Monday, 1 March 2010

Go treat yourself

Every so often some bright spark suggests that the NHS shouldn't treat people with "self-inflicted" ailments. Things like alcoholism, drug addiction, obesity, anorexia.

It sounds good on paper, for about five minutes. It would save the NHS millions of pounds, we would all pay less tax, and it would encourage people to take more care of their health.

But in reality the idea just doesn't stack up. For a start, how do you decide that something is self-inflicted? If someone is overweight, they may be over-eating or they might have faulty genes or a hormone imbalance. They might say they've genuinely tried to lose weight but nothing has worked.

If you refuse to treat a "self-inflicted" illness it could get worse, meaning far more expense farther down the line as the illness becomes terminal or the person loses their job or becomes a burden on others.

Also, any ailment can be seen as self-inflicted if you so choose. The hill-walker who breaks a leg on a mountain-top. The gym enthusiast who has a heart attack during a workout. The rock musician with hearing loss. If they hadn't been doing those things in the first place, they would be fine....

And who exactly would make the fateful decision? A doctor? A petty official? Your right to medical treatment would be subject either to someone's personal whim or some baffling set of guidelines. You sometimes use the lift and not the stairs? Sorry, mate, we can't help you.

Not to mention the awful choice for someone who's hard-up whether to scrape the money together for private treatment or somehow live with the illness.

In the end, it's just an attempt to blame the victim for their problem instead of giving them what they need. Of course we all try to avoid getting ill. Nobody wants to be swallowing a load of medicines or languishing in a hospital ward. But despite our best efforts, we can still succumb to ill health and it's up to the NHS to help us.

This half-baked idea belongs in the dustbin.

14 comments:

kylie said...

yes, that idea gets tossed around here at times and my reponse is always the same. exactly where should the line be drawn?
its just the tip of a user pays iceberg and the people who say these things have obviously never been really sick

Nick said...

Kylie - Precisely, where do you draw the line? It sounds simple but as soon as you start thinking about it, it's impossible to define. And you're right, these idiots can't ever have been seriously ill.

Wisewebwoman said...

It is appalling it is even up for debate, Nick.
As if these guardians of the purse can ever be objective!!
Blame the victim. As if they consciously choose to smoke/drink/eat themselves to death.
XO
WWW

Nick said...

www - It usually gets knocked on the head pretty quickly, but sooner or later it pops up again. No, people don't deliberately kill themselves, but they must be aware of the long-term health risk.

Baino said...

We have a similar health system here as you know and yet we all finance it whether our illness is self inflicted or not. I pay private health insurance and a Medicare levy even though I don't uses the public system except for the very rare doctor's visit and have spent 3 stints in hospital (all covered by my private insurance and two of those for the birth of my children) over the past 53 years! I think I've paid for my 'indulgences' even if they do make me ill one day! Do we stop treating drug addicts? Homeless drunks and psychotics . . I think not.

Nick said...

Baino - You certainly have paid for your indulgences, you deserve proper care if they ever catch up with you! Of course we all pay for the NHS as well, but are we ever consulted about radical changes in the way it's run? Of course not. Apart from election manifestos, that is.

Leah said...

Very interesting, and oddly paternalistic in reverse, if you know what I mean...

I mean it's still sort of parental: "you made your bed, now lie in it!!!" Like a punishment for "bad" behavior. Disturbing indeed.

By the way, I've enjoyed catching up a little here. I've gotten so used to reading every post of yours when they're posted, it felt strange to miss out! Man, I'm out of the loop. You have no idea. I'm telling you, Nick, this has been one crappy winter here at our house...(whinge, whinge, I know, I can't help it...)

nick said...

Leah - Very perceptive. Yes, it's not just refusing treatment, it's punishment for bad behaviour as well.

Sorry you've had such a shitty winter. But things can only get better....

tattytiara said...

It is a dangerous precedent, and not just for medical treatment. I mean if you draw the line at not treating people who are sick because they allegedly made themselves sick, why would you give food and shelter to homeless people who made themselves homeless? Justice to a beating victim who willingly went back to an abusive spouse?

It's not them, about why someone needs help. It's about us, and why we show compassion. Because we're human, and that's what humans do.

Nick said...

Tattytiara - Very true, the principle could be applied to all sorts of things. So eventually nobody gets any help at all and everyone's left to fend for themselves. Perfect.

Liz said...

Sometimes I can get very self-righteous and mutter about smokers (my pet hate) but then I think 'there but for the grace of God,' and if not there, then quite possibly somewhere else.

Nick said...

Liz - Some people find it very hard to give up smoking, even if they're fully aware of the serious health risk, and simply condemning them for their bad habit is pretty pointless.

Rummuser said...

Nick, in India we do not anything remotely like the NHS. The poor have access to Government hospitals which they use quite freely at minimal cost. The middle classes and the better offs have to fend for themselves and some take health insurance which factors in various qualifications but by and large works. Most however depend on the family's support for good medical treatment. I now personally have a problem in looking after my father and another very serious case of a boy withbipolar disorder with alcohol abuse, who is undergoing the most expensive treatment and the family are selling their family jewels to finance the treatment. Families do not have the luxury of drawing any lines however fine that may be.

Nick said...

Ramana - I'm sorry to hear of your difficulties over medical problems. It's absurd that families should have to bear the cost of what can be very expensive treatments, instead of the cost falling on the whole society. We sometimes forget that for all its faults the NHS is still a remarkably egalitarian and democratic service.