For BMJ Blogs, Phoebe Friesen argues that including “personal responsibility” in health care policy can end up penalizing those who engage in stigmatizing behaviors. “The likelihood of health outcomes improving as a result of these policies also looks dire,” she writes. “A robust link between inequality and negative health outcomes has been demonstrated using data from around the globe, and since policies based on personal responsibility would inevitably restrict care for those who are already the worst off, we could expect an increase in overall inequality, and a decrease in overall health outcomes.”