Do some patients not deserve health care reform?

That’s a controversial question that emergency physician Edwin Leap asks in a recent column.

What’s missing in the current health reform proposals is language enforcing one’s sense of personal responsibility. So, as Dr. Leap writes, “there are people who really don’t deserve health care reform . . .The ‘elephant in the room’ is that some patients (rich and poor alike) do nothing to care for themselves, take no responsibility for their well-being, are never accountable for their actions and will happily bleed any system dry, public or private.”

We do need to find a way to cover everyone with affordable health insurance. Your job status shouldn’t be a primary determinant of whether you pay exorbitant amounts for medical care. But Dr. Leap says a dose of personal responsibility is in order as well, and “we have to be willing to address the morality of giving more of our tax dollars, with no personal expectations, to those who already cost us so very much.”

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