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No, I take responsibility for my own actions. Starting to smoke was a seriously reckless and ill-informed one. But now I am a smoker, its in everyone's interests for me to quit as soon as possible - including yours, since you'll be contributing to my NHS treatment if I come down with lung cancer. Thus doctors etc should be hammering that home whenever they get the oppurtunity. I don't know if you've ever been a smoker yourself, but quitting is quite a difficult thing to do. Also, I wouldn't call smoking a "habit" but a physical and psychological addiction.
No, I'm saying its very difficult to quit and the more pressure health professionals and the general public pile on the better. Not just for me, for other smokers and society in general.
I'd just like to make the point that just because a person is obese it is not necessarily "self-inflicted". My mum is overweight, not MASSIVELY so, but she IS overweight, and she eats a great deal more healthily than I do, does a lot more exercise than I do, and yet by BMI I am bordering on underweight, and she is overweight. I eat McDonalds at least 3 times a week, don't exercise nearly as much as I should, and I smoke, yet because my mum has an underactive thyroid and therefore finds it increasingly difficult to lose weight, what is being implied is that she is less entitled to NHS treatment than I am. On the smoking front - considering I am paying over 6 times what I had to pay in Peru for a 20pack of Lucky Strike (£5.10 minimum over here compared to the equivalent of about 80p in Peru) because of tax, I think I am perfectly entitled to NHS treatment, thank you . If it wasn't for the taxation on cigarettes, I would be of the opinion that smokers should have to pay for those treatments which were brought about as a consequence of their smoking, but with the taxes, if/when I get a smoking-related disease I think I'll probably have payed far over what the treatment would have cost in tax on my Luckies anyway.
Not by my reasoning, no, self-harming seems pretty unrelated to me and at any rate I know very little about the subject, so I wouldn't feel qualified to comment.
I'm not asking for anyone to "wipe my arse" for me, I'm simply saying that it is the job of healthcare professionals to point out what is extremely harmful to your health and discourage these activities. Its a comprimise between the initial premise of this thread (that those who do engage in unhealthy practises should be denied NHS treatment) and doing nothing - I really don't see an argument against it. Doesn't cost any money (in fact would potentially save money) and it would save lives. At least nobody could claim they didn't know what the consequences of their actions would be...
But that makes no difference as to whether a person should be treated. All people should be treated, as the level of "self infliction" should make no difference to the level of treatment afforded by the NHS.
My point with skiing and marathon running and fellwalking is not that they should also be barred from the NHS; it was to show what a ludicrous point it is to bring in a determining level of "self infliction". The man who walks up Scafell Pike in shorts and a T-shirt and gets stuck should be rescued, and he should be treated for the resultant injuries, yet he is far more cuplable for his injuries than someone who is a bit overweight or drinks a little bit too much beer. The same goes for the man who tries to ski down a slope that is slightly beyond his ability and breaks both his legs on the descent. The same goes for the man who rides his motorbike a little bit too fast around a corner and crashes into a tree.
And whilst skiing has proven health benefits (it is one of the best cardiovascular exercise regimes), so does swimming, and there is little danger of any injury in a swimming pool.
If a measurement of self-infliction was brought in, where would the line be drawn? That was my question. The skiier chooses to do a risky sport (that's the enjoyment), so why should his treatment be free when he is more culpable (should he crash) than someone who is a bit overweight.
I note sofie hasn't responded yet.
Of course health professionals should (and do) provide ample direction and support to smokers and the overweight, but it is not their job to hold our hands and mollycoddle us along through life and all the potential health hazards we face every day. Good grief.
As for the topic, of course I think smokers should be treated on the NHS the same as anyone else. If there was any justice in financial terms then the smokers would probably get the hospital beds with solid gold bedknobs :chin:. But to be honest, I actually think non-smokers would be wise to keep their traps shut as if smokers ever did stop being treated on the NHS and were forced to go private then there would be a huge deficit that some other form of tax revenue would have to fill in order for the saintly smoke-free to be treated without charge. In terms of clinically obese people, I find it preposterous - not to mention cruel and pretty twisted - to suggest not treating someone purely on the basis of their weight. Whether self-inflicted or not. But that's just my take on it.
I agree its not their responsibility to make people eat healthily and exercise - but they should advise it and strongly encourage it, just as they should discourage smoking and eating a junk food diet.
My point in my experience that your "99%" figure just isn't true. I've only once been questioned on my smoking habit, and I've never been asked or advised about diet. I'm not saying the NHS should be running some kind of Big Brother style regime, or even necessarily record the lifestyle of the patient, but they should be doing everything they can to improve the health of the nation. And prevention is more important (and less expensive) than cure.
Look at Cuba's health system. Their's is also an all inclusive, no-one excluded health system but they achieve results many times better than ours, especially considering the scarcity of resources and the US embargo on medicines. This is mainly because they operate on prevention rather than cure. (admittedly its also partly because they have less of a problem than us in terms of obesity as the population isn't exposed to the same level of junk food as we are).
