Careening Down Cliffs

A delightful commentary on today's health-care debate was recently offered in the comic strip "Outland." Opus and his little friends are perched precariously on a tricycle at the edge of a precipice. Warning signs are posted everywhere, but the kids ignore them and go careening down the cliff. The tricycle topples, they all fly off, and from the mud Opus cries out, "Quick! Free, unlimited health care!" The comic strip skewers the attitude many Americans take toward health care. Most leading causes of death today are influenced by lifestyle factors, behavior we have some control over. But instead of exerting self-control, we go careening down cliffs, figuratively speaking, and then expect the health-care system to compensate for our irresponsibility. The most obvious example is AIDS. The liberal culture says we must never make moral judgments about homosexuality. But when gay promiscuity leads to fatal diseases, society is supposed to pick up the tab. In a similar vein, the liberal culture preaches that we must never make moral judgments about divorce or single-parenthood. Yet statistics show clearly that family breakup is linked to higher rates of illness and emotional problems-and society pays the bill. Take, for example, the words of sociologist Christopher Jencks. If people prefer single-parent families, Jencks writes, we should never try to influence their choices; instead government should "invent ways of providing such families with the same physical and psychic necessities of life available to other kinds of families." In short, if people choose to leave their families, it's up to society to pick up the pieces. Violent crime is packing our hospital emergency rooms. Yet the liberal culture refuses to hold criminals responsible-treating them instead as victims of their environment. Even ordinary Americans fall into this trap. Many of us know we should stop smoking, cut out junk food, use seatbelts, get regular exercise. But how many of us take these basic steps in preventive care? And when our unhealthy habits give us heart disease or lung cancer, we go running for medical treatment. We choose unhealthy behavior, then expect the health-care system to protect us from the consequences of our own bad habits. No wonder medical costs are rising. The American Medical Association says the growth in health-care expenses can be traced largely to "lifestyle factors and social problems." President Clinton's health-reform plan could actually make the problem worse. How? By socializing health care expenses across an entire geographical region. Your family may be conscientious and adopt health-conscious behavior, but your insurance costs would still be inflated by neighbors who sleep around, who abuse drugs or alcohol, or who drive motorcycles without a helmet. The system gives no reward for self-discipline and responsibility. This ought to trouble anyone who accepts biblical principles of accountability. Private behavior has public consequences-and public policy ought to hold us accountable for those consequences. Government ought to create incentives for responsible behavior and disincentives for irresponsible behavior. People who go careening down dangerous cliffs should not be allowed to force the rest of us to finance their irresponsibility.

12/29/93