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Sunday, May 20th 2007

A Question Echoed…

Where’s the personal responsibility?

The conventional wisdom is that the American health care system is broken. This is the party line parroted by the various media organs of the dependocracy in their attempt to stampede an excitable public towards socialized medicine. Like a lot of the conventional wisdom, the idea of a broken health care system gets repeated so often that it has become a cliche, something that people spout in a self-righteous reflex.

We pay lip service to the idea of patient-centered health care of course, and including the patient as an equal partner in medical decisions is the New Religion. In our society however, where a physician can get sued for not having written on the discharge instructions for a dead crack dealer, “Return to Emergency Department if chest pain returns,” well, there just isn’t as much equal partnering as you’d like to believe.

In fact, there’s none to speak of where it counts. Not an artery hardens or liver fails without a physician somewhere, somehow being blamed. Personal responsibilty having long ago been abandoned in every other part of society has finally been driven from medicine which is the one place above all others where it is critical. The medical schools, for their part, have moved completely away from the notion of expecting patients to care. To even breathe the words “personal responsibility” is to invite criticism from your instructors…

This creeping paternalism is the new medical paradigm and, as it will serve to dissipate finite medical resources instead of concentrating them where they may do the most good, it could not have arrived at a worse time. The level of involvement required to change bad habits is simply more than we will be able to fund.

The emphasis is my own.

This is a question echoed innumerous times on this blog, but Panda Bear puts it more eloquently than I’ve ever managed. The fact is that virtually no health care “system” is equipped to promote life style modification. And as Panda Bear points out, they really can’t reasonably be equipped for such.

The death of personal responsibility is enabled in part by the growth of social guarantees and the rapid pace with which health care advanced through the 20th century, creating expectations. This societal problem stretches far beyond the realm of medicine. It is manifested in the morphing of America into a ‘lawsuit nation’ and in plenty of other examples. And unfortunately, it is far beyond the power of health care professionals alone to even slow its growth.

H/T Kevin, MD