Saturday, May 9, 2009

On trade-offs

Remember how your mom made you choose between a cookie and a piece of chocolate for dessert? Remember how shocked you were the first time it happened? "You mean I can't have both?" Now as an adult you stand in front of your closet packing for a trip and deciding between the brown loafers and the black heels, because surely you do not have room for both in your luggage.

Every day we make hundreds of choices, and by choosing one thing we are giving up something else. We mostly do this almost subconsciously (tea or coffee? paper or plastic? hot dog or hamburger?), though with some choices we need to think a little harder (vacation or a new roof?). On the other hand, some ostensibly simple decisions may have far-reaching consequences: should I take up smoking, should I watch TV instead of going for a walk, should I grab that greasy cheeseburger for lunch again?  

As citizens of a nation founded on self-determinism, we view the opportunity to make these choices as our inalienable  right. But with any right comes personal responsibility. Oddly, we seem to leave this right/responsibility doublet at the door when dealing with our health choices. Indeed, for many it is precisely the choice to have that cheeseburger while sitting in front of the TV or to pick up that cigarette or to put exercise at the bottom of the priorities list that leads to the logical trade-off between health and disease. But because the steps between that cigarette and heart attack are many, these choices, as if moves in a chess game, are removed from the check mate. Nevertheless, by picking up that cigarette, you have made a health trade-off.

Of course, today the medical science can pull us out of the abyss of near-death like never before. We have drugs and surgeries and other procedures to deal with the consequences of the choices we make. In fact, where is the trade-off in that? So, maybe mom was wrong (heavens!), and I can have both a cookie and a piece of chocolate? Not so fast. The treatments themselves represent a trade-off. That is, every time a pill or an injection or a scalpel invades your body, there is a chance for an adverse consequence. Also, we are now spending over 2 trillion US$ on healthcare annually in the US! And this represents that trade-off, that decision to have a cigarette. By choosing to smoke, we have implicitly decided that we would rather be spending all this money on healthcare rather than on, I don't know, a baseball game. Like with any budget, if you spend money on one, you may not be able to afford the other -- your choice!

So, unless we see no better way of spending our money than on the consequences of our near-sighted health choices, we had better make smarter decisions and think about trade-offs far down the road. And by the way, perhaps this means that we don't need a bigger and more costly healthcare system, but one that is more efficient. Who knows, perhaps we can provide everyone with access to quality healthcare that will not bankrupt our children. And with a piece of chocolate (or a cookie).   

No comments:

Post a Comment