If a government-run healthcare system is the only means by which this natural right can be made into positive law, he may have supported it, however reluctantly. But I believe he would have wanted it limited to providing treatments for conditions that are beyond a person's ability to control.

Why? Because one thing that I think is certain is that Jefferson would have told us that we needed to focus on the issue of personal responsibility in matters of our health. How much healthier would we be if everyone took a half-hour walk every day? If we eschewed fast-food in favor of light, home-cooked meals? If we didn't smoke? If we looked to our own health with more responsibility and common sense, it would do more to improve the overall health of the American people than the creation of the best healthcare system in the world.

Jefferson himself was an extremely healthy man, which he attributed to his lifelong habit of soaking his feet in ice water every morning. Throughout his life, he was essentially his own doctor. In his time, everyone was expected to have rudimentary medical knowledge in order to take care of themselves and other members of their household. They expected to take care of themselves whenever possible, rather than putting their trust in someone else. In that regard, they were far more free than we are.

Obviously, we need a healthcare system of some form so as to provide citizens access to medical science in the event of serious illnesses and diseases, to ensure the safe delivery of babies, and to take proper advantage of the tremendous advances in medical science that have taken place since Jefferson's time. But we must face the fact that a very large proportion of our health problems stem from our own lack of responsibility.

Rather than depend entirely on the government, let's start by putting down the cheeseburger and getting a bit of exercise.

No comments: