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Sep 09, 2009


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How dare you condone and suggest people take responsibility for things like their own health!

Yes, Guillermo, there is a flaw in Goldhill's argument, and it is surprising that you, as a proponent of the influence of the irrational, did not see it. Goldhill presumes that people, seeing the economic and physical consequences of their own poor health decisions, will correct course and make better decisions in order to improve their economic and physical health.

It is a charming thought, but I would like to see some evidence for the likelihood of that occurring. I would imagine much the opposite taking hold: many people, either with poor health habits or having the bad luck to have chronic illnesses from no fault of their own, becoming increasingly desperate as they watch their health savings accounts continually depleted, and in that desperation actually worsening their bad health habits and making other poor decisions based on desperation. Smoking and over-indulgence in food and drink are some of the most available and reliable pleasures in life, and are regularly resorted to ease stress, particularly by those with less education and economic opportunity. Similarly, desperation would drive people to making other bad economic decisions, including more spending on the lottery and other low-return activities.

Thus, I believe the program Goldhill proposes would work well for a relatively small minority of the population, i.e., those already decently positioned economically, with relatively good health and good health habits, and with a generally hopeful attitude towards the future. Those requirements eliminate quite a lot of our fellow citizens. So, Goldhill's program, by playing into pre-existing lifestyles, would end up widening the class divides in our country.

By the way, I imagine some readers of my comments might find them elitist and offensive. I would suggest to those so offended to look at some of the research on class and health and note how strikingly they are correlated and look at the other variables associated with those correlations.

This is irrationality indeed; talking of a financial incentive to get people to bother to maintain their health. Has it occurred to you that if a person doesn't care about managing to stay alive, avoid pain, etc, they're probably not going to care too much about the money they'll be saving instead of being dead or stuck in hospital dying?

I suggest you try reading Irrationality by Stuart Sutherland. Chapter 8. Misuse of Rewards and Punishments.

Also you might want to try simply looking at the health care systems of other industrialized nations; all those other nations which have a higher life expectancy than the US, lower per capita costs and all of whom have universal health care.

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