03/18/2010 05:12 am ET | Updated May 25, 2011

Mad at Greedy Insurers for This Health Care Mess? Then Why Aren't You Mad at Your Greedy Neighbors?

Raise your hand if you are still filled with anger when you hear the name AIG and picture the more than $100 million of your tax dollars that were delegated--without your consent--for employee bonuses there.

Now raise your hand if you were angry when you learned that Citigroup (which has received so much bailout money that American taxpayers have been dubbed "its major stockholder") was planning to spend $50 million of your money on a luxury jet. (A purchase that was later nixed thanks to criticism from the media and government watchdogs.)

If you raised your hand you're not alone. If you're still angry, you should be. There is something inherently distasteful about being expected to foot the tax bill for someone else's personal choices--particularly bad ones--and not being given any choice of your own in the matter. Which is why I am so surprised that there has been so little anger expressed by leaders on either side of the health care debate when it comes to the issue of personal choice and responsibility in health care.

According to the Centers for Disease Control, "obesity costs our nation as much as $147 billion per year in direct health care costs and lost productivity." And according to the nation's oldest anti-smoking organization smoking costs taxpayers a whopping $300 billion dollars annually, or 1,000 times the amount of the AIG bonuses.

Some health care reform advocates will argue these costs would be lower if there were government subsidized health care, but my question is why should the government, specifically taxpayers, subsidize health care costs for conditions that are not only preventable but essentially chosen by the patient? With all of the anger surrounding the health care debate, at town halls, in the House and Senate, where is the anger about personal responsibility?

This issue hits close to home for me. Diabetes runs in my family (a reality that unfortunately, hangs over my sweet tooth like a dark cloud). Of two family members battling the disease--one in its earliest stages--both were given a strict dietary regiment to follow. One did, and was able to forgo costly medication. The other chose the irresistible Southern cuisine that is a staple of so many African-American diets (mine included) over doctor's warnings and the promise of a healthier weight. His health has suffered accordingly. Now I'm not self-righteously proclaiming that I am definitely disciplined enough to make a different choice than he (ask me in a few decades), but I simply don't believe that whether I do or not is your problem.

To be clear, personal responsibility is not only up to consumers. Mayor Bloomberg's success in curbing smoking in New York is due to a multi-pronged strategy of aggressively fining bars and restaurants that allow patrons to flout the anti-smoking ban and raising the cost of cigarettes, in essence targeting the dealer as much as the addict. A similar strategy should be undertaken federally against fatty foods and drinks (including many of the ones I love). But as long as groups like the AFL-CIO oppose efforts to hold Americans financially accountable for their personal health choices, so that the system can afford to treat those who do not choose to be sick, taxpayers have every reason to question handing the government a blank check to "fix" health care.

In addition to being angry with AIG, I am also angry at the greed displayed by insurance executives such as the ones who so barbarically tried to deny coverage of Dawn Smith's brain tumor treatment. (Not to mention the one who recently required my doctor to verify--twice--that I "need" a medication, despite the exorbitant premium that I pay.) Greed is certainly one culprit to blame for this broken system, but personal responsibility is another. Yet elected officials--including the President--seem just as afraid of losing voters by telling this tough truth, as they are afraid of losing the contributions of the insurance and fast food lobby.

So the next time you are reminded of how angry you are at AIG or any other institution that was "bailed out" with your money, just remember that AIG may have mugged you once, but McDonald's and your neighbor keeping them in business (and whoever invented the doughnut, bacon cheeseburger), will be sucking your wallet dry for decades to come.

An earlier version of this piece ran on for which Goff is a political writer.