Harvard economist Jeffrey Frankel has written an interesting column in response to Mitt Romney’s comment that 47% of the US electorate pays no federal income tax, so freerides on the federal system.
Cultural generalisations are dangerous. But since questions have been raised, the fearless social scientist will not shrink from confronting them. Are residents of ‘red states’, who tend to vote Republican, indeed more likely to take responsibility for their personal behaviour than those who live in ‘blue states’ and tend to vote Democratic?
The statistical reality is that the red-staters are, on average, less prone to pay income taxes, more prone to receive subsidies from the federal government, less physically fit, less responsible in their sexual behaviour, more prone to inflict harm on themselves and on others through smoking, drunk driving and misuse of firearms, and more prone to freeride on the healthcare system, compared to blue-staters. ….
It is particularly striking that the states where the most residents exhibit behaviour that endangers their health and that of others – with many of these unhealthy people later freeriding on their fellow citizens when they show up uninsured in the hospital emergency room – are also the states where congressmen tended to vote against the Affordable Care Act (Obamacare) in 2010. …. This risky behaviour includes poor physical fitness (as measured by rates of obesity, lack of exercise, and poor diet), careless sexual behaviour (as measured by rates of pregnancy among girls aged 15 to 17 and rates of chlamydia), smoking, drunk driving (as reflected in fatalities) and irresponsible use of guns (as reflected in armed assaults). Each obese American incurs medical costs 42% higher than those of normal weight. Often others are stuck with the bill because they are uninsured. They may, for example, be unable to get health insurance because they are so overweight. These people are freeriders on the healthcare system even if they don’t want to be. Obamacare was designed to fix this problem.
Most US citizens don’t know what the Affordable Care Act does. Many think that it reduces personal responsibility for healthcare, but the truth is the opposite. Under the current system, hospitals are required to treat patients who show up at the emergency entrance with a heart attack – even if their condition is partly their fault, due to habits of overeating and under-exercising. The hospitals have to pass the costs on, and the rest of the US ends up footing the bill. The individual mandate is designed to fix that, by making everyone pay for the health care they get. One benefit is that it will encourage them to see a doctor, who will typically advise them to adopt a healthy lifestyle by exercising, eating better, stop smoking, and deal with alcoholism. Establishing personal responsibility, not socialised medicine, is the reason why conservative think tanks such as the Heritage Foundation proposed the idea of the universal mandate in the first place, and why Mitt Romney enacted it in Massachusetts when he was governor.
Jeffrey Frankel, “Sex, money, red states and blue states“, Vox EU, 2 October 2012.
There is much more. Click on the link to read the entire column.