NHS: Should those who fail to look after their health continue to get free treatment?

mike1948mike1948 Posts: 2,156
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I am a big supporter of the NHS but recent events have made me wonder if those who repeatedly fail to look after their health should continue to receive free care - often at the expense of those who act sensibly.

The recent Channel 4 series The Hospital was a big eye-opener for me. One programme showed the relatively young people who have destroyed their livers with excess alcohol consumption, drug use, or by being too fat. Some die before they can get a liver transplant but if they are lucky and are selected it costs the NHS £90,000. Another programme showed the diabetics who failed to check their sugar levels and to keep hospital appointments.

Now there are reports about how people are repeatedly contracting sexual infections as a result of not taking the most elementary of precautions.

NHS funds are not unlimited and we can already see the hard choices being made over costly treatments.

If you do not close your windows and are burgled, your insurance company will probably not pay your claim. Should the NHS adopt a similar stance with alcoholics, drug users, the obese and others who fail to mend their ways?
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Comments

  • The SnakesThe Snakes Posts: 8,940
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    I think people that are deliberately unhealthy should have to pay a higher rate of national insurance.
  • slapmattslapmatt Posts: 2,359
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    mike1948 wrote: »
    Should the NHS adopt a similar stance with alcoholics, drug users, the obese and others who fail to mend their ways?

    In the same programme they turned down several people for transplant operations because they had showed no intent to change their lifestyles, so in a way this is already happening.

    Personally I would prefer a move to payment on demand, but then I would, I'm young, relatively healthy and have private medical insurance! I'm sure older people who don't have insurance think the current system is ideal.
  • Daveoc64Daveoc64 Posts: 15,374
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    The Snakes wrote: »
    I think people that are deliberately unhealthy should have to pay a higher rate of national insurance.

    Define "unhealthy".

    The main problem is that these things are hard to pin down.

    I know people who are in their 80s and have smoked all of their life.

    Then there are people much younger than them that have died from lung cancer caused by Smoking.

    While the idea of making people pay more for an unhealthy lifestyle makes some sense, I don't see how you can clearly define what that lifestyle is in order to start taxing people.

    The current system (while not directly linked to the NHS) favours taxing things like Cigarettes and Alcohol at the point of sale.
  • [Deleted User][Deleted User] Posts: 6,400
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    Only people being charged are the drunks at the weekends who blight A&E's the land over. They should be billed the full costs of the NHS, police in dealing with their self inflicted stupidity.

    :)
  • PhoebidasPhoebidas Posts: 3,941
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    It would be a dangerous step to take to start blaming people for health issues. Where does it stop?

    You played rugby so the broken neck is your own fault?

    You chose to drive that car when you could have walked the journey to the shops so no treatment for you after your serious crash?

    And then do we consider the personality or responsibility of the person involved?

    You care for elderly relatives and work with the disabled but you smoke. Compared to a child abusing health fanatic.
  • jmclaughjmclaugh Posts: 63,988
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    Treatment on the NHS is not free unless you don't/never did pay any tax. Refusing to treat people based on their lifestyle or increasing NICs for them is not I would suggest a practical solution and in any case you can argue smokers and drinkers already pay more tax.
  • MAWMAW Posts: 38,777
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    My OH abuses her health. She has a chronic condition, needs attention and drugs, but does not comply with doctor's instructions, fails to keep appointments (because her work diary committments have to come before her personal matters) and she'sgetting worse. The irony of it is that her employer pushes an extraordinary work shcedule onto her, and puts her under tremendous pressure to perform, and to achieve, and her employer is the NHS. Not for much longer if I get my way. They treat their staff appallingly.
  • The SnakesThe Snakes Posts: 8,940
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    I saw a massively obese woman buying several multipacks of crisps the other day. Why should people like her pay the same rate of NI as someone like me that eats healthily and goes to the gym 5-6 times a week?
  • PhoebidasPhoebidas Posts: 3,941
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    The Snakes wrote: »
    I saw a massively obese woman buying several multipacks of crisps the other day. Why should people like her pay the same rate of NI as someone like me that eats healthily and goes to the gym 5-6 times a week?

    Because you could injure yourself in the gym and cause the NHS even more than she does.

