This past week, the President launched his Health Care Summit and named his nominee to serve as the Secretary of Health and Human Services, Governor Sebelius. During these events he spoke eloquently of ‘shared responsibility,’ and like a lot of his speeches, this seemed to be something both profound and appropriate.
But like most of his speeches, a bit of thinking about the words leads to a different conclusion. In fact, this phrase, ‘shared responsibility’ should be quickly exposed as the oxymoron that it is.
Merriam’s on-line dictionary defines responsibility as “the quality or state of being responsible as moral, legal or mental accountability,” with accountability defined as “accountability is the willingness to account for one’s actions.” There is no notion that someone should be held to account for the actions of others.
So, in the case of health care, exactly what is this ‘shared responsibility’ the President speaks of? Why am I responsible or accountable for the health of others, or for the provision of their care? If I am to be responsible, how will I be held accountable? How will I know when I’m doing too little or too much? If I am to share this accountability, how will I know when I’ve done what I should, but the others who share the responsibility are not? If others are not pulling their share of the load, how do I remedy that?
There seem to be no clear answers in the President’s proposal to these questions. Therefore, I do not believe that we should be willing to be held accountable for the result until the answers are provided. This is particularly true of health care, since a large fraction of health care needs are caused by individual lack of responsibility in diet, exercise, and other aspects of individual choice. Holding others accountable for individual actions is the quickest way to create division and distrust.