PERSONAL RESPONSIBILITY

Posted in Rants on December 28th, 2010 by Ed

Americans spent more time talking about our nation's healthcare system in 2010 than in the last few decades combined, which is good. Unfortunately most of what they know and believe about it is false, retarded, or both. Which is bad. We learned mostly that there is a powerful noise machine in our society that can make anything, no matter how ridiculous, plausible to dullards through sheer force of repetition. We learned that 'mericans don't like Socialism and Government Takeovers and Death Panels and Rationing Care and lots of other straw men. We learned that people will argue passionately to defend a system from which they derive no benefit and, in many cases, actively fucks them.

What we did not do – indeed, what we never do, because it is hard and requires more than 15 seconds of attention – is question the fundamental premise of our, uh, "unique" approach to healthcare in this country. Think for a moment about the way we do things here. Not about the bureaucracy, the inefficiency, the clusterfuck of third-party payers, or the all-encompassing atmosphere of inaccessibility. Consider how this system works on the most basic level: you have to pay for getting sick or injured.

You slip on a patch of ice and break your hip, and then next thing you know you're out $10,000 if you happen to be uninsured or poorly insured. You develop breast cancer and a hospital (and eventually a collection agency) sends you a bill for $25,000 because you got cancer. You get tagged for $100-200/month in prescription drug copays for making the mistake of having allergies or some other congenital medical problem. You pay several hundred dollars in fines and penalties for catching some weird virus from a stranger at the airport. No matter the reason, and no matter whether you are insured or uninsured, being sick and getting injured cost a lot of money in this country.

Is that not a little fucked up? I'm sorry to tell you that you have leukemia, Mr. Jones. Just give us tens of thousands of dollars and we can do some chemo, or maybe think about a bone marrow transplant. If you can't afford it, you can either go home and die or get the treatment anyway and we'll take your house.

The American attitude toward the healthcare system represents our national obsession with Personal Responsibility taken to its ludicrous extreme. We feel that people should have to pay for any services they receive because A) we're proud capitalists, and thus everything of value must have a price attached to it and B) we blame individuals who end up in the hospital, just as we blame the ones you end up poor, in prison, on drugs, or unemployed. Everything that happens to you up to and including getting cancer is your own damn fault.

Our system is the way it is because we generally believe that illness and injury are preventable, thus in the classic Reaganite mindset you should have been smart enough to prevent it. Admittedly this outlook has some appeal and anecdotal supporting evidence. It is often hard to generate sympathy for someone who drunk drives into a tree or smokes for 50 years and develops lung cancer. Sometimes the trip to the hospital is indeed a consequence of our own actions. It raises the larger question of where the line between personal responsibility and bad luck should be drawn – which is a red herring for the even bigger question of why, in a wealthy, industrialized, and allegedly civilized nation, that should matter when it comes to something as fundamental as access to a doctor.

Our culture (and especially our media) would have you believe that an obese person who has diabetes or heart problems is undeserving of sympathy, and certainly undeserving of free access to medical care. He did it to himself, we are encouraged to tell ourselves. Probably sat around all day stuffing his face with KFC. This personal responsibility fetish relies upon a number of important assumptions – namely that the consequences of every action can be known or predicted in advance and that prevention is usually (if not always) possible. More importantly, it keeps us from questioning the idea that is the cornerstone of a for-profit healthcare system: that access to medical care, the need for which may be driven by our own actions or random chance, is not a human right but a privilege reserved for those who can afford it.