Good health requires good health care, not morality police

My brother led a good life. He didn’t smoke, rarely drank, didn’t eat too much and wasn’t hooked on sugar.

It’s true that he didn’t sleep or exercise enough, primarily because he had a long car commute to his job, and at that job, which didn’t pay enough, he sat too much because that’s what the work required.

But the work allowed him to pay the mortgage on the small tract house he shared with his wife and two young sons and, because he was a good husband and father, he did it.

His life was hard in many ways, but in every way that counts, I’d call it good.

His so-called health choices, which weren’t entirely choices, weren’t perfect but they weren’t bad.

He died of colon cancer at 57.

I tell this story because whenever a relatively young person gets a debilitating or deadly disease, the question inevitably arises: What did they do wrong? How could they have prevented it?

How much responsibility do they bear for their untimely fate?

There’s a line of thinking in this country that neatly equates good health with good health choices and good health choices with morally good living.

In that math, mortality is a function of morality.

Live right, live healthy and long. Live wrong, and, sorry, pal, you’ll pay for it, and that includes with money.

Such thinking has run through our health care debate for ages and has flared in the current argument over the Republicans’ new health care plan, which passed in the House of Representatives last Thursday.

Recently, Mo Brooks, a Republican congressman from Alabama, explained why “people who have high health care costs” — meaning sick people — should pay more for insurance.

“That helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy.

And right now, those are the people — who’ve done things the right way — that are seeing their costs skyrocketing.”

It should be noted that Brooks added a small qualifier to his remark: “Now, in fairness, a lot of these people with preexisting conditions, they have those conditions through no fault of their own.

And I think our society under those circumstances needs to help.”

But even his addendum suggests that many people who get sick are at fault and that we need to do triage on the worthy sick vs. the unworthy.

Obviously, how we treat our bodies affects our health.

Smoke for years and you hugely increase the chance of getting lung cancer.

Live on a diet of fatty, sugary food and you’re likely to carry a dangerous amount of weight.

Drink soda pop every day and you increase the likelihood of getting diabetes.

But there are two problems with the good life-good health equation.

One problem is that you can make great choices and still wind up with a debilitating disease.

I know more than one person who exercised, ate organic and lived by the mantra of moderation then died on the young side anyway after an excruciating illness and in a swamp of medical bills.

The second problem with the good life-good health equation is that socalled good choices aren’t available to many people.

The notion that health is purely a personal responsibility ignores the circumstances of how many people are forced to live.

Under ideal circumstances, everyone would eat lots of vegetables, avoid junk food and soft drinks, drink alcohol only in moderation, enjoy work that didn’t wreck their bodies or their minds and walk at least 10,000 steps a day, preferably somewhere with luxuriant trees and clean air.

But the perfect circumstances are not available to many people.

Many live where it’s dangerous to walk.

Many grow up eating junk, and habits are hard to break, especially when the options are limited.

Not everyone can afford a gym. Some people work the night shift and can’t sleep properly.

There are those who have a genetic predisposition to addiction. When people who live in those circumstances get sick, it’s not a failure of goodness.

Good health is a complicated formula. So is what qualifies as a good life.

But one thing’s sure about a good life, and it’s something the senators should keep in mind when the health care bill gets to the U.S. Senate:

A good life means caring about people beyond yourself and sharing responsibility for making a society in which we take care of each other.

Mary Schmich is a Pulitzer Prize-winning columnist for the Chicago Tribune. Contact her at mschmich@tribune.com. You can follow her on twitter.com/maryschmich or contact her on facebook.com/maryschmich