Thursday, 22 October 2009

#welovethenhs Except When Inconvenient

There has been a lot of cyber noise about that human pole vault crash mat in Ipswich. The Sun have been working the room, too.

The general consensus is that he is irresponsible and should be allowed to suffer/starve/rot because the rest of us are paying for him.

However, there are two types of people saying it ... and there is a distinct contrast, between consistency and hypocrisy, depending on where the proponent's theoretical starting point lies.

Take an odious worm like the National Obesity Forum's Tam Fry, for example. On a BBC radio phone-in yesterday, he was advocating his fake charity's policy that such people should be made to pay for their treatment.

What he is saying is that if you overeat, you should pay for related healthcare or "accept the consequences", said consequences being, of course, that you either cough up a barrowload of money ... or die.

Hmmm, sounds familiar. Hold on, it'll come to me in a minute. Uh-huh, got it. It was the same line taken in June by a fellow Director of the National Obesity Forum, one Jane "They'll Just Have To Die" DeVille-Almond.

The message from these nasty eugenicists is that unapproved lifestyle choices should not be tolerated by the majority of 'responsible' users of the NHS. Yet they are basing their entire reasoning on an actuarial theory that costs borne by the NHS, which are as a direct result of personal choices, should not be included in the category of 'free at the point of delivery'. They have decided which substances or practices are to be demonised and are inferring that the NHS spend on treating smokers/drinkers/obesity is a theft from the public purse.

In short, they are playing on the public's jealousy that someone else is getting more for their money than the average Joe does.

The fact that, with regard to 'unhealthy' lifestyles, this is demonstrably untrue, is immaterial as it is what the public believe after an avalanche of righteous fear-peddling.

Fry (another bloody prissy meddling Jock! Why are we no longer surprised?) is very consistent in his approach to this policy. There are no exceptions. He includes himself as a possible for falling foul of this, for he likes a drink, but as he drinks 'responsibly' he appears 100% certain that it will never happen to him (besides, he can afford it as the state pays him a fortune for peddling this shit). He is not merely talking about egregious examples like the East Anglian barrage balloon either - a 12 stone nurse who received treatment for breast cancer was equally informed that she should have paid for her chemotherapy.

If the criteria is set at such an incredibly low level, there will be a hell of a lot of people paying for what they always believed to be a 'free' service. After all, the vast majority will have paid heftily for it in good faith.

How many greasy spoons up and down the country have been host to the ranting of fry-up guzzling workers, poring over their copy of the currant bun, and venting their spleen at the Ipswich blubber-butt? how many gaggles of slightly overweight Mums, at primary school gates, have been bemoaning their taxes being wasted by this man, before toddling off to Weight Watchers classes? How many of them also smoke, how many drink above recommended unitary limits? How many have been opining that his ilk should be made to pay for his treatment, blissfully unaware that should such a policy be implemented, they too would be made to empty their paltry savings?

Presumably, all such people believe that the bar should be set at the level at which they find objectionable ... that is, anyone visibly larger than them, or who drinks more than them, or who smokes 'too much'. They are all right of course, they are only a bit tubby, they get pissed at weekends but hey, doesn't everyone? And if they smoke, it's not a lot really and they honestly want to give up, so they will be fine.

But if the public trust the proscriptive types in the NHS to tackle only what the public deem as the worst excesses, they are going to be in for a very nasty surprise.

Once the bills begin to be slapped into their hands at the local A&E, they might not #welovethenhs so much anymore. They may then see that it is a system which was sold as being entirely free, which has been paid for through their taxes, but for which extra payment is now being pursued.

It won't be viewed as so bloody perfect then. And how long before the outcry begins to be able to opt out of national insurance payments if this is going to be the case. Why not? If smokers, drinkers and the obese are going to have to take out insurance policies to cover crippling financial penalties (which is an obvious consequence), then why not be allowed to give the private operator all of the business? Why should we be forced by law to pay for a service which only affords the user limited use based on what is deemed correct behaviour and what is not?

Which, funnily enough, is exactly where I stand on the issue. There is a need for a universal health service, but it should be on a voucher system which covers every citizen with a necessary health care. You can choose where you spend your government vouchers, but if you want a higher level of care, you should be prepared (and able) to pay for it.

You see, I can say that he is a fat fucker and I don't want him to be treated on the NHS, but that's because I have always said that the NHS is a thieving organisation which wants us to pay sackloads of cash and then deny our use of it by any means possible. But I don't say that, because while we have an NHS which is designed to treat everyone no matter their lifestyle, he is as deserving as anyone else.

If Tam Fry wants that to change, he must either push for a seismic overhaul in the way healthcare is provided in the UK or shut the fuck up. Tam, of course, doesn't want that at all. Tam wants to keep the NHS exactly as it is, but just make people he doesn't like pay more for it. That's because Tam is himself a hideously pompous drain on the NHS, and deserves to have his intestines removed violently by a psychotic, genetically-enlarged woodpecker.

