I’m not really sure how to word this, it’s just some thoughts floating through my head I’m trying to make sense of.
Some people believe in universal health care as a right. Some people believe that people should be able to do whatever they want to their own bodies.
Is there a tipping point when society has the right to say, “Yes, you can do this, but if you make this choice, we will not be responsible for the effects it has on you?” or do we allow any behavior that only affects them no matter how dangerous and force the rest of society to pay for them?
What got me to thinking on this track was the poll on legalizing drugs. I voted that yes they should be legal, it’s my body after all and it’s not affecting anyone else. But then I got to thinking that’s not really true. There are the costs of treating overdoses, addiction recovery, and I’m sure there are other negative effects I haven’t thought about, that affect everyone in society.
Remember the parable of The Grasshopper and the Ants? I remember two different endings to the story; each of which illustrate a point I think you are asking about. In one version, the Ants let the Grasshopper into their nest and fed him. In the other, the Ants leave the Grasshopper to die outside.
I feel that the
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tipping point when society has the right to say, "Yes, you can do this, but if you make this choice, we will not be responsible for the effects it has on you
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is when society looks into its own stores (the individuals feel that their taxes going towards welfare are too high, or the governors show us that our communal stores of X commodity is low and cannot be given to everyone who needs it, etc) and finds that they (the good producers and taxpayers of the group) would need to feel too much of their “fair share” of the pain in order to keep others (those seen as lesser, lazy, irresponsible) from suffering/dieing from their own bad decisions.
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do we allow any behavior that only affects them no matter how dangerous and force the rest of society to pay for them?
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Society treats its people, as we in our variously rich/poor families treat our family members. If we (a society) are rich we can lavish gifts upon our children and give them all sorts of extracurricular activities and expensive medical/psychological support. We govern them with a gentler hand prone to spoiling them later in life. If instead we are poor, every cent must be accounted for and we cannot find the extra time in our busy day to properly care for our own kids. Everyone feels the full force of their own mistakes, and either dies early or quickly learns how to act.
It is just as you said, that in times of plenty people act as though it is the responsibility of Society to uphold its end of the “social contract” for its citizens. In lean times people act as though it is the responsibility of every individual Citizen to uphold their end of the “social contract” for Society.
I see universal healthcare in the same light as public education. I don’t think we have some sacred inalienable right to education. But society doesn’t work too well citizens aren’t given basic tools to improve themselves. Likewise, I think society doesn’t work too well when citizens aren’t given basic healthcare.
We tell kids they have the responsibility to do their homework, pay attention to the teacher, and study for tests. Schools provide incentives to encourage good behavior and disincentives for bad behavior. But it’s not like we ban lazy or ill-behaved kids from public school. Everyone–even difficult students–are entitled to an education.
There’s no reason to think that universal healthcare would have to be handled any different. You aren’t compliant with taking your meds and prescribed lifestyle plan? OK. But don’t expect to be pushed to the front of the line for organ transplants or expensive surgerical procedures.
The short answer is there is no consensus. But ultimately every society must deal with weighing the good of the individual vs the good of society.
As a general rule, a free society does not require “forcing” people to do or not do stuff. But it also prevents people from taking actions whose consequences can affect others.
A good example is random DUI checkpoints. Society has determined that people’s right to not be randomly searched by the police does not outweigh people’s rights to not have to share the road with dangerously impaired drivers.
Total agreement with this and the rest of your post. Absolutely so. It isn’t a “right” like the right to a trial by jury or the right to practice a religion, but it’s a privilege, like having clean water and good roads, that we should be demanding. It would be good for our society, just as it is good for Britain, Canada, Australia…and pretty much all the other rich industrialized democracies.
well, an amazing proportion of health care costs today are due to people deciding to not exercise and eat too much or getting addicted to nicotine. Do you think we should cut off health care for someone who regularly eats deep-fried twinkies? Anyone who doesn’t exercise daily? Who smokes? Throw people who eat french fries into prison?
I don’t know, that’s what I’m wrestling with, I just hadn’t really thought about how my actions affect society before. I pay higher insurance rates at work because of my BMI. I get a discount because I have quit smoking, going on 9 years now.
I definitely don’t think prison is the right answer, I do think we have too many people in prison already (war on drugs). I think monstro’s last sentence is sort of where I’m leaning. A person doesn’t want to exercise and doesn’t want to eat healthy, well, society will help with basic health care, but heroic health care (organ transplants for example) you aren’t a priority for the limited resources.
But then, who am I to say who has been good enough to deserve priority for a new heart?
Yes, in countries with universal healthcare you still need for example special insurance for high-risk sports. There are medications and benefits which will be covered the same no matter what, but other things to which you don’t have access or have it more difficult if you “did it to yourself”.
As for non-compliant patients, on one hand it’s something which is as likely to make them worse in UHC countries as in those without and it’s one of the items which is taken into account when deciding which medications and procedures someone gets. If you need a liver transplant due to cirrhosis brought by childhood hepatitis and you otherwise take good care of yourself, you’ll be put on the list. If you need a liver transplant and any time your caretakers lose sight of you they find you at the nearest bar trying to empty the shelves, you won’t.
There are diabetes care things for which my mother is ineligible on account of having notions about “compliance” which differ from those of doctors. She thinks a pair of deep-fried tapas and a glass of sweet wine “don’t count”; they disagree, as does her glucometer. Since they know she won’t follow anything that requires a minimum of discipline, they avoid anything which does require it as much as they possibly can.
Instead the US chose to restrict citizens behavior and not guarantee them health care. It is interesting that the party that is most in favor of restricting behavior is the one that is bound to repeal even the limited health care that exists (not just Obamacare, pitiful though it is, but medicare and medicaid too).
In Canada at least, no attempt is made to cut off medicare from people who don’t take good care of themselves and I guess that is reasonable even though I understand the counter-argument. Arguably the most damaging drugs–tobacco and alcohol–are perfectly legal. I think, on reflection, that this is a non-issue.