    And how do you know they crisps were for her? She could be overweight as the result of a medical condition and the crisps could have been for a healthy relative/friend who will eat sparingly as part of a balanced diet.;)
  • MuggsyMuggsy Posts: 19,251
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    The Snakes wrote: »
    I saw a massively obese woman buying several multipacks of crisps the other day. Why should people like her pay the same rate of NI as someone like me that eats healthily and goes to the gym 5-6 times a week?

    I agree. Such a high level of gym activity is massively more risky than supermarket shopping. You should pay more NI.
  • Sniffle774Sniffle774 Posts: 20,290
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    The question with all these ideas is would it cost more to manage than it would save ? Someone gets rushed into hospital as well as treating them you now need to take a full, none clinical, history to judge how much of what was wrong with them was self inflicted. Who decided what is accepted risk and what isnt ? Not sure the idea is that workable tbh.

    How do we track people habits and bill there NI accordingly , which was another suggestion ?
  • paulschapmanpaulschapman Posts: 35,536
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    mike1948 wrote: »
    I am a big supporter of the NHS but recent events have made me wonder if those who repeatedly fail to look after their health should continue to receive free care - often at the expense of those who act sensibly.

    The recent Channel 4 series The Hospital was a big eye-opener for me. One programme showed the relatively young people who have destroyed their livers with excess alcohol consumption, drug use, or by being too fat. Some die before they can get a liver transplant but if they are lucky and are selected it costs the NHS £90,000. Another programme showed the diabetics who failed to check their sugar levels and to keep hospital appointments.

    Now there are reports about how people are repeatedly contracting sexual infections as a result of not taking the most elementary of precautions.

    NHS funds are not unlimited and we can already see the hard choices being made over costly treatments.

    If you do not close your windows and are burgled, your insurance company will probably not pay your claim. Should the NHS adopt a similar stance with alcoholics, drug users, the obese and others who fail to mend their ways?

    Do you believe the NHS is there to look after you from the cradle to the grave?

    Simply put once you allow one to deny or delay treatment where does it stop.

    Obeseity for example can be related to the speed of the metabolism or genetic even, equally can be a sign of other psycological problems.

    Same thing with Cancer - do you differentiate between for example smokers and those who carry genes that make getting cancer more likely and who also smoke.

    Until recently few knew that Sergei Brin - cofounder of Google has a genetic disposition for Parkinson's - caused by a gene called LRRK2, which sits on the 12th chromosome—a genetic mutation that has been associated with higher rates of Parkinson’s. However with careful excercise and diet the chances of him getting the disease go from between 30-75% to as low as 10% (the average American has a 1% chance). Do we deny treatment therefore to those who have this gene if they do not exercise or change their diet?

    Alcholism for example, as are other forms additiction a sign of other more deep seated problems - should be not deal with those, rather than deny them treatment?

    As for those who think it is clever to get drunk on a Saturday night and think they look clever throwing up in someone's doorstep perhaps we need to educate them better. Certainly I never did and I'm only in my 40's - I was educated to the problems of alchohol and anyway I hate the feeling of being drunk!

    No, banning treatment to such people is not the answer - education and treatment of underlying problems is.
  • mike1948mike1948 Posts: 2,156
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    Do you believe the NHS is there to look after you from the cradle to the grave?


    No, banning treatment to such people is not the answer - education and treatment of underlying problems is.

    In theory, yes, but total care is proving to be financially impossible. That's why people with assets worth more than a certain amount have to pay for their care in later life.

    My point was what should happen to those who repeatedly fail to act responsibly. Failing to use a condom and getting SIs repeatedly is surely gross irresponsibility.

    Go back 30 years and there were very few hugely obese people. In fact, they turned heads. Now you can see several of them shopping in every supermarket and no one bats an eyelid. Look in their trolleys and you will see they have bought every unhealthy, fattening food they can find.
  • ResonanceResonance Posts: 16,638
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    The Snakes wrote: »
    I think people that are deliberately unhealthy should have to pay a higher rate of national insurance.

    In the case of smoking and drinking they kind of do. Maybe not national insurance, but they pay a lot in duty. In the case of smoking they more than pay for smoking related illness.
  • paulschapmanpaulschapman Posts: 35,536
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    mike1948 wrote: »
    In theory, yes, but total care is proving to be financially impossible. That's why people with assets worth more than a certain amount have to pay for their care in later life.

    My point was what should happen to those who repeatedly fail to act responsibly. Failing to use a condom and getting SIs repeatedly is surely gross irresponsibility.

