The Tories in England want to implement a plan that if you don’t lead a healthy life you will be denied health care. I thought this was interesting considering Alex Knapp’s post on a smoker in England who wont have his injured ankle treated because he smokes. Some argued that this is an anecdote, but this article suggests that the practice could become national policy in England.
And it isn’t just smoking, but doing things that the government deems as unhealthy. Heck, I’d list people who go snowboarding as having a high risk life style. Same for skiing. For example, this article on telemark skiing injuries inidicates a pretty high rate of injury1. Basically, we have the government controlling various aspects of your life or risk not having access to health care.
Some might argue so what? They can always opt for private health care. True, but that is what we have now in the U.S. and that is considered bad because not everyone is covered. Yet, when a policy is suggested that would exclude various portions of the population then that is okay. The schizophrenic view point here is hard to understand.
Further, when you kick people off of the government health program you are saying to the insurance industry: These are really, really large consumers of health care resources–i.e. they cost a bundle. Their health insurance would be extremely expensive. And since unhealthy life styles aren’t something confined to just the wealthy many non-wealthy individuals would find themselves in quite a bind.
And there is also an equity issue as well. Suppose one is already healthy and fit. What do you get? Nothing.
Yet while the Health Miles Card would award points for giving up smoking and losing weight, it could penalise those who are already fit and well because they would receive no benefits under the scheme.
And what is the difference, in terms of dollars, between a person who is obese and a person who was born with a congenital defect that requires lots of care? One could argue there is a choice involved with obesity, but the way many people fluctuate in their weight indicates it isn’t as simple as deciding to be fat or not. But one person is punished, the other is not.
Then there is this article about how over 6,000 patients in the Eastern part of England had to wait over 20 weeks for treatment to start. Hey, you got “free” health care for everybody….but only after waiting 5 months.
Also interesting in that article are the budget numbers. NHS in the Eastern region went over budget by 230 million pounds. This is why the mantra of, “Other countries provide health care for everyone and for cheaper” are rather dubious. Spending isn’t allowed to rise to a level that it would be if access to care was what it was like here in the U.S. for most people. Those 20 week wait times for treatments are costs, but they aren’t easily measured in monetary terms so they often get ignored. One way to measure them would be to determine the cost for that fiscal year of treating the person and adding that on top of the costs for something like the NHS. Of course nobody does this because it would make government programs like NHS look relatively worse and the U.S. system look relatively better. We can’t honesty when discussing health care.
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1This is just the abstract so this evidence should be considered tentative.
