Denying Health Care

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.

FILED UNDER: Economics and Business, Europe, Government, Health, World Politics,
Steve Verdon
About Steve Verdon
Steve has a B.A. in Economics from the University of California, Los Angeles and attended graduate school at The George Washington University, leaving school shortly before staring work on his dissertation when his first child was born. He works in the energy industry and prior to that worked at the Bureau of Labor Statistics in the Division of Price Index and Number Research. He joined the staff at OTB in November 2004.

Comments

  1. kb says:

    The Tories in England want to implement a plan that if you don’t lead a healthy life you will be denied health care.

    If you actually read the tories proposals they are proposing nothing of the sort.

    What they’re suggesting is

    We have considered ideas such as a ‘NHS Health Miles Card’ to promote the concept of wellbeing.Although much work would be required for development; we think that the creation of a small
    individual benefit scheme would change the language of health from illness to wellbeing. We are attracted by the idea of promoting health awareness through marketing tools. Health miles could be given as ‘reward points’ for giving up smoking, losing weight, receiving immunisations or attending screening programmes. Such rewards could be redeemed against fresh vegetables, discounted gym membership, or priority within other public services.

    http://www.careandhealth.com/resources/pdfs/psipg-report.pdf

    So they’re looking at ways to encourage healthier lifestyles(which is cheaper in the long run) without forcing anyone to do anything.

    Still ,The Daily Mail which you link to has quite a track record of deliberately misleading its readers about this sort of thing.

  2. Tano says:

    The Tory plan doesnt seem to me to be something that could actually become national policy. Far more likely to simply cost the Tories any chance they might have had of winning the next election.

    I dont think their proposal can be used to criticze national health – it is, lets face it, a proposal coming from people who at some level dont really believe in national health care. It represents an attempt to infuse a little private-market logic into the system – lets “run government more like a business” by thinking the way a private insurer would think – do what we can to minimize outlays.

    As for the BBC story about wait lists, I find it odd that nowhere is it mentioned the type of treatment, or the type of illness involved. Pending the reciept of contrary evidence, perhaps we can just assume that these are non-critical, elective treatments for relatively minor ailments?

    I certainly agree with what I sense is your opposition to the idea of denying coverage to people percieved to be high-risk. But that is, of course, a core principle in private markets. That conservatives wish to bring this ethic to a public, universal system is not a rap on those systems, but rather on conservatives.

  3. ken says:

    Of course what Steve does not mention is that the smoker in question is indeed recieving health care. The doctors have prescribed a treatment plan that starts with stopping smoking. Until the risk associated with smoking is eliminated any non emergency surgery should be postponed because it could lead to him actually losing his leg due to his circulatory problems caused by his smoking. He doesn’t pay for his doctor visits or for the advice. It is covered by the National Health Plan.

    This is no different than postponing certain blood tests until the patient has voluntarily fasted for twelve hours. Certain medical procedures require patient cooperation otherwise it is just a waste of time and money.

  4. yetanotherjohn says:

    Lets think about a list of “unhealthy activities”

    Illegal drugs (some worse than others)
    sex with multiple partners (could be mitigated by protection, but not truly)
    over eating
    not getting enough sleep
    not exercising enough
    not eating the “right things”
    excessive alcohol
    overwork

    Just think about the number of people who do not conform to the classic food pyramid. If you exclude them, you probably can get the health care costs down to a manageable level.

  5. Steve Verdon says:

    Actually kb you need to read the entire article.

    But heavy smokers, the obese and binge drinkers who were a drain on the NHS could be denied some routine treatments such as hip replacements until they cleaned up their act.

    ken,

    Of course what Steve does not mention is that the smoker in question is indeed recieving health care. The doctors have prescribed a treatment plan that starts with stopping smoking. Until the risk associated with smoking is eliminated any non emergency surgery should be postponed because it could lead to him actually losing his leg due to his circulatory problems caused by his smoking. He doesn’t pay for his doctor visits or for the advice. It is covered by the National Health Plan.

    Thank you, yes, I already covered that the government would control aspects of your life simply because of costs.

    YAJ,

    Just think about the number of people who do not conform to the classic food pyramid. If you exclude them, you probably can get the health care costs down to a manageable level.

    Funny under a private system people who do many of those things can get health insurance they just might have to pay more. But in places like Canada or under Clinton Care that option would not exist.

    And lets not forget people engaging in extreme sports, late in life pregnancies, and other high risk activities. How dare these people make decisions.

  6. kb says:

    Actually kb you need to read the entire article.

    I did read the article. I also read (and provided a link to) the actual policy review document on which the article was reporting.

    There is a significant difference between what is actually said in the policy document and what is claimed is said by your article.

    I’m basing my views on the policy document , and you’re basing yours on the article.

    If the daily mail’s analysis is accurate then it also seems strange that no other UK media source has interpreted the proposals in this way. Not even the traditionally anti-tory ones.

  7. Grewgills says:

    Of course what Steve does not mention is that the smoker in question is indeed recieving health care. The doctors have prescribed a treatment plan that starts with stopping smoking. Until the risk associated with smoking is eliminated any non emergency surgery should be postponed because it could lead to him actually losing his leg due to his circulatory problems caused by his smoking. He doesn’t pay for his doctor visits or for the advice. It is covered by the National Health Plan.

    Thank you, yes, I already covered that the government would control aspects of your life simply because of costs.

    The man in question is in poor health. He cannot work due to unspecified “chest problems.” Do you know what his “chest problem” is? Have you seen his chart? Don’t you think there might actually be something to the hospitals statement that his smoking would substantially increase the risks of the surgery? If not what do you base your conclusion on?
    People in the US regularly have to alter their behavior prior to surgery. He is required to cease smoking for four weeks in order to have the surgery. He will not quit for even four weeks to end what he calls agony. Remember your support for his choice next time you are berating someone for lack of personal responsibility.

  8. Tano says:

    “Funny under a private system people who do many of those things can get health insurance they just might have to pay more. But in places like Canada or under Clinton Care that option would not exist.”

    I think you should take a deep breath Steve, and tone down the false propaganda and keep to the facts.

  9. M1EK says:

    No kidding, Tano. The idea that there’s a competitive market out there for individual health insurance for people who are addicted to smoking betrays a complete ignorance of the current state of affairs.

  10. Andy says:

    Here in America, smokers with pre-existing conditions can always get affordable medical insurance. Right? Right?