More Big Problems

Rather than a reply in the comments section of the Big Problems post, it seemed easier and probably more effective to write a continuation. I know I'm not very good at replying to comments, something at which I intend to improve, but just so you know, I read and appreciate them all! Well, except the spam ones wanting to sell me watches, bank accounts in the Far East and prescription drugs...

It's a difficult issue to tackle, because I genuinely believe that there's no one simple solution, much like a large number of issues within health care. Luckily, I'm not big, brave, clever or well paid enough to make these decisions, but as they do impact me directly, I see no reason why I shouldn't have my say.

Paying for health care has always been, and will continue to be a contentious issue in these shores. In North America this argument, to a certain extent, is incongruous with reality, as the vast majority pay into an insurance scheme and receive their health care dependant on if and what they've paid. However, on both sides of the Atlantic - times, they are a changin'...

As far as taxing foods that are bad for us, and those taxes going directly to health care, well, in truth, that already happens. There's no VAT (purchase tax) on food that isn't considered a luxury. Fruit and vegetables are tax free. Chocolate isn't. Simple. Putting up tax in a way that would make these luxuries only affordable to the upper echelons, will only mean that we have very fat rich people. Well, maybe not. But the question remains of how much of a nanny state do we want to live in? Do we want a government scheme by which you must clock in the exact number of calories you've consumed every day? The idea is impossible to manage, and is the antithesis of living in a land where we are free to make our own choices. And as Fee said, taxing cigarettes and alcohol more and more every year, seems to have done nothing to reduce the overall number of smokers and drunks.

Girliebob made a fantastic point. We can't judge whether a person's worthy of an ambulance just because they're overweight. She's paid umpteen years worth of income tax and national insurance into the system with no obvious return from health care, and should be no less entitled than the young mum next door who's feeding three kids on state benefits, despite having paid in nothing. Irrefutable logic.

A private message I received also questioned the charging of patients who self-harm. More often than not, self harm is caused by mental health issues, whether short-term, temporary issues, acute moments of madness if you will, or some who are chronically ill, clinically depressed, and on a downwards spiral that society struggles to understand and accept. Do these people, those who take blades to their arms, those who genuinely attempt suicide, deliberately overdose on drugs, also deserve to be charged when using the health care system? I'd find it very difficult to justify that these people should be charged, despite the fact that these injuries are self inflicted.

Charging for medical services does occur,  even in the UK. We have to pay for prescriptions (certainly in England and Scotland, although the Welsh get them, errr, scot free), we pay at least part for dental care, even under the NHS, and I suspect that more charges are coming. Minty mentioned frequent callers and also questioned at what point on the overweight scale would we start charging. They're good points, and I wish I had the answers. But then, I'd be a politician and have to make them up, so I think I'll stick to what I hope I'm good at.

I've said it before. The NHS is the victim of its own success, and we're all going to have to get used to the idea that the free ride is well and truly over, at least to some extent. I still don't have the answers, but the questions are fascinating, and the discussions you all prompt are even more so.

I'll leave you with yet another point to ponder.

What about the smoker who improves their life by giving up the cigarettes, but then puts on the weight because of it?