Wednesday, 7 May 2008

Quote of the day

“ Here is my final point. About drugs, about alcohol, about pornography and smoking and everything else. What business is it of yours what I do, read, buy, see, say, think, who I fuck, what I take into my body - as long as I do not harm another human being on this planet?”

Bill Hicks


jmb said...

Yes but the healthcare system (and taxpayers' dollars or pounds) has to take care of the damage that you do to your body so it does affect others in the long run.

Phil A said...

JMB, The fact is that smokers, as an example, amongst whom I incidentally do not number myself, generally pay far more to the state in the form of tax than non smokers. Given that they may also be reducing their life expectancy, they, after the sums are done are, as best as I can tell, a profit making proposition for the State on the basis of the extra taxes they have paid alone. When you consider that they are also paying a full share of their contributions to the NHS as well, at least in the UK I don’t think your argument holds too much water. A similar argument applies to the average consumer of alcoholic drinks. Where they are currently touting two glasses of wine a day as excessive consumption.

All this leaves aside the fact that the British states co-opts and coerces every one into paying for the NHS. There is no choice. It is compulsory.

Rather like the State saying you will have a car and it will be a Trabant - and if you don’t want a Trabant ? Well you will pay for it anyway, before you can go out and buy the car you actually want.

This forces the less well paid to go with it, if they want to or not, as they can not afford to pay twice for medical insurance, and the State has already taken what they might have used towards that end. One of the arguments for forcing this is that people are not capable or do not care to take responsibility for themselves in this.

So in the case of a smoker, or indeed someone slightly overweight, or a moderate drinker of alcohol, the argument seems to go. We are taking your money if you like it or not - and because we are taking your money to fund the NHS that gives us a right to say what you can, or can’t, do with your body, because that NHS may have to treat a problem your lifestyle may have caused. We know you will on average have covered the cost of any treatment several times over but we are keeping quiet on that. In addition for your own good we will increase the tax on these things even more and maybe make them illegal.

Sorry I don’t buy the argument.

On the wider front people's sexuality, preferences etc. providing it is consensual etc. should surely be their own business.

BobG said...

“There’s no way to rule innocent men. The only power any government has is the power to crack down on criminals.

“Well, when there aren’t enough criminals, one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws. Who wants a nation of law-abiding citizens? What’s there in that for anyone?

“But just pass the kind of laws that can neither be observed nor enforced nor objectively interpreted-and you create a nation of law-breakers-and then you cash in on the guilt.”
-Ayn Rand

jmb said...

Well I got the two emails before I came to see this, so I was wondering what are those two on about. What arguing?

I don't believe my comment included sexual congress so I don't disagree with you there. Well provided people are not having unprotected sex and spreading the HIV virus or something like that which is an unbelievably expensive disease to treat and let's not forget herpes and STDs. But these are preventable.

I don't think you can assume that all consumers of drugs and alcohol or even smokers are actually paying taxes, above and beyond the taxes on those goods. How many people exactly in GB are on social assistance. Isn't 1 in 3 pounds in the budget spent on this? So there must be quite a number of non tax paying individuals who are smoking and drinking.(I remember TP ranting about this, the social welfare budget that is.) Naturally the illegal drug users and traffickers are completely under the radar taxwise but still cost the system with methadone programs and needle exchange programs plus the cost to society too in break-ins and burglary to fund their habit.

I guess one point I am coming from (and don't forget we have fully taxpayer funded socialized medicine in Canada) is when I worked in the hospital for almost twenty years we had these repeat patients who were alcoholics who ended up coming in through our emergency dept, malnourished and with internal bleeding and their liver functions shot. So they stayed a while, got put back on their feet and finally discharged. So guess what? They were back in three months and so the cycle went on, over and over. Oh, not Mr X back again! Mr Y here? He was just discharged two weeks ago!

Then we have the smoking cardiac and hypertensive patients, oh and the ones with emphysema and chronic pulmonary lung disease (all either caused by smoking or certainly exacerbated by it) who refuse to give up smoking despite the harm they have done and continue to do to their bodies. Yep, they are regulars too.

No, these people have not paid more than enough into the system with their so-called "sin" taxes to fund their treatment. Trust me on that. But not only that, they overburden the system so that not everyone can get the treatment they require. For even if the money supply was unlimited (which it is not) the healthcare personnel supply is not and so we (you) get the long waiting lists for various treatments.