I agree, but there is no real logic to our opinion - its simply a matter of faith in what the NHS was set up to do. Also beware considering it an absolute, unless you are completely emotionally unattached. Should a guy with a heroin overdose be treated with the same priority as a worker who has inhaled fumes in an industrial accident? Should a terrorist who has been injured when he set off a bomb slightly too early be treated with the same priority as one of his mutilated victims?
Ok, so you're talking about negligent or reckless people who follow these pursuits. In which case the person who initially proposed denying treatment to smokers and the obese would presumably also propose denial of treatment to them.
I would also add that since there are no moral aboslutes in politics, and it is the job of policy makers to make policies that benefit society, you could still argue that treatment should be denied to smokers and those who eat a poor diet, while still treating those injured in risky sports, because at least sports provide health benefit when you aren't injured, whereas smoking and poor diet always have a negative effect on the health.
I'm sorry but you analogies keep making me laugh. What do you think life-guards are for? :yeees:
But why would you be incensed? The point is that everyone else is going to have to pay for your treatment, so everyone else has a stake in trying to make you live a healthier life. Hence why somebody started this thread - they feel angry abot paying for other people who have chosen to live unhealthy lifestyles.
But not "of course," thats the whole point I'm making. I reiterate, its not their job to hold our hands or "mollycoddle" us, but it is (or should be) their job to increase the health of the nation as a whole, which means pointing it out to people if they are living an unhealthy lifestyle, and the consequences of their actions.
I'm not talking about negligent or reckless people, people make mistakes, and the more dangerous the sport is the more risk there is. People who take risks should, under a system based on a rating of "self infliction", be left on the mountainside to freeze to death. I'm still waiting for the poster to explain how she reckons self-infliction should be measured (especially as she considers mental illness to be self-inflicted), and suggesting examples of how her views are abhorrent and those only shared by morons.
You're not going to break both your legs in a swimming pool, either- compare a lifeguard at the city pool to a mountain rescue team and tell me what's more dangerous.
I also think that there is plenty of information already available about diet and exercise. Everyone knows that smoking kills, mmkay, and everyone knows you should eat five bits of fruit and veg a day. Everyone knows that broccoli is healthier than chips, and that too much salt is bad. Everyone knows the practice nurse is always available to answer questions about diet or exercise or fitness. It isn't a doctor's responsbility to do anything more than offer the information, and as they already do that, its hard to see how they can be more active without starting to interfere in people's lives.
Erm, no they don't. It's been said, smokers put 7x more money into the Government than they take out from health care, now I'm not sure how much of the money the put in goes towards health care but I'm sure it's around at least 1/7 of that money.
Fiend-smokers want to quit, it's not like they're waiting for help it's just they don't really see an incentive at the moment because it is so hard, this isn't the secret tub of ice cream you like on a friday night, it's a real addiction.
Because I am an adult with a modicum of common sense and rational thought, and they are a health professional trained and employed to provide a service to me. As I have already said, if I went to my GP with a hacking cough or chest pains then I would be open to their suggestions and advice about modifying my lifestyle. But I don't think they should be expected to double up their existing work with that of a private investigator and use an appointment to start recommending lifestyle changes completely unrelated to the medical problem I am suffering (or not, as the case often is during routine doctor's appointments). I think you are a wee bit strange if you wish to live in a society where doctors and other medical professionals take it upon themselves to tell you how to run your life, but that's your own business.
I take your point about people's opinions on treating those who are afflicted because of predilections - and, yes, habits - that they themselves do not have. But it will be a sad state of affairs when we do not think our peers worthy of medical attention because they have a habit (which they may or may not want to kick) which we ourselves don't.
I'm not sure I understand your bone of contention here. I said I do certainly believe that the advice and support to live a healthier life is a vital part of the health service in this country. But you don't seem to be content with doctors "pointing it out", or maybe you're confused, because generally they already do. I actually do have a problem with that, because I feel that I should be able to seek medical advice when I wish, not have it thrust upon me when I go to get my repeat prescription.
As for whether a patient who has OD'd on heroin should be given the same level and priority of care as someone who has suffered an industrial accident, of course they should. If they are not both treated with the same level of care then we are getting into a situation where someone decides that one life is more worthy because the problem is viewed as self-inflicted. For all your high-level talk of the workings of the NHS, I think that if the view I just mentioned is the one you hold then you have a poor understanding of human nature and extremely low tolerance for the fact that we all do things that are bad for us and are lucky, lucky, lucky enough to live in a society that provides us with care without judgement. Or are you putting yourself forward as someone worthy to judge who is deserving of free and comprehensive treatment, and who is not?
