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There's also some degree of moral judgment involved. It would be much easier to sell single-payer to Americans if coverage was denied to lifestyle illnesses. It

There's also some degree of moral judgment involved. It would be much easier to sell single-payer to Americans if coverage was denied to lifestyle illnesses. It's easier for the American ethos to swallow charity for the poor sap who got brain cancer from an errant cosmic ray than for the obese chain-smoker with type II diabetes and lung cancer. There is a long history of Puritanical thought running in American culture, in which personal virtue is reflected in outcomes.

ams6110 11y ago
On that basis you'd also have to exclude coverage for injuries from almost any sport or exercise activities done "by choice"
- rogerbinns 11y ago
  It goes way further than that. How about people who have children (again a choice) as that also increases health expenses. Living in areas with more sun (let's call that a choice too) means more likelihood of skin cancer. Those people using private cars rather than public transport are also more likely to be more severely hurt in more accidents. Someone engaging in "bad behaviour" like smoking may have higher health costs at the end of their life, but their lifetime total costs may be lower because their life ends quicker than healthy people having a longer end of life period. (And the smokers paid more tax, collected less social security etc.) Realistically all legal choices and activities have to be covered, or you would be arbitrarily victimising certain groups.
HarryHirsch 11y ago
The personal responsibility riff gets really problematic when you are faced with things like alcoholism or venereal diseases. People certainly have a choice to keep alcohol consumption down practice safe sex &c. But it's a reality that some people catch STDs or drink too much even though they should not, and these things have a way of affecting more than the afflicted individual. And food deserts are a very real thing. If you live in one of those you haven't even much of a choice regarding obesity.

ams6110 11y ago

On that basis you'd also have to exclude coverage for injuries from almost any sport or exercise activities done "by choice"

rogerbinns 11y ago
It goes way further than that. How about people who have children (again a choice) as that also increases health expenses. Living in areas with more sun (let's call that a choice too) means more likelihood of skin cancer. Those people using private cars rather than public transport are also more likely to be more severely hurt in more accidents. Someone engaging in "bad behaviour" like smoking may have higher health costs at the end of their life, but their lifetime total costs may be lower because their life ends quicker than healthy people having a longer end of life period. (And the smokers paid more tax, collected less social security etc.) Realistically all legal choices and activities have to be covered, or you would be arbitrarily victimising certain groups.

HarryHirsch 11y ago

The personal responsibility riff gets really problematic when you are faced with things like alcoholism or venereal diseases. People certainly have a choice to keep alcohol consumption down practice safe sex &c. But it's a reality that some people catch STDs or drink too much even though they should not, and these things have a way of affecting more than the afflicted individual. And food deserts are a very real thing. If you live in one of those you haven't even much of a choice regarding obesity.