And you know what? Wouldn't you rather be healthy than unhealthy? Wouldn't you rather try to do everything you could to maintain your health? I know which I would prefer.

When I was young everyone smoked because they did not realize how harmful it was. Now they know and they make a choice. And brother, is smoking addictive! I know it is very difficult to give up once you start and become hooked. Yes even I was a smoker but gave it up in my mid twenties. I know it's not easy but worth it in the long run.

In theory that quote of the day sounds very reasonable. Live and let live. I even agree with it to a certain extent.

"I can do whatever I want because I am not harming any one else directly."

But indirectly, in ways that "you" never contemplated you are costing society.

You know I am a very strong believer in socialized medicine. I know what it was like before when poor people could not afford to take their sick children to see the doctor. I don't want to see socialized medicine abandoned but the money supply is not unlimited, the treatments escalate in cost every year and more and more become available. So I think we have our part to do by taking some responsibility for our own health. There are all kinds of horrible diseases which are going to happen anyway.

Every day I went to work I used to be grateful that I was in the Pharmacy Dept and not this patient or that patient upstairs on the ward with this disease or that one. You never take your good health for granted after that. As for me, I say, why jeopardize it knowingly?

Oh, knock "yourself" out reading whatever you want.

I guess that hit a hot button with me and my reply with you :) I hope I don't sound like a redneck here. I really am a soft "socialist".

Have a good day Phil, as they say in this part of the world.

Phil A said...

JMB, I can’t say I disagree with some of what you say. Anything that is carries to the point where it damages you and you know it does is just stupid. Deep down inside I think to myself ‘Why don’t people just walk away from it?’ but I suppose it is not always that simple for some people.

Re socialised health care. I have nothing intrinsically against the concept, although I am libertarian leaning I recognise there should be a safety net - Hell I actually do pay something towards a couple out of my own pocket on a long term basis because the NHS won’t fund it, but that is my choice, no one makes me. My problem is with the actual system imposed in the UK and the way it is imposed. Add to that the way the state is increasingly taking away our rights and liberties and often using socialised medicine as one of their excuses.

As I see it if you are of sound mind and being forced to do something, even if it might be seen to be for your own good, it is wrong.

And taking ciggys as an example the last time I did the sums rough and a while back I reckoned averaging tobacco ‘sin’ tax together with reduced pension paid out more than covered average additional costs to the NHS incurred by smokers. Leaving aside their actual contribution to the NHS.

I see exactly the points you are making, I just think that they are being made within the confines of a specific system imposed by authority and if the system were different then they wouldn’t necessarily still actually be problems. In the same way that it is Socialist welfare states designed to work in isolation that really have a problem with immigration, or indeed emigration.

Me - I am not necessarily specifically either left, or right, I tend to orientate more on the Authoritarian to Libertarian political axis.

Re arguments, Maybe in the discussion sense ;-) I think M thought I was being mean disagreeing with you at all ;-) Nothing to do with the subject or the merits of the arguments ;-)

Phil A said...

Bob G, excellent point in your quote, exactly articulates the problem.

jmb said...

I know that I am only focusing on some aspects here but they are the ones I know best I guess.

One problem is that the system does not save on reduced pensions for these people because they are kept alive by the medical system at great cost and with a very reduced quality of life. Assuming they get a pension. Is it means-tested in GB? It's not exactly here but clawed back over a certain threshold of income. Same in many other countries. I am entitled to an Australian pension but can't get a penny because of the means test as well as having some of my pension here in Canada clawed back. Another aside.

Now you know the NHS is failing to provide adequate healthcare for all the citizens of the GB. What would you do if you were in charge? Increase taxes or try to save costs? Of course the latter makes more sense. I don't hear about all the measures suggested to do that in GB, well the non-smoking ban was discussed at length. We have lived through that in Vancouver and it has worked very well indeed. Smoking is way down and it is pleasant to work and play in a non-smoking environment. With limiting smoking you are ensuring a safe workplace and cutting down the exposure of second hand smoke for others. It's hard at the beginning for people to adjust but they do.

I don't remember what the anti-drinking proposals were in GB recently. But I do remember a huff over certain statements. It seemed like more a way to shame people into drinking less as I recall. That does not go down well. Education is the only acceptable way but somehow it does not work with smoking. Most people with alcohol can take it or leave it. Not so with cigarettes. You get hooked very thoroughly and need to feed the habit regularly.

