Universal Healthcare: Not at All Universal
Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.The position of the doctors is not utterly nonsensical. People who live unheathy lifestyles really are imposing costs on taxpayers.
Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.
£1.7 billion is spent treating diseases caused by smoking, such as lung cancer and emphysema
Fertility treatment and “social” abortions are also on the list of procedures that many doctors say should not be funded by the state.
The findings of a survey conducted by Doctor magazine sparked a fierce row last night, with the British Medical Association and campaign groups describing the recommendations from family and hospital doctors as “outrageous” and “disgraceful”.
About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.
Managers defend the policies because of the higher risk of complications on the operating table for unfit patients. But critics believe that patients are being denied care simply to save money.
The Government announced plans last week to offer fat people cash incentives to diet and exercise as part of a desperate strategy to steer Britain off a course that will otherwise see half the population dangerously overweight by 2050.
Obesity costs the British taxpayer £7 billion a year. Overweight people are more likely to contract diabetes, cancer and heart disease, and to require replacement joints or stomach-stapling operations.
Meanwhile, £1.7 billion is spent treating diseases caused by smoking, such as lung cancer, bronchitis and emphysema, with a similar sum spent by the NHS on alcohol problems. Cases of cirrhosis have tripled over the past decade.
Among the survey of 870 family and hospital doctors, almost 60 per cent said the NHS could not provide full healthcare to everyone and that some individuals should pay for services.
One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.
Tony Calland, chairman of the BMA’s ethics committee, said it would be “outrageous” to limit care on age grounds. Age Concern called the doctors’ views “disgraceful”.
Gordon Brown promised this month that a new NHS constitution would set out people’s “responsibilities” as well as their rights, a move interpreted as meaning restrictions on patients who bring health problems on themselves. The only sanction threatened so far, however, is to send patients to the bottom of the waiting list if they miss appointments.
The survey found that medical professionals wanted to go much further in denying care to patients who do not look after their bodies.
But isn’t letting them do that part of the basic logic of the welfare state?
Doesn’t “enlightened opinion” say that drug users should get treatment -- and get it at the taxpayer’s expense? Isn’t it considered mean-spirited, and even downright racist, to condemn a woman who has a child out of wedlock, imposing all sorts of costs on society, starting with welfare benefits, but going on to include all the social pathologies that come with out-of-wedlock births?
Of course, once government takes responsibility for everybody’s health care, one logical possibility is to tell people “live as we say or we won’t treat you.” The other possibility is to say “since we have to treat you, we are going to force you to live as we say.”
The more sensible viewpoint is the market-oriented one. It says, in effect “you can live however you want, and then you can see whether you can get insurance and how much it will cost.” That’s what prevails with life insurance and long-term care insurance in the United States. It’s less a factor with health insurance, which usually tends to be “all or nothing.” But it’s clearly more humane than the alternatives.