However, anyone who joined in the #welovethenhs bullshit earlier this year, but simultaneously wants this guy to be allowed to die, is hypocritical and stupid. You either love a warts-and-all health service which treats everyone regardless of illness or means ... or you don't. You can't have it both ways.


Curmudgeon said...

Obviously if you follow that line of reasoning, no sports injuries should be covered, so you have to take out health insurance if you wish to take part in sport. So you end up getting fat instead...

Dick Puddlecote said...

That point was raised PB. Tam was strangely silent, but as we all know from the righteous, once they gain one concession, they are after the next. I'm sure they will push for such a thing if the charging for obesity/smoking/drinking scam gets adopted.

It will be "the next logical step" (copywright: ASH).

banned said...

What about all those people who selfishly get old and expect free treatment for their dotage ?
Make them sell their houses to pay for their greed says I.

Personal note, after paying for the NHS for 28 years.
6 months ago, slight back injury, some pain.
5 months ago, approach GP.
3 months ago referred to Physio Clinic
2 months ago, Physio recommends visit to Orthop. hospital
1 month ago GP agrees.
( Privately recommended to Osteopath, seen in 2 days, £33.00 = pain relief )
Next month Appointment with NHS Consultant, 10 minutes !
Prediction. 2 month waiting list for CAT scan.
NHS = Rationing by Waiting List.

( note to self, don't tell 'em about the private treatment or they will chuck you off their list. )

Angry Exile said...

The country's broke. The idea is probably to move further and further from the 'free at the point of delivery' model and towards a pay per use system until there are hardly any people who remember being able to pitch up with a problem and not have to fork out for treatment. Tax and NI contributions will still be needed to pay for running the NHS of course ;-) but I expect there's a date on a calendar somewhere in Whitehall marking the time by which only A&E treatment is still 'free'.

Jim said...

I have to admit that as a slim non smoking, non drinking, non drug taking man, I get a bit pissed off that my taxes are paying for all the pissed up idiots who injure themsleves (and others) on a Saturday night, for all the smoking cancer victims, for all the drug related problems and for all the health issues related to people who think food only comes in pizza boxes. And if I need some small treatment I get shoved to bottom of the list as there's always more 'deserving' cases ahead of me.

Is it surprising that if you take away the consequences of peoples actions (that if you do stupid stuff and your health suffers, you have to pay for it to be fixed) that you get more stupid behaviour?

The NHS was designed to help people in need with everyday sicknesses and accidents, not to treat self inflicted ailments and catastrophes. I hardly think Nye Bevan created the NHS so pissed up idiots who drink 15 pints of Stella and put their hands through glass windows can get their wounds stitched up for free.

The NHS is a vast organisation primarily tasked with preventing stupid people from killing themselves before their three score years and ten. Which as far as I'm concerned, they should be allowed to do. It might make life better for the rest of us.

Dick Puddlecote said...

Controversial, Jim (decently argued, though).

Are you saying the NHS should be scrapped in favour of something different? Or just that those who have 'objectionable' lives should be excluded from treatment while still paying? Cos there is a difference IMO.

Just a small point. They smoked in Nye Bevan's time too, you know. ;-)

Jim said...

The NHS used to work on the insurance principle. That we were all equally likely (or not) to have an accident a work, or break our legs, or catch pneumonia, or have apendicitis. Everyone knew the consequences of illness before the NHS - it cost money to be cured, and if you didn't have the cash you had to fall back on what little safety net there was. So it was in everyones interest to stay healthy. Everyone had a pretty equal chance of needing the NHS.

Nowadays the NHS is a glorified wealth transfer system from those who look after their health, pay their taxes and make little call on the NHS to those who pay no tax, take no care of their health or wellbeing and make many calls on the NHS.

I am firmly of the opinion that I should be able to take my 'National Insurance' contributions to another insurer other than the State, who might, because of my healthier lifestyle, insure me for less than I pay now. I would also get defined benefits by having a contract of insurance, rather than nothing written down at all.

Where is it actually written that in return for your hard earned tax you have the right to any NHS treatment at all? If my GP refused to treat me could I take him to court? If the NHS refuses me an operation on whatever grounds it chooses, I cannot force them to treat me. The whole system is an extortion racket. They take my money but offer no defined service.

I say give me my NI cash, and I'll take my health insurance needs elsewhere. Anything has got to be better than a monolithic State provider that wouldn't look out of place in 1950s Soviet Russia.

Dick Puddlecote said...

That'll do me. I'm sold. :-)

And for us hedonists, the added bonus of never having to listen to another "It costs the NHS £x" again.

Does Tam Fry really think about what he could be proposing here?

Junican said...

Why do we do it? We do it all the time. We go from the particular to the general quite unjustifiably.
This fat chap is clearly a one off and must be helped. Nevertheless, there are questions which come to mind. For example, since he was so fat, he probably was not able to go to the shops himself, so who went to the shops and bought these mountains of food for him? Who paid? Who cooked? It would have been very simple for his 'carer' to have said, "No! You cannot have 4 cod portions, two pies and six helpings of chips. All we have is apples and pears".

