I read an interesting article last week that I can't really get out of my head. In this article, economist Dave Leonhart talks about how there might be good reason to shift the debate around health care reform from the institutions that are responsible for the provision of health care to the individuals who receive it. In his article, he interviews Dr. Delos M. Cosgrove, the chief executive of the Cleveland Clinic which enforces a policy of not hiring smokers. Dr. Cosgrove suggests that obesity is the biggest health problem that America is facing today and says that if he had his way he would not hire obese people either. His rationale behind this controversial statement is that behavior is the biggest contributor to early deaths. I am not quite sure what is meant by the term 'early deaths' but one would think early deaths refer to deaths that occur before a person had reached the average life expectancy for the demographic group or nation that he/she is a part of. The key to ensuring good health it seems would lie in engaging in behavior that is either healthy or not damaging to health. This topic is interesting to me not so much for the provocative argument that is set forth in it (viz., that obesity ia result of choices people make and people should be taxed for the unhealthy behavioral choices they make). Rather, it suggests to me an avenue to realize the potential for groups at the institutional or interpersonal level to influence behavior. The internet and social media could be especially useful in exercising this influence. For example, I know of quitnet.com an online community that provides resources, advice from counselors, and, social support to individuals who wish to quit smoking. Perhaps, the thing to realize is that while individuals are responsible in behavior, behavior is not simply the product of agency (= free will) but is in fact embedded in structures.
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You'd enjoy reading the work of Nicholas Christakis (who I think you've read) and James Fowler. See this recent story on these scientists here: http://www.nytimes.com/2009/09/13/magazine/13contagion-t.html?_r=1&ref=magazine .
ReplyDelete(Un)healthy behaviors and attitudes are contagious, and both individual and structural factors contribute to what this means at societal levels.
For a person of my age, this is a horror story. Perhaps in a world with ever-increasing population it will become necessary to exercise such inordinate control over the individual. I for one cannot tolerate much further control.
ReplyDeleteAccording to a recent article I read, technology will soon advance to the stage where immortality will become fact. Infinistesimal robotic blood cells will take over the function of circulating life through the body. We will become robots. This will morph into a world of total control by a central mainframe.
But I'll be gone, thankfully.