Food for thought: What’s the optimal role government should play in its citizens’ health? Where does the line lie between doing too little and overstepping bounds? Does anyone other than the individual share responsibility for a person’s health?
Following World War II, governments in a number of Western nations got into the business of health promotion in a more concerted way, whether by developing full-blown systems of national health insurance and care or simply by creating offices and instituting policies intended to optimize citizens’ health. To work, the systems needed sustainable economic growth and budget surpluses that allowed “nice to haves” to become “must haves.” Why not provide universal vaccination and “zero to three” wellness programs when the coffers are full?
More than a half century later, cash-strapped governments are caught between long-term communal health goals and immediate skyrocketing costs. Faith in government to make up for shortcomings in private healthcare is increasingly scarce--and opinion is deeply divided over what role government should even be attempting. In the U.S., the battle over the future of Medicare and Medicaid is fierce, with both sides playing to the fears of the people who rely on this financial assistance for their health maintenance. In China, Health Minister Chen Zhu has reiterated that nation’s reluctance to become responsible for individuals’ medical needs, saying, “The health of 1.3 billion people cannot depend on healthcare and medicine; private prevention has to come first.” In other words: personal responsibility, not public handouts.
During earlier financial crises in the West, the consensus was that those health and social protections currently in place were sacrosanct. This time, the crisis has been deep enough and lasted long enough that we’re seeing a shift: People are recognizing the limitations of government and have come to realize that the safety net they once counted on likely won’t be there when they need it. At the same time, they are struggling under their own personal debts and feelings of financial insecurity, which is leading them to be more fearful than ever before of what the future holds. People are feeling that they simply cannot afford to get sick—first, because they can’t afford treatment and, second, because being sick interferes with their ability to earn the money their families need to survive. As a consequence, they are taking more steps to ward off illness, and, when they do fall sick, they are picking and choosing among healthcare options based on their ability to pay. A 2009 survey by Consumers Union found that 28 percent of Americans were putting off doctors’ visits and 22 percent had put off one or more medical procedures as a way to reduce their healthcare costs.
In a number of ways, what is happening today in healthcare echoes what has taken place over the last 10 years in terms of attitudes toward the environment. People in various countries waited and waited for government to step in and fix things, until finally reaching the conclusion that individuals—and the consuming public as a whole—must handle the situation themselves. The feeling that “everything will work out” and that government will do what needs to be done has been replaced by a more grown-up recognition that we are living in countries and on a planet with limited resources, and it is up to each of us to invent new solutions and alter our behaviors to better fit the new realities.
Governments, too, are coming to grips with these new realities. While socialized medicine will retain its hold in some markets, the focus more and more will be on government efforts to educate and promote preventative behaviors rather than just pick up the bill when a body needs fixing. Given people’s tendency to react faster to immediate financial concerns than distant health threats, we’ll see more governmental organizations follow examples the likes of Britain’s NHS, which has released a SmokeFree smartphone app that lets users calculate how much money they’re saving each day by staying off cigarettes.
Now, more than ever before, health and finances are interlinked.
The big question for business: Our studies have shown that people increasingly are expecting corporations to take on roles once relegated to government--including the promotion of social and environmental progress. Is healthcare next? And, if it is, what role can and should our most powerful corporations play?
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