With the health care reform bill passed and debate about it simmering in the background (several states plan to allocate scarce funds to try to fight it in court), I thought to bring up a few statistics that involve personal responsibility and health.

Personal responsibility is, after all, a sort of touchstone for a lot of folks. There are those that use it to unfairly put down welfare recipients. And then there are folks that use it to justify pursuing their libertarian ideals. And there are those that take personal responsibility seriously and contribute to their communities in all sorts of beneficial ways. This type takes the form of altruistic volunteerism, participation in their church’s social outreach, contributing to youth sports and activities, serving on committees, donations to a favorite cause or charity are just a few of its expressions.

A quick search on the PubMed website, a portal to the U.S. National Library of Medicine at the National Institutes of Health, using the search terms “benefits of altruism,” yields 238 scientific journal articles related to altruistic behaviors. This literature covers the effects of altruistic behaviors in everything from aphids and despotic macaques (a type of primate that will sometime withhold food from other macaques through “be feared when needed and loved when possible” behaviors), to moral choices in choosing to recycle or buying “green” products. There are even research papers on what motivates grandparents to invest in their children and grandchildren. Being social animals, personal responsibility has everything to do with how we view our role as an individual in society.

Now certainly personal responsibility is not all about altruism. Playing a responsible role in society requires each individual to obey the laws, pay one’s taxes, and as much as one is able to not be a burden to others needlessly. One could say it is each individual’s personal responsibility to be informed as best as one can be to participate in the election of civic leaders, or in referendums on the matters important to civil society. Personal responsibility extends to our relationship to government and its role in society.

Individualism is sometimes hailed as a uniquely American quality and speaks of self-determination, self-sufficiency, or entrepreneurial inventiveness. At times it speaks much less favorably of hubris, greed and stunning arrogance. The Goldman Sachs officers that appeared before Congress, unapologetically excusing their company’s role in helping create the financial crisis, are pretty good examples of individuals whose sense of personal responsibility may be a bit off. Time, and a criminal investigation, may tell.

But back to some health statistics that relate to personal responsibility. Smoking is responsible for roughly 443,000 deaths each year in the United States. Men who smoke die on average 13.2 years earlier than male non-smokers, women die 14.5 years earlier. Nearly 50,000 die each year from secondhand smoke. With these odds, the individual might feel they can roll the dice and choose for themselves to smoke or not.

But let?s look at the cost of that personal decision to the broader society. Direct medical costs for smoking-related disease ($96 billion) plus lost productivity cost ($97 billion) totals up to $193 billion per year. Add another $10 billion per year for healthcare costs associated to being exposed to secondhand smoke. If you look at the total estimated cost to society from cardiovascular disease ? of which smoking is one of the leading contributing causes, along with unhealthy diets, obesity, and lack of exercise ? the estimated cost is $503 billion per year for a disease syndrome that is largely prevented by personal choices and taking personal responsibility for one?s health. $503 billion per year is about half the estimated total health care costs for this year. How much is the health care reform bill projected to cost over the next 10 years? Somewhere around $950 billion according to the Congressional Budget Office.

I can’t help wonder how different the health care reform debate might have been if personal responsibility had entered the discussion as an individual’s responsibility to maintain better health and not as political rhetoric meant to marginalize those unable to afford health coverage.

Steve Demetriou lives in Windham.