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Personal responsibility: Is that driven by financial penalties/incentives or does it come from improving a culture of health?

Personal responsibility: Is that driven by financial penalties/incentives or does it come from improving a culture of health? Does cost-sharing, or skin in the game cause people to forego needed care or avoid unnecessary care? Do people make logical and sound decisions about health? Is it our business if people do not make wise decisions and end up in poor health or with unaffordable bills?