I wouldn't be too skeptical about Cuba's health service, its pretty open and the figures are compiled by the UN. And our life expectancy is only a year more than Cuba - a country subjected to regular hurricanes, tropical diseases, etc.
You're right that smokers put a lot of money into the NHS through taxation. However the figure that they take out is disputable because as I said before smoking is a complicating and or/contributory factor in many seemingly unrelated ilnesses.
Also I meant the comment more generally about unhealthy habits, most of which (e.g. obesity/poor diet) cost more than they generate from revenue.
I agree, as you'll see earlier in the thread I confessed I am a smoker who is finding it difficult to quit.
Even someone of limited intelligence couldn't fail to understand the SMOKING KILLS AND MAKES YOU DIE AND STUFF labels over their packet of Lamberts.
So you are advocating medical and governmental interference then.
People should be given advice on how to improve, and people are given advice. But this should not be imposed upon them, and people shouldn't be lectured at. It's hard enough to get a lot of people to go to the doctors about ailments, especially poor men, and knowing that they'll be lectured at will just prevent them going at all.
Horses can be led to water but they can't be forced to drink. The information and advice is already there- you can't move around here without seeing adverts for healthy exercise and healthy eating- and that's all the medical profession should do.
Well surely you could say the same for a lot of illnesses, in fact we've discussed this quit thoroughly in this thread.
The simple fact is that the UK prides itself on free health care, it's one of the last throwbacks to our welfare reforms. It needs to be kept.
That might be true if you were at a private practise, you would be paying for an individual service to yourself and nobody else would be affected by it and nobody would be entitled to criticise you for unhealthy habits (except perhaps for causing illness by second-hand smoke, but thats a different argument). But the point about the NHS is that everybody is forced to pool their resources to pay for those who get ill. Therefore everybody has a stake in preventing illness in other people. Because we (pretty much) all agree that you can't deny treatment to people (whether or not the illness is self-inflicted) then the key is trying to prevent people from living unhealthy lifestyles. Thats why I think healthcare professionals have a duty to point it out more directly and forcefully to people than they seem to at the moment.
Well personally if I had the choice to prioritise then I would decide that an industrial accident should be treated heroin OD case, precisely because the latter is self inflicted. But I don't think it should be made NHS policy because it would be impossible to implement and there would be no way of drawing a meaningful line. Nor do I think a heroin OD should be denied treatment. But if it was a choice between the two I'd treat the industrial accident.
The reality is that healthcare professionals do have to prioritise between treatments, often on fairly arbitary criteria. I'm sure many of them will make a moral judgement rather than stick blind to their hippocratic oath.
You say that, but I knew a guy who always asked for a pack of cigarrettes only with a "smoking harms your baby" warning on them, because he thought "those ones" wouldn't hurt him.
Yes, but so are you if you wish to keep the NHS. The government already inteferes by forcing them to pay for everybody's healthcare, even if they live a perfect lifestyle and have private insurance just in case something goes wrong.
I'm not saying that patients should be denied treatment, or forced to live healthy lifestyles. All I'm saying is the NHS (through doctors, other healthcare professionals) should make a position clear to everybody, but particularly those who choose an unhealthy lifestyle: "Everybody has taken reponsibility for paying for your treatment, through taxation, should (God forbid) you get ill or suffer injury. But that gives you the responsibility to try and avoid activities which you know are going to be bad for your health, because that would be unfair on everybody else. If at all possible you should take exercise or other activities that will actively improve your health. Its for your benefit and everyone else's."
If you take the attitude that its nobody else's business what you get up to health-wise and its your own individual reponsibility, get private healthcare. The fact we have the NHS makes it everyone else's business.
Classic.
Personally if anyone is stupid enough to suggest that self-harmers should have to pay to get their wounds sorted out or told to stop doing it for their own health, then they can pay to have their wounds sorted out from their drinking sessions/personnal injuries as well. I know self-harmers they wont go to get their wounds sorted out because their too embarassed/scared.
In what way doesn't that happen now?
I mean apart from the smoking cessation services, the Quality and Outcomes points (which is how GPs get their income these days) the healt hpromotion on both a local and national basis, the references to quitting which will come about from any nurse doing a health check on a patient, the ban on smoking on NHS property (nationwide from January 1st), the warning on cigarette packs....
No it doesn't, all the time that the tax burden on smokers [and drinkers for that matter) is higher. You seem to be suggesting that we all make an equal contribution to the NHS coffers. We don't.
You seem to be suggesting that whoever "makes a contribution" (nice way of putting it ) should have a directly proportional say in the distribution of that contribution .
Is my interpretation correct ?
Sure I can.
Whether I will is a different matter.
The future is uncertain.
Could you diminish my uncertainty by confirming/denying my interpretation ?
Or more appropriately, will you ?
Yeah, but, who are "you"? Who am "i"? What is the "future"? Do "interpretations" exist? Ad nauseam.