The USA will shout it has the best health care system in the world. I don't think so. One third of all Americans have no health insurance coverage and that's more than the total population of GB. They either use emergency departments in hospitals inappropriately and suffer horrendous waits or try to find free clinics. As for the rest who do have insurance they are constantly denied coverage for this or that because the insurance business is a money making one. Bonuses are paid to workers for the number of claims denied. This is a fact!
I follow more than 50 medbloggers most of whom are in the States. They are just as mad at their "system" as Dr Crippen is at the NHS. The one thing they agree on is they want universal health care but do not want the government to run it since Medicaid and Medicare too seem to be disasters in their minds.

I read your quotes every day and I do enjoy them. I don't know why I decided to comment on this one. What a tangent it has taken us on, so far from the original quote.

As I said to Miss M, I'm a tough old bird and can stand up for myself and never considered it mean that you argued (debated) with me. :)

I always think your avatar here is
a llama, Phil the llama, but she thinks it is a toy dog. She might be right but you'll always be a llama in my mind.
Cheers from the Westie.

Phil A said...

JMB, Hey! No fair! Call your trained attack tiger/cat off - or I’ll be forced to defend myself with a water pistol ;-)

I shall leave the exact identity of my icon as a mystery. Trust a cat to see a dog ;-) It shall henceforth be all things to all people…

Your arguments against the American system make it sound as bad as ours “use emergency departments in hospitals inappropriately (NHS direct actually seems to encourage that ) and suffer horrendous waits… constantly denied coverage for this or that (we have something inappropriately called NICE in charge of doing that)”

I agree that paying bonuses to insurance workers for the number of claims denied is wrong. A contract should be a contract; to fiddle out of it based on small print is just wrong and dishonourable, denying an obligation. They never seem to try to wriggle out of collecting premiums, Medical or otherwise.

Our system seems to be being managed like the old Soviet Union command economy. Huge sums of money are being wasted whilst entirely preventable super bugs are infecting and killing because of poor hygiene practices. I have had close relatives have the system inflicted on them in London and frankly politeness prohibits me frankly describing my opinion of it. I would and do work hard to avoid it. The system appears to be top heavy with ever increasing numbers of expensive and ineffectual managers and hamstrung by insane targets and regulations. Some staff are still wonderful but plenty of others should be sacked so fast they break the sound barrier.

Saving costs would probably be politically difficult, as it would require ditching targets, managers, political correctness and sacking people who don’t, or wont, do a decent job.

Throwing cash at it is clearly a waste of time, they already did that. Maybe if they gave a basic ‘allowance’ based on the effective current levels spent per citizen that the citizen could top up themselves with extra payments of cash lump sums and then allow them to spend the lot on what they wanted in the places they wanted.

Better still if they actually invested the cash paid, so there was actual real money rather than expecting future generations to pay for previous generations. The same goes for pensions. Even the socialist Unions don’t trust the state to manage their pension schemes.

Essentially I don’t consider the State Qualified, competent or capable enough to trust them to manage much of what they insist on taking charge of. Furthermore they then use this as an excuse to clamp down on our personal freedom.

jmb said...

Now you have gone all political on me! But I'll just say one last thing before I disappear from this post.

Management costs do cause a lot of the waste in the health care system. The layers and layers of managerial staff who do nothing to further patient care and what's more have no idea and in their interminable meetings often make bad decisions because of their ignorance which actually make things worse for patient care. Not only that the top layers seem to have very lucrative contracts with massive golden handshakes.

In one case the CEO of our hospital was let go with a golden handshake of $500,000. He was replaced by a similar person who had been fired elsewhere and in fact he to went another province to take a position. Within a few months another CEO of a local hospital was let go. $1.5 million paid from the health care budget to three individuals in a short time for no furtherance of patient care.

For 18 years I watched this waste happen in a brand new hospital where I worked from the very first day of its existence.

Towards the end of my time there we spent a huge amount of money on a new computer system which was way over budget and not that much better than our last one (well not for pharmacy). I believe the NHS has a similar computer story but on an even huger scale.

I don't know what the answer is.

I inspected your avatar more closely on your profile page and even with only one good eye I can see that it is a knitted stuffed toy animal. But I'll just continue to think of it as a knitted llama.

See you in SL sooner or later.