    Go back 30 years and there were very few hugely obese people. In fact, they turned heads. Now you can see several of them shopping in every supermarket and no one bats an eyelid. Look in their trolleys and you will see they have bought every unhealthy, fattening food they can find.

    My original point still stands rather than refusing treatment to those who have a degree of responsibility for their condition - deal with the condition that got them to that point.

    This might be psycological, or genetic but deal with it.

    Consider for example; people from the Asian sub-continent have a higher chance of getting diabetes - do we therefore ration that.

    You cannot ration something unless you set clear rules as to where the break is and having done so how do you stop slippage so that someone who you might think is deserving but later society changes and they cease to be so.

    An obese person who piles up high fat foods when buying shopping may just need educating. They may not know that the food is unhealthy nore make the connection with being large and their diet - this may simply be an educationally thing, or a sign of more deep seated problems. A fat person may just be lonely (food becomes a comfort thing rather than nurishment - the obese person then becomes more lonely as their size increases and it gets worse as they cannot do things like excercise).

    To restrict people's access to care becomes a judgemental thing and inevitably one ends up making a subjective judgement on the worth of someone's life as a result of their behaviour.
  • TassiumTassium Posts: 31,639
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    The definition of "self inflicted" is always strangely biased against the behavior of those without much status in society. Funny that.


    You can be sure, however, that over time the definition of self-inflicted would widen. Especially if the Conservatives get their way and introduce private insurance.

    It's a bad move to turn against the weakest in society, it will be you next.
  • jmclaughjmclaugh Posts: 63,988
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    Tassium wrote: »
    You can be sure, however, that over time the definition of self-inflicted would widen. Especially if the Conservatives get their way and introduce private insurance.

    Ano example of unadulterated tosh.
  • camercamer Posts: 5,237
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    i noticed some comments about smoking and drinking, if everyone stopped smoking or drinking the country would be bankrupt overnight.
  • himerushimerus Posts: 3,040
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    jmclaugh wrote: »
    Ano example of unadulterated tosh.

    Were you saying it was all tosh or just the political element?
  • The 12th DoctorThe 12th Doctor Posts: 4,338
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    The amount raised by tobacco revenue hugely outweighs the amount the NHS spends on smoking-related illnesses. Smokers actually have credit with the NHS.
  • paulschapmanpaulschapman Posts: 35,536
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    Tassium wrote: »
    The definition of "self inflicted" is always strangely biased against the behavior of those without much status in society. Funny that.


    You can be sure, however, that over time the definition of self-inflicted would widen. Especially if the Conservatives get their way and introduce private insurance.

    It's a bad move to turn against the weakest in society, it will be you next.

    This statement is absolute rubbish! Look up the thread and you can see that despite being a lifelong conservative voter I am arguing against withholding treatment from those who bear responsibility for their condition.

    However I will conceed your point that there may be higher instances of smoking, obesity and alcholism amongst poorer people - it might also have something to do with lower educational achievement so they do not know what fats are good for you, and which ones are bad - or that excessive drinking leads to liver disease.

    This is not a political question, it is an economic one and therefore people from across the political divide will have differing opinions - mine is that this is a bad idea.
  • stud u likestud u like Posts: 42,100
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    The Snakes wrote: »
    I saw a massively obese woman buying several multipacks of crisps the other day. Why should people like her pay the same rate of NI as someone like me that eats healthily and goes to the gym 5-6 times a week?

    For all you know,she might be healthier than you are.
  • raidon04raidon04 Posts: 3,448
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    It's called universal health care for a good reason. The ethics of healthcare were scrutinised at the NHS' founding and the consensus was agreed as a result.
    Article 25 of the Universal Declaration of Human Rights of 1948 would be violated in doing so also.
  • PhoebidasPhoebidas Posts: 3,941
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    However I will conceed your point that there may be higher instances of smoking, obesity and alcholism amongst poorer people - it might also have something to do with lower educational achievement so they do not know what fats are good for you, and which ones are bad - or that excessive drinking leads to liver disease.

    Perhaps they do know but just do not care?
  • [Deleted User][Deleted User] Posts: 13,672
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    Are people mistaking the NHS with Public Health?

    The NHS is there to treat anybody who needs it

    A lot of the arguments here are about people's ignorance of their own health - they don't seem to know about obesity, smoking, alcohol, sexually transmitted diseases. Where are the public health campaigns which we saw through the 80s? Speaking with teenagers today they are really ignorant about safe sexual practices.
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