There are obvious failings all over the place in this particular case, but, in my opinion, they primarily lodge at the door of his carers.

My wife and I go to Majorca three or four times a year. These trips are an excellent opportunity to sit back, do nothing and observe humanity.

It really is surprising just how many plump people there are. In all probability, they would be designated as 'obese' if judged by whoever it was who defined obesity, but none of the people I refer to looked anything but perfectly healthy. I have my own little phrase to describe this 'plumpness' and that is 'affluent flab'.

However, it is also true that one sees many, many people who are, frankly, grossly flabby. My wife and I call them 'blubalubs'. We ask ourselves how on earth they get there bums into aircraft seats. Funnily enough, one never ever SEES these people in airports. It is a very strange thing.

From the above, merely as a result of observing humanity, it seems obvious to me that being pleasantly plump is the natural body shape for a middle-aged human being. It is a healthy state. On the other hand, blubalubs have gone too far.

Nevertheless, it is their decision to become blubalubs. The flab that they carry must restrict their activities terribly, but that is their decision. And I doubt very much that they trouble the NHS significantly other than in the extreme case of this particular chap.

And so we come back, once again, to the gross interference in the way in which we conduct our individual lives by health professionals and the blatant prosecution of people who just want to enjoy their loves as best they can - cigareets and whiskey and .........eating.

banned said...

Jim, I agree with your conclusion about being able to shop around for our health insurance needs but you will find that smokers and drinkers contribute far more to the taxman than they cost the NHS, £Billions in each case; same applies to drivers btw ( I expect that Dick can point to this in one of his excellent posts ).

My current health problems ( see above ) have nothing whatever to do with the fact that I smoke and drink, nor was I involved in a hazardous or extreme activity, just an everyday accident, helping someone else actually yet five months since approaching the NHS I am still a month away from a 10 minute chat with the consultant and know that there will be a further 2 month delay for proper diagnosis.

Jim, back in Olden Days over 90% of the population had access to affordable health care through Union dues, staff benefits and Mutual Aid, the Labour Party did not create the NHS, they Nationalised what was already there.

Jim said...

I realise that NI contributions alone do not pay for the NHS, and that drinkers, smokers and drivers pay extra taxes which help cover the NHS costs. But that just makes the system less opaque. No one can say how much of the beer tax, or cigarette tax ends up in the NHS. It all goes in the general spending pot.

Far better to give everyone cash vouchers for a basic level of care - that covers all conditions, just as the NHS does now, but that would be subject to additional charges based on your lifestyle. The cost of these vouchers would be less than the NHS now as they would be based on the costs related to healthy individuals. The savings could then be used to reduce national insurance taxes, cigarette taxes, drink taxes and car taxes.

Thus those that had unhealthy lifestyles would pay more in insurance charges (but save on cheaper fags'n'booze) while the 'my body is a temple brigade' (population - me) would just use the basic vouchers, and save on our NI contributions. The likely cost of treating any individual would therefore be more aligned to their level of contribution. Not entirely as you get the basic package for 'free', but you'd pay extra out of your own pocket for your own lifestyle choices.

I would place people with inherited disabilities (ie born with them) in a separate category - covered more by the DHSS than the health budget, as they would struggle to get insurance at any price let alone the basic voucher. Given the number of people born this way is pretty fixed it would not be a massive cost, or a rising one.

JuliaM said...

"Nevertheless, there are questions which come to mind. For example, since he was so fat, he probably was not able to go to the shops himself, so who went to the shops and bought these mountains of food for him? Who paid? Who cooked? "

We paid. And the people who cared for him? Yes, we paid their wages too.

As for his carers saying 'No', well...

You can guess what the answer is going to be to that, can't you?

Anonymous said...

As I have posted elsewhere, if you smoke, drink moderately, eat a few pies the NHS are prepared to let you die. However, if you are suffering from a debilitating, terminal disease you will be hooked up as many machines necessary to keep you aspirating and make sure criminal charges are pressed against relatives who want to take you away for a long weekend in Switzerland.

Anonymous said...

@Henry - I don't think they do any longer, or at least not if you're old and in one of the hospitals that practises the new-fangled 'Pathway to Death' or 'Gateway to Heaven' policy.

I've been listening closely to politicians' proposals for dealing with the looming crisis that is care for the elderly. All too aware of the resentment felt by those whose modest assets will be stripped to pay for care, desirous of the grey vote and knowing perfectly well that there isn't a penny in the state purse, they're frantically trying to make the infeasible sound plausible.

The Government on its website cynically suggests using trusts, knowing full well that no-one in the appropriate demographic group will find its suggestion.


Anonymous said...

...That last paragraph doesn't really make sense in context!!

Should have said that until an election hove into view the Government hid away its suggestion. Now, along with the Tories, it's keen to trumpet (useless) proposals.