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'Responsibility' can mean many things

I've been hearing a lot of talk about responsibility lately.

Most often, the point about responsibility is that other people need to be taking it.

It's pretty unusual to hear somebody say, "You know, I just don't take enough responsibility.''

The other week, I spoke with a civic group in Tampa about the Affordable Care Act. Talk, not surprisingly, turned to the cost of health care and why it's so much higher in the United States than anywhere else in the world.

Lots of suggestions bubbled up. Americans are too fat. We don't move enough. We expect doctors to fix us. We expect our insurance to pay for it.

We just don't take enough responsibility for ourselves.

Patient responsibility is one of the biggest buzzwords in health care these days. But the r-word can mean many things. It can be the kind of personal health responsibility my lunch companions spoke of.

It also can be the dreaded "patient responsibility'' column on insurance company forms.

Remember when you just handed over your copay and that was the end of it?

Yeah, me too.

Now, with high-deductible plans, we have to pay close attention to the cost of what our doctors want to do to us. The theory is that if we have more skin in the game, we won't allow so much to be spent on our behalf.

Have you ever tried to find out what a procedure is going to cost before you have it? Have your inquiries been met with blank stares, long pauses and conflicting answers?

Yeah, me too.

Bad as all that is, what's even more frustrating to consider is how many people don't even have access to health insurance, imperfect as it may be. I'm referring, of course, to the 800,000 Floridians who can't afford to buy subsidized health insurance under the Affordable Care Act, yet can't qualify for Medicaid, the insurance program for the poor.

Florida's refusal to accept the federal dollars that would help those folks is tied up mainly in partisan politics. Given my theme here, I'll note another objection that goes roughly like this: People should take responsibility for themselves and earn the money they need to buy insurance.

Like patients negotiating their own health care costs, however, this is a theory that falls apart in practice.

Basic health insurance isn't a luxury like a nice car or a designer handbag. It's more like public education — an opportunity to be responsible.

Sure, you can waste your education by goofing off until you're old enough to drop out. Or you can work hard, graduate, get a college scholarship and be on your way to a better life.

Similarly, you can keep your insurance card in your wallet and never use it until you are so ill that not much can be done for you. Or you can get your checkups and follow the advice you get from doctors, nurses and pharmacists and be on your way to a healthier life.

Today in Personal Best, our cover story is about the great work that local volunteers do at local hospitals and other health care organizations. Their example brings up another fact about responsibility — it's a community thing.

Yes, we should all take more responsibility for our health and our health care. But we also should ask ourselves what we can do to help those who need more than we do — whether it's a hospital visit, a hot meal, or a chance at better health through access to care.

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'Responsibility' can mean many things 12/12/13 [Last modified: Monday, July 21, 2014 8:37am]

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