The Right Prescription

Unhealthy Choice

Personal responsibility and the health care debate.

By 9.17.09

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Of the countless reasons for our health care crisis, one, a lack of personal responsibility, has been getting short shrift. It certainly failed to get a single mention in President Obama's health care speech last week.

Likely it is because the whole concept of personal responsibility and its cousin self-reliance get short shrift. Once as American as pumpkin pie, personal responsibility has slowly been whittled away to the nub of an idea. When New England farmers -- the original and definitive self-reliantists -- began accepting farm aid and relying on government handouts, you knew it was over.

The problem was "briefly" addressed in the Republican response to Obama's speech. Louisiana Congressman Charles Boustany angered those few newspaper columnists left when he said: "I operated on too many people who could have avoided surgery if they'd simply made healthier choices earlier in life."

Sadly, what Boustany did not say was something to the effect that my health is my responsibility, not my government's. He also failed to mention that 75 percent of the $2.1 trillion dollars spent in this country last year on health care costs were for chronic diseases such as heart disease that are largely preventable and even reversible by changing diet and lifestyle. No, that was mentioned by Dr. Dean Ornish, founder and president of the Preventive Medicine Research Institute.

By the time the morning edition landed on the lawn, apologists had fired back at Boustany with a litany of pretexts for being fat and lazy as long as my arm. Mary Schmich -- who certainly looks healthy judging from her mugshot -- had more excuses than a pregnant nun: "A lot of people don't have a wide set of… healthy lifestyle choices," wrote Schmich in the Chicago Tribune. Schmich interviewed an "expert" who observed that "not everyone can afford to buy organic, join the gym, live in a walkable neighborhood."

Schmich and her expert are being disingenuous. She is erecting a whiny, politically correct straw man in the hopes of drawing attention away from the issue. Rep. Boustany was certainly not referring to those with genetic predispositions, or the poorest of the poor who live in drug and crime-infested areas where supermarkets and organic farmer's markets are few and far between, and cannot afford gym memberships. (By the way, I know of a gym everyone can afford. It's called the outdoors. I use it every evening.) Nor was he talking about the few folks who live in the bayous and Appalachian hollers and in Death Valley trailers.

No, he was talking about average Americans who weigh way above average.


SCHMICH ALLEGES that we are too busy to eat well, and -- allow me to paraphrase here -- that you can't expect us to turn off Gossip Girl and go for a brisk walk 'round the block; that you can't expect us to stop smoking or stop at two drinks; that you can't expect us to bring a healthy lunch to work when you could order in a pizza with extra toppings. Besides somebody has to bring in Krispy Kreme donuts every morning or how are we going to get motivated to sit our big butts down in front of the computer? Rep. Boustany is not being fair. He's for punishing the poor. And the lazy. And the obese. In other words, punishing the victims.

Of course, who is really being punished are those Americans who maintain a healthy lifestyle and then have to pay the medical bills of those who won't.

In a piece in the August 12 Wall Street Journal, Whole Foods CEO Jim Mackey offered a modest proposal that upset more than a few liberals: "Rather than increase government spending and control, we need to address the root causes of poor health," he wrote. "This begins with the realization that every American adult is responsible for his or her own health."

Mackey's op-ed resulted in a call for a nationwide boycott from its liberal base of shoppers. The Boycott Whole Foods' Facebook page now has nearly 34,000 members, all of whom seem offended by Mackey's suggestion that government-run health care is not a human right.

I have always chafed at the government telling motorcyclists or bicyclists that we have to wear helmets for our own safety. Such laws, however, have always been embraced by liberals who note that the taxpayer might have to pay for your hospitalization, surgery, and rehab should you suffer a head injury. This liberal logic, however, doesn't seem to apply to other types of reckless behavior, like shoveling two Big Macs down your gullet every day for lunch. Suddenly it is not an issue of taxpayers being made to pay for others' reckless and stupid behavior. It's an issue of punishing society's victims.

I realize it is not easy to be healthy in this country. It takes a genuine effort. With the exception of produce sections, supermarkets stock mostly unhealthy foods, full of sodium and fats, because that's what most of us continue to demand. Some towns -- my own hometown, for instance -- have chosen to ban farmer's markets in an attempt to lessen the competition on brick and mortar grocers. Here in the Midwest we've chosen to design our cities and towns with few if any sidewalks and with wide, fast streets in what seems an effort to discourage walking. With both parents choosing to work, no one has the energy to cook slow, healthier food. And forget about trying to eat healthy in a restaurant. Brown rice? Whole wheat pasta? What are you, a comedian?

We libertarians would never dream of telling people how to live their lives. You want to smoke a carton of cigarettes a day, let me get out of your way. But when the day comes -- and come it will -- don't expect me to pony up for your open-heart surgery with a public option.

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About the Author
Christopher Orlet writes from St. Louis.