Twenty years ago, there were few bank branches and few residents with bank accounts on the Lower East Side of Manhattan. Poverty advocates and government officials predictably concluded that those nasty banks were discriminating against the poor and mandated that banks open branches in the area. Equally predictable result: The percentage of residents with bank accounts has barely budged, reports the New York Times. Turns out that the cause of the low number of banks was not discrimination but the lack of consumer demand: the heavily immigrant population prefers to send its extra cash right back to the Dominican Republic, say, rather than depositing it in a bank.
There may be a lesson here for would-be health reformers: Ignore consumer behavior at your peril. It’s easy to blame unsatisfactory health outcomes, especially among the poor, on racist doctors or inadequate preventive medicine. But getting people to take advantage of the medical services available to them—to follow doctor’s orders, show up for appointments, complete a course of antibiotics–is not so easy. Pretending that unequal behavior plays no role in unequal social outcomes is one of the biggest mystifications in contemporary political discourse.
This year’s five-year plan will mandate pocket-size electric cars, creating consumer demand.
That’s incredibly true. A recent survey of health habits shows that New Englanders have surprisingly better health habits than Southerners and as a result enjoy longer lives. Personal responsibility plays a huge role in what ails the health system today. Just because diet food is available doesn’t mean you’ll buy it, just because your doctor tells you to exercise doesn’t mean you’ll do it. If you smoke in Britain, strangers get angry at you, they’re right, because you raise their taxes if you get lung cancer. If strangers get pissed at you in the United States for smoking, it’s probably because they’re from California.
Good one, Tony.
Thanks. BTW, I’ve been reading a lot of your comments. I agree with a lot, especially when stating the positive Golden Rule is only human when restated as the negative Silver Rule. Too true, good sir.
“There may be a lesson here for would-be health reformers:”
Reformers of all sorts have repeatedly had similar lessons over the years but it doesn’t seem to sink-in because the information is contrary to their ideology, which is that capitalism, corporations and white people are bad ‘n’ greedy , etc.
From http://www.udel.edu/educ/gottfredson/reprints/
“Thinking More Deeply About Health Disparities”
“…
Although health disparities within nations are still routinely attributed to differences in wealth and social status, health scientists have noted for decades that differences in material resources and access to health care cannot explain three remarkable facts about group disparities in health: (a) disparities are ubiquitous, regardless of country, health system, decade, disease, organ system involved, and treatability of disease, (b) health is better at successively higher levels of socioeconomic status, even beyond the level of resources required for good health and health care, and (c) health disparities increase when health information and medical care become more widely available (as happened, for instance, when the media alerted the public to the dangers of smoking and when Great Britain instituted free national health care in the 1950s).
Investment in better health care matters, of course, and it raises average levels of health in all groups. But it simultaneously creates greater variation (disparities) in health, because some individuals are better able to capitalize on the new resources.
…”
Note that more health care = more disparity, which will provide never-ending excuses for more government intervention, er, I guess I should say “more reasons for hope and change.”