Individual Responsibility for Health

The concept of personal responsibility in health care is that if individuals are held accountable for behaviors that impact their health--such as whether they exercise, drink alcohol or smoke cigarettes--they will adopt healthier lifestyles and ultimately require less health care expenditures.

Programs and Policies

• Some companies offer financial incentives, such as lower health care premiums, to employees who participate in wellness programs like fitness or smoking-cessation. West Virginia's Medicaid program is an example of a public policy that emphasizes personal responsibility for health--enrollees receive enhanced benefits, including preventative health services, if they participate in a program where they agree to certain healthful behaviors.

Effectiveness

• According to a 2006 article published in "The New England Journal of Medicine," programs that emphasize personal responsibility for health are untested as regards their effectiveness in improving health or saving money. A policy report examining West Virginia's Medicaid program concluded that its design may actually result in higher health care costs for the state in the long run due in part to low participation in the program that offers preventative care.

Fairness

• Some advocacy groups, such as Families and Children Educate the State on Medicaid, have criticized as unfair, policies that provide services based on personal behaviors rather than need. In "The Hastings Center Report" published in "Bioethics Journal," Scot Yoder, PhD, argues that since it is difficult to ascribe moral responsibility for an individual's health, policies that assign such responsibility must be well-designed so as to avoid bias or arbitrary decisions.