Tuesday, June 15, 2010

What Happened To The Personal Responsibility For Our Own Healthcare?

We all have some personal practices that may put our health at some degree of risk, things like overeating, smoking, alcohol consumption, high stress jobs, etc. Some people take that risk to unreasonable levels resulting eventually in a medical catastrophe. For some it is lifestyle and upbringing that brings out this behavior. For others it is physical addiction. But for some it is a financially driven decision.

I just read two studies that each in their own way amaze me about human behavior and the influence of money. In the first, it was discovered that by paying noncompliant patients to take the medicines that were prescribed for them, they suddenly became more compliant. Keep in mind that these patients had some significant medical problems resulting from not taking their prescriptions regularly. Apparently they were ok with that. To make matters worse, after a period of payment, this incentive was removed. The result was that patients regressed back to "forgetting" to take their meds. What is going on here? As we move forward with healthcare reform and treating these non compliant patients' eventual acute crises becomes our financial responsibility, we should have a say in their behavioral choices. Perhaps there should be some measure of personal responsibility demonstrated in order to qualify for unlimited healthcare coverage.

The second study states that last year over 2 million cancer survivors did not get needed medical services because of concerns over the cost of care. This represents 18% of all U.S. cancer survivors. Some of the care avoided was not directly related to cancer treatments but most of it was. This behavior may be a little more understandable than the first study where patients already had access to drugs and just chose not to take them. Still, once a diagnosis of cancer is given, I would think that patients would make treatment their first financial priority. In these patients, a more liberal healthcare coverage plan certainly should have a positive impact. I would hope that removing financial concerns would improve their compliance significantly.

Healthcare coverage should be expanded to all those who need it. But as we do this, each of us also carries a personal responsibility for at least a level of good health practices. If you choose not to take medications that are prescribed and given to you, we as a society should not be responsible for the cost of your ultimate medical crisis. At least that is my opinion.

More on this later.

Mark Brodeur

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