Why it certainly seems reasonable on the surface to have people "pay for
their bad health choices", there are some shortcomings with the argument.
First, all the healthy lifestyle choices we hear about are actually very
small contributers to our health.  The primary determinants of whether we
get heart disease, type II diabetes, arthritis, and a wealth of other
diseases are our income, availability of food and housing, and access to
services.  Having these or not having access to these is a result of
government decisions on how to allocate resources, not personal choices.
Second, most people who partake in these risky behaviours, do so as means
of coping with difficult life situations related to material and social
deprivation related to lack of resources.  Again, public policy shapes
these decisions and subsequent actions.  Third, blaming victims of poorly
thought out policies that create poor people and other marginalized
individuals lets governments off the hook for these health-threatening
actions.  So the question should really be: "Shouldn't governemnts be made
to pay for their bad health choices?"

Sincerely,

Dennis Raphael

Of interest:

Social Determinants of Health: Canadian Perspectives
General Editor, Dennis Raphael, Foreword by Hon. Roy J. Romanow, P.C., O.C, Q.C.
http://www.cspi.org/books/s/socialdeter.htm

Staying Alive: Critical Perspectives on Health, Illness, and Care (coming Feb. 2006)
General Editors, Dennis Raphael, Toba Bryant, Marcia Rioux, Foreword by Dr. Gary Teeple
http://tinyurl.com/cojcf

Dennis Raphael, Ph.D.
Associate Professor & Undergraduate Programme Director
School of Health Policy & Management
Atkinson Faculty of Liberal & Professional Studies
York University
4700 Keele St.
Toronto ON M3J 1P3
Ph: 416-736-2100 ext. 22134
Fax: 416-736-5227
E-mail: [log in to unmask]
Website: http://www.atkinson.yorku.ca/draphael

-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]
SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html