January 02, 2008

The Nanny State starts out sounding helpful, promising universal care with no waiting.

But as costs rise and quality declines, Nanny State bureaucrats have to find ways to slash costs and improve performance. But how to accomplish that in a centralized system that purports to be free at the point of service? Here's a great idea: only offer care to fit, healthy people!

You cannot make this stuff up: Britain's National Health Service is floating plans to withold care from the obese and smokers until they shape up.

Patients could be required to stop smoking, take exercise or lose weight before they can be treated on the National Health Service, Gordon Brown has suggested.

In a New Year message to NHS staff, the Prime Minister indicates people may have to fulfil new "responsibilities" in order to establish their entitlement to care.

Despite the NHS commitment to provide free universal care, it is already common for doctors to set conditions on patients seeking treatment.

Now the interesting thing about this movement towards "mandatory prevention" is that the government gets to ration care by appealing to popular prejudices about smoking and obesity - that they are merely signs of personal weakness.

We are, of course, all in favor of private insurers and employers offering discounts or other perks to employees to help them stay healthy; people who smoke, for instance, pay higher premiums than those who don't. We are even more in favor or individuals having more responsibility for their own health care by owning and controlling their own insurance.

But the NHS plan goes beyond market competition or persuasion, which enourages autonomy - it edges toward outright coercion, which is likely to hurt its most vulnerable low-income citizens.

The one bright side to this program? The next time Michael Moore heads to the England to praise the NHS, they'll send him off to the gym.

Posted by Paul Howard at January 2, 2008 11:30 AM

Comments

Post a comment