Entitle-Tude

I'm a compassionate guy. I really am. Ask anybody and they'll tell you I wouldn't speak ill of anyone, don't disparage people randomly, step sideways to avoid ants and small children. And I know how much simple pleasure there is out there for the taking, the blandishments of modern life, alcohol, cigarettes, rich fatty foods, red meat and calorie-laden desserts, I know all about that stuff. I indulge them myself from time to time. I don't exercise as much as I should. I eat too much ice cream and drink too much wine, sit around too much (hey, I'm a writer, I call it work). But I also know about the ravages of all this modern richness, the indulgent lifestyle we immerse ourselves in at the expense of our health. I saw the end results of our over-fed, under-exercised, sedentary, TV-numbed life that too many Americans adopt too early in life. For twenty years I flew folks to a hospital after their heart attacks, strokes, intoxicated driving mishaps, cancer-related medical crises. Many of those health crises are connected to choices we make about the indulgences listed above. And then what do we do? We demand that the system patch us up, fix our self-inflicted wounds, our heart attacks, strokes, cancer-related medical crises. We're entitled to the care; we're Americans, after all, living in a country that provides all that richness and wealth and indulgence to us. Entitled, to the care and remedy available to address our most egregious health problems so we can resume our smoking and drinking and dietary impulses without hindrance.
But even when I was flying all those patients, and happy to do so I should add, something nagged at me. It's never a good idea, or a compassionate first thought, to focus on financial matters in the middle of a health crisis. But dammit, someone must pay the freight for all this indulgence, the often poor choices we make that result in sickness and morbidity down the road. The payer is--all of us. There's no getting around it. We're all in this leaky little boat together, and no matter how one feels about health care policy, or dietary science & its pronouncements or sociology, when the health care bill comes due, we're all on the hook for it. Many times I'd land at the hospital with a patient who had clearly ignored all manner of health-related items in their personal lives: they smoked (a lot), drank too much (often driving afterward--or during--which brought them to me), they chose to ignore good food offerings for junk, they plugged their brain into a television ten hours a day and became ballast for the La-Z-Boy. The nagging thought that pushed into my head all those times was that those patients chose their situation. No one forced them (or any of us) to live the way they did, or eat that way, drink that way, smoke cigarettes, etc. etc. It was a choice. I avoid the preaching mode. No one really likes a preacher except perhaps the preacher's wife. And I confess, again, that I've been there. I was a pack-a-day smoker for ten years.
It's what I call the entitle-tude that's the real problem. It seems to me that with any entitlement there must be commensurate responsibility, and this crisis--for health care in America is in crisis--this is no exception. I'm not sure that health insurance policies shouldn't contain reasonable restrictions on coverage for those who choose to keep smoking, those whose BMI is above a certain point, those who refuse to follow dietary guidelines. I know; the nanny state. It's always politics. But it's truly conservative politics. We make choices; we should be responsible for those choices, not entitled to whatever interventions society heaps on us like that extra bowl of ice cream.