Obamacare champions personal responsibility. The states that hate it don't. (+video)
Bill Clinton rightly defended Obamacare at the Democratic National Convention. Mitt Romney and the GOP say the law neglects personal responsibility, but the opposite is true. Plus, states that voted against the law exhibit the least personal responsibility in health behaviors.
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Similarly, states that show signs of risky sexual behavior – high incidences of pregnancy among girls age 15-17 and the sexually transmitted disease chlamydia – tended to vote against the ACA. The same is true of states with high rates of smoking, drunk driving, and shootings.
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Look at the graph above. The vertical axis shows how many of each state’s members of Congress supported the 2010 reform. The horizontal axis is a composite index of measures of personal responsibility. It is an average of a physical fitness index, which includes obesity and physical exercise, and a risky behavior index, which includes teenage pregnancy, drunk driving, and firearms assaults. These are patterns of irresponsible behavior that impose costs on others in two ways: directly (victims of a drunk driver) and indirectly (passing on hospital costs of treating the uninsured).
The vote was strongly against health reform among the congressional delegations from Mississippi, Alabama, South Carolina, Kentucky, Oklahoma, Kansas, Georgia, Tennessee, Texas, and Missouri. These tend to be some of the states with the highest rates of obesity, teenage pregnancy, drunk-driving fatalities, and firearms assaults in the country.
The reverse is true among many of the state delegations that voted for Obamacare: Colorado, Massachusetts, Connecticut, Hawaii, New York, New Hampshire, Minnesota, Rhode Island, New Jersey, and California.
There are outliers, of course, especially Utah. Perhaps this is because much of its population abide by Mormon teachings that promote healthy personal behaviors and prohibit risky ones.
Overall, however, states that voted against Obamacare, often in the name of personal responsibility, are those where populations exhibit the least individual responsibility when it comes to their own personal health behaviors, as identified by medical researchers.
In spite of the predominant GOP rhetoric, Obamacare is actually the right answer for those who believe in personal responsibility – not just in word but in deed as well. The pre-Obamacare system is not.
Jeffrey Frankel is the Harpel professor of capital formation and growth at the Harvard Kennedy School of Government.
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