The news for the last few weeks, coming out of the Beltway, has focused on the struggle to reform America’s health care system.

Many, on the side of President Barack Obama, have seen his popular support as the opportunity to finally move this country in the direction of a strong, public health insurance option. On the Republican side of the aisle, cries of socialized medicine and the perceived failures of similar Canadian and European systems dominate rhetoric.

A column by Paul Krugman that appeared in the New York Times this week stated that “with costs soaring and insurance dwindling, nobody can now say with a straight face that the U.S. health care system is O.K.”

Before we move to discussion of what to do, there must be agreement about whether or not a problem exists. Krugman hit the nail on the head — the health care system in this country is not OK. So with that, we might want to get into the semantics, because the debate wanders quickly at this point.

If the system is not OK, the obvious question is what does the system include?

From my perspective, the system includes individuals, physicians, treatments, health care facilities, insurers, those paying for the insurance, regulators and probably many other unidentified silos but you get my point: there are many cooks in this health care kitchen.

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If you have followed the debate, and you placed a check-mark next to each part of the system being targeted for “reform,” you would likely cover every area dozens of times with the exception of the individual.

The arguments break down neatly by party line. Democrats strongly prefer creating some “public option” for insurance that can compete with private insurers to keep prices for policies down. In addition, ensuring every American has coverage is a critical priority for the party. Republicans fall quickly in line in their search for a “marketplace” solution that would have the private sector enticed to compete to drive prices down.

Neither party seems convinced that the voter, ahem, the insured individual, should be affected in how they live their daily life.

And why should we look at health care reform that would impact the lives of individuals? Clearly, we don’t share any blame for the current predicament.

Rarely do I go to the local big-box store and see check-out lines full of people buying mostly unhealthy foods. And it’s only on a rare occasion the local convenience store line has people buying a handful of $7-a-box cigarettes. The rush hour traffic in and out of town is seldom slowed by people pulling in and out of fast food joints.

C’mon, it’s obvious that American self-indulgence, obesity and smoking has absolutely no impact on the cost of providing health care. Therefore, I find it completely acceptable to tax my current health insurance, or raise my income or sales taxes, to pay for something that is clearly out of the hands of average Americans to impact.

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My dripping sarcasm should be quite obvious by now.

In a country that was founded by, and has found its success through, the notion of individual responsibility, it is quite remarkable to observe one of the most significant domestic policy debates of our generation occur without a mention of it.

What would the true cost of a “safety net” insurance policy be if popping pills and expensive surgeries were needed on a lower frequency, because each individual made better decisions about their lifestyles?

What would an insurance policy cost if we were charged based on our lifestyle choices and not by lumping those who take responsibility for their health with those who choose not to? This is not a push for “high risk pools” per se, but government has already seen fit to penalize those who “sin” by jacking up cigarette taxes or taxes on particular snack foods or alcohol.

Americans are known to vote with their wallets. If we repositioned our health care system to make good lifestyle choices cheaper than poor choices, that might reform the system more sustainably. Unfortunately, impacting the lifestyles of voters might hurt reelection.

And there’s no insurance, yet, for that. 

Jonathan LaBonte, of New Auburn, is a columnist for the Sun Journal and an Androscoggin County Commissioner. E-mail: [email protected].


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