Health Care a Responsibility Too - Tom Brokaw // Summit Should Include Personal Responsibility

Feb. 25, 2010 - PRLog -- Tom Brokaw asked during the presidential debates whether health care is a right, a privilege or a responsibility, implying that it probably is -- or at least should be -- a mixture of all three.  

But today's health summit appears likely to focus exclusively on rights -- especially rights to have free medical care paid for by taxpayers (for the poor), and rights to have health insurance provided at much lower than the anticipated costs (for those with pre-existing conditions) -- but with little if any discussion about attaching any responsibility to these and other rights, suggests public interest law professor John Banzhaf of Action on Smoking and Health (ASH).

Tens of millions of people too poor to pay for their own medical care will have it provided by taxpayers who will be forced to bear the huge costs, and millions of people with pre-existing conditions will be entitled to health insurance at rates far too low to cover their anticipated costs and paid for largely by healthy people, but these recipients of this largesse will not be asked to do anything to prevent the huge unnecessary costs their lifestyle choices impose on others.

"The poor may not be able to pay for any health insurance, and the sickly may not be able to afford insurance which includes their very costly care, but both can take the single step of quitting smoking to slash those costs by hundreds of billions of dollars.  Without imposing some measure of personal responsibility under health care reform, costs will continue to escalate, regardless of electronic records, more effective treatments, and other palliative measures," says Banzhaf.

Smoking costs the American economy almost $200 billion a year -- more than enough money in only five years to fund all of health care reform without cutting Medicare or imposing new taxes -- most of which is paid by nonsmokers in the form of ever-increasing taxes and grossly inflated health insurance premiums.

That's why it would be fair to impose on smokers some small part of the enormous costs their smoking now imposes on others by including a surcharge on health insurance premiums paid by smokers -- just as ten states and hundreds of companies already do.  The plans have been proven to work, and to slash health care costs by providing a strong and immediate additional incentive for smokers to quit, says Banzhaf.

Everyone appears to agree in principle, but may lack the political courage to actually propose this simple step.  For example, President Barack Obama reminded Americans that "we've got to have the American people doing something about their own [health] care."  HHS Secretary Kathleen Sebelius has frequently stated that personal responsibility for health care extends to lifestyle.  Many conservative politicians and commentators have said the same thing.

Yet the only proposal to actually incorporate personal responsibility into health care reform is one by ASH to add a modest surcharge to health insurance premiums paid by smokers.  Interestingly enough, it is the only funding mechanism favored by a majority of voters -- much more popular than major cuts in Medicare, or steep taxes on union members and the elderly with comprehensive health insurance plans, or on successful entrepreneurs.

Banzhaf notes that study after study shows that increasing the cost of the habit results in a substantial decrease in smoking with a corresponding saving from fewer heart attacks, strokes, cancers, and many other very-expensive-to-treat diseases.  In contrast, cutting Medicare or taxing comprehensive health insurance plans will, according to some experts, increase overall health care costs because people will not get medical intervention in time to prevent serious health problems later.

A copy of ASH's smokers' surcharge proposal -- including additional arguments for it, why it would not logically have to be extended to include the obese, and a more detailed financial analysis comparing it to other funding mechanisms, may be found at: http://ash.org/proposalsurcharge

PROFESSOR JOHN F. BANZHAF III
Professor of Public Interest Law at GWU,
FAMRI Dr. William Cahan Distinguished Professor,
FELLOW, World Technology Network, and
Executive Director and Chief Counsel
Action on Smoking and Health (ASH)
America’s First Antismoking Organization
2013 H Street, NW
Washington, DC 20006, USA
(202) 659-4310 // (703) 527-8418
http://ash.org/

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Action on Smoking and Health (ASH), America's first antismoking organization, got antismoking messages on the air, cigarette commercials off the air, the modern nonsmokers' movement, the principle of charging smokers more for health insurance, and many more victories for nonsmokers.