Thursday 19 April 2012

Reader's Letter Of The Day

From City AM:

Individuals have rights, but those rights come with consequences. You have a right to smoke and drive booze and live off fast food. But if you then demand free treatment on the NHS, then the rest of us have to pay for it.

It is hardly surprising that a government with such a large budget deficit should try and force government spending costs down. If that results in some heavy handed nannying of people acting stupidly then so be it. Rights won't count for much in a bankrupt state.

Nick Reid

WTF? The anti-smokers keep trotting out this line about non-smokers being forced to pay for "free" healthcare for smokers, but truth of the matter is the other way round. Tax on fags far exceeds any marginal extra cost of healthcare for smokers, and some studies have shown that over a lifetime, smokers cost the NHS less than non-smokers than non-smokers anyway. Add to this all the old age pensions which smokers don't claim. I started mentally drafting a reply to this nonsense and moved on to the next letter:

Smokers pay far more into the NHS than they get back, and in some circumstances are denied treatment because they smoke. Continue the nannying, drive industries out of Britain, and enforce the closure of businesses (like the pubs no longer open because of the smoking ban), and for sure you will very soon reach a bankrupt state.

Pat Nurse

Well done Pat! Saved me the bother.

(Another cunning plan I dreamed up this morning is to set up a Big Tobacco Fund, similar to the Big Lottery Fund, i.e. each packet of fags will show a list of all the "good causes" which tobacco duty is paying for, and all tobacco advertising (once re-legalised) will be emblazoned with slogans saying "For every packet you buy, we donate ten pence to [worthy cause]" and non-smokers will be looked down on as being uncharitable so-and-so's. The plan needs a bit of work.)


Sarton Bander said...

Sounds like another argument against the NHS.

Curmudgeon said...

When people start bleating on about the cost to the NHS of supposedly self-inflicted health problems caused by tobacco, alcohol etc. I often ask them whether the NHS should also charge people for treating STDs. That generally shuts them up.

Old BE said...

One of my employers was overheard recently suggesting to someone else that when it comes to buying life assurance or a pension annuity he should lie and say that he is a forty a day man.

Mark Wadsworth said...

SB, not really, it's an argument in favour of being honest. Let's establish actual facts before diving in with conclusions (like the first letter writer who works backwards from his own prejudices).

C, STD's are also "self inflicted" as are obesity, sporting injuries, pregnancy related stuff, old age related stuff, DIY injuries, drinking injuries, car crahes, and so on. If you filter out all the "self-inflicted" stuff there'd be precious little for the NHS to do.

BE, I've wondered about that, how do they police it? I've hedged my bensons by being honest on every form that I smoke, so at least I've got a proven track record. It might look a bit suspicious if everybody starts smoking like a chimney on the say they retire.

Jonathan Bagley said...

It seems imposssible to quash the myth that smokers consume more in health resources than non smokers, but it has been repeatedly demonstrated not to be the case. This is without accounting for tobacco duty and the saving on pension payments (google smoker annuities to see how much). See below, for example, and the references at the end.

"At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions."

Bayard said...

Health does seem to be a reason and fact-free zone. If you are employing someone full time, it costs you the same whether they are busy or idle. Therefore whilst the treatment a smoker receives can be costed in terms of doctors' and nurses' time and the standing costs of the NHS, most of these costs will be still have to be paid for, whether he is treated or not.
The people who really cost the NHS loads are the old. Really radical savings could be made to the NHS if they refused to treat anyone who had retired. The absurdity of this idea shows that the arguments of the anti-smokers have nothing to do with money and everything to do with their desire to stop other people doing what they, personally, disapprove of.

Mark Wadsworth said...

JB, brilliant, that's the article I meant, thanks for linking.

B, exactly.

Staffordshire man said...

Why don't the manufacturers put the actual (net of special tax)price on the packet. The petrol companies could do they same for fuel adverts, it would be interesting.

