The Missing Ingredient in America’s Health Care Debate

Charles Colson’s essay "Clean Livin': Protecting Ourselves from Ourselves" cuts through the noise of today’s endless health care debates with a simple, uncomfortable truth: America’s most expensive health problems aren’t caused by a lack of government programs—they’re self-inflicted.

We live in a culture obsessed with policy solutions, where every problem demands a federal fix. But while politicians argue over trillion-dollar health care overhauls, the real crisis isn’t in Washington—it’s in our daily choices. Smoking, alcoholism, drug abuse, reckless eating, and promiscuity aren’t just personal vices; they’re public health catastrophes that drain billions from the system. And no amount of taxpayer-funded medicine can undo the damage of a lifetime of bad decisions.

Colson’s argument is blunt but undeniable: If Americans took better care of themselves, the health care system wouldn’t be in crisis. So why does this common-sense solution get ignored? Because it’s easier to demand a government bailout than to admit we’re the problem.

The Myth of the "Fix-It" Health Care System

Too many Americans treat health care like an all-you-can-eat buffet of consequences. We smoke, drink excessively, eat junk food, sleep around, and then expect doctors to magically undo the damage. The system wasn’t designed to be a safety net for self-destruction—yet that’s exactly how we use it.

Consider the numbers:

Smoking costs $52 billion annually in health care expenses.

Alcohol-related incidents account for nearly half of all motor-vehicle deaths.

Obesity-related diseases (heart disease, diabetes) are among the top killers in the U.S.

STDs, including AIDS, cost billions in treatment and lost productivity.

These aren’t random misfortunes—they’re direct results of personal behavior. Yet instead of addressing the root cause (our choices), we demand that hospitals, insurers, and taxpayers foot the bill.

The Government Can’t Save Us from Ourselves

Politicians love promising "universal health care" as if it’s a magic wand. But no policy can force people to stop smoking, eat vegetables, or stay faithful in marriage. You can’t legislate self-control. Dr. Louis Sullivan, former Health and Human Services Secretary, estimated that 40-70% of premature deaths in America are tied to preventable behaviors. That means millions of lives—and billions of dollars—could be saved if people simply made better choices.

Yet instead of promoting personal responsibility, our culture glorifies indulgence:

Fast food is cheaper and more accessible than healthy meals.

Hookup culture normalizes risky sexual behavior.

Social media glamorizes binge drinking and drug use.

Mental health is treated with pills instead of discipline.

We’ve created a society where vice is celebrated, consequences are ignored, and the health care system is expected to clean up the mess.

The Solution Starts in the Mirror

The prescription is simple: "Clean living." Don’t smoke. Don’t drink excessively. Don’t sleep around. Don’t eat garbage. Exercise. Take care of your body. It’s not complicated—just inconvenient in a culture that hates saying "no" to itself. Some will dismiss this as "victim-blaming." But that’s a cop-out. Acknowledging personal responsibility isn’t cruelty—it’s empowerment. If your health is destroyed by your own choices, no government program can truly save you. But if you take control, you won’t need saving.

A Culture That Encourages—Not Enables—Health

Real reform doesn’t start with Congress—it starts at home, in schools, and in communities. We need:

Honest education about the consequences of bad habits (not just scare tactics, but real-life cost breakdowns).

Cultural shifts that celebrate discipline over indulgence.

Personal accountability in health insurance (why should responsible non-smokers pay the same as chain-smokers?).

Stronger families and communities that reinforce healthy living.

Government can’t (and shouldn’t) micromanage our lives. But we can stop pretending that more spending will fix problems that only self-discipline can solve.