"transparency" is a hot buzzword so let's have some

Mark Wadsworth said...

Snarf, the govt's incentives are aligned with those of their mates, not the people who vote for them.

Staffs, exactly, we could have hours of fun with this - at the petrol station you get a receipt telling you that your petrol prices includes two hours of nurse's salary caring for old folk or something.

TheFatBigot said...

I don't often disagree with that nice Mr Bayard, but on this occasion I must (although the difference between us is more semantic than substantive).

Healthcare in hospitals is rationed primarily by the seriousness of the patient's condition. Although it is true that the docs and nurses would be there anyway, the option for their time is not treating smokers or doing nothing, it is treating smoking-related ailments or treating people (whether or not they are smokers) with less serious ailments. Some of them will drop off the twig or recover or pay BUPA whilst waiting thereby saving the NHS the trouble of dealing with them.

There is no identifiable additional cost to treating smokers, but there is a detriment to those suffering less serious conditions who have to wait longer for treatment because filthy smokers are more ill and get priority.

That, of course, looks at the position at a single given time. Looking at it over a lifetime, it is plain common sense that years spent dribbling in the Harold Shipman Happy Home for Retired Gentlefolk cost a vast amount and the more people who snuff-it before they reach the dribbling stage the less the NHS budget is stretched.

Looking at the cost of treating smoking-related ailments is a complete red herring. It is meaningless unless placed in the context of a lifetime of medical care being provided by the NHS. In that context, smokers place lower financial demands on NHS resources than non-smokers.

Anonymous said...

One thing to ponder is how the measure the time and resources devoted (?) to patient care. As an example: I was up at the dentist's the other day. (Because I live in the back of the back of beyond, there's still an NHS dental service here).

Being a sad git, I like to arrive a few minutes early for appointments and so after 15 minutes I was 10 minutes after my allotted time. Reduced to reading the notices pinned to the wall, I read the following: "Last month", it began sombrely, "52 hours of dentists' time was wasted because patients didn't turn up for appointments". (In truth they got the apostrophe wrong on "dentists'" but lets leave that aside).

So I'm left wondering why the failure of the citizenry to turn up on command represents wasted time for dentists? Don't they have something else to do? Can't they see emergency appointments? (it takes days to get an emergency appointment). Are they Schrödinger's Dentists? Do they cease to exist if there's no patient to observe them?

If there's dodgy measuring going on, you can prove anything you like, of course. And should there be another notice pinned to the wall saying "Last month, hours of patients' time was wasted while dentists sat around on their arses / ceased to exist at various times".

Anonymous said...

Bugger. "...let's leave that aside.... arrrgghh. I hate hubris.

Mark Wadsworth said...

TFB, ta for back up. We can learn a lesson from China here, who (until recently at least) encouraged people to smoke for exactly those reasons.

FT, exactly. These people surely know that if they book in 20 patients a day, a certain number (say 4) won't turn up, so they simply book in 24 patients a day to keep themselves busy. Occasionally, they'll all turn up, oops, in which case patients have to wait a bit. But observation tells us, it's usually you waiting for the dentist/doctor etc rather than the other way round.

Bayard said...

"Some of them will drop off the twig or recover or pay BUPA whilst waiting thereby saving the NHS the trouble of dealing with them."

Some of them will also simply be bored or hypochondriacs and not need to be there in the first place. In fact the smokers are doing the NHS a favour by edging these people out of the queue.

"Don't they have something else to do? Can't they see emergency appointments?"

Well, no, seeing that the dentist has zero notice of someone simply forgetting to turn up. Unless the emergency patient lives just around the corner, they aren't going to be able to get to the dentist before the next patient's appointment.

Anonymous said...

Well, no, seeing that the dentist has zero notice of someone simply forgetting to turn up.

I suppose you may have a point, but I'd be happy to wager a modest tenner that if it was private practice they'd find something profitable to do.