A More General Way To State My Two Last Axiom Questions

[ILoveShowGirls]

What you say is possible, however it is very unlikely. The NHS spends more on IT projects per annum than the £9bn you quote, which equates to around 9% of the NHS budget, 52% of the NHS budget is spent on ER services.
Most of the drinkers you refer to (the vast bulk of buyers of alcohol and related services) are reasonably responsible people. Those who enjoy a good pint of ale, or a glass of wine.
They are not the people who are clogging up the ERs week in week out.
The small minority who do seem unable to stop themselves from going too far, are in absolutely no way responsible for more than a fraction of that £9bn in revenue. But the UK government estimates that they are responsible for £20bn of the NHS costs by themselves, that's over 20% of total NHS expenditure.
So all drinkers in the UK pay less than half the costs of the idiotic binge drinker's medical treatments.

Given the evidence, I feel pretty certain that I can say that it is not possible that the drinkers that I previously referred to, are subsidising the treatment of the people that you say I claim concern for.

In fact given the cost of damage to the city centres and policing costs each week in the UK as well as the medical and compensation costs of those attacked by drunken fools (around 47% of assaults in the UK are perpetrated by drunks), it can be argued that that by taxing alcohol at such a low margin and still providing services and benefits for free to those who overindulge, the UK government is in fact subsidising anti-social behaviour.

That is not to say I personally want the price of beer to go up. [img]/images/graemlins/shocked.gif[/img] I would prefer the morons having to pay their way.

[ILoveShowGirls]

All the evidence on tobacco related costs and tax take shows you to be completely correct as far as the UK is concerned.

In fact an average UK smokers lifetime medical costs from general taxation are around 12% less than the costs of a non smoker, thanks to this subsidy

[chezlaw]

[ QUOTE ]
Given the evidence, I feel pretty certain that I can say that it is not possible that the drinkers that I previously referred to, are subsidising the treatment of the people that you say I claim concern for.

[/ QUOTE ]

[ QUOTE ]
All the evidence on tobacco related costs and tax take shows you to be completely correct as far as the UK is concerned.

In fact an average UK smokers lifetime medical costs from general taxation are around 12% less than the costs of a non smoker, thanks to this subsidy

[/ QUOTE ]
1 out of 2 aint bad [img]/images/graemlins/grin.gif[/img]


but I'm not too bothered about the actual facts but the paucity of the argument. Most who say they are against equal treatment for drinkers/smokers because they are a drain don't argue for preferential treatment for them if they are subsidising everyone else.

It appears they are being inconsistant but I suspect its more a consistant use of any old rhetoric to enact their moral opinion.

chez

[ILoveShowGirls]

I do see and agree with your point Chez, and I try not to allow myself to push moral opinions when I have no evidence for them. [img]/images/graemlins/wink.gif[/img]

To be honest, I would have no problem with preferential treatment for smokers by the NHS. By paying so much tax on their vice they are in effect insuring society against the cost of their illnesses and paying a hefty premium to do so.

I somehow doubt that any major political party would propose anything like that even though they would know it is completely justifiable.
With hypocrisy being so rife in the political classes, they are much more likely to insist that smokers receive no treatment until they give up smoking, because cigarettes are seen by the population at large as a harmful and immoral vice as well as a public nuisance and health hazard, and being tough on smokers is likely to prove a vote winner.

Anyway, I should have been more specific in my initial points instead of floundering around with emotional arguments, because I suspect that you and I are much closer to being in agreement than our first exchange would suggest.
[img]/images/graemlins/grin.gif[/img]

[iggymcfly]

Medical treatment is not, nor should it be free/provided by the government. The first criteria for expensive/exotic treatments should be that a person can afford to pay for them, especially since this payment allows more of such treatments to take place. Insurance is widely available for people that want to make sure their health needs will be taken care of.

Given that both patients can pay for a treatment, but it's only available to one, I think it should go to the patient to whom it would be most useful, not the patient who "deserves it most". This includes consideration of whether said patient needs the treatment immediately, and also how likely they are to die even if they receive it.

[ILoveShowGirls]

[ QUOTE ]
Medical treatment is not, nor should it be free/provided by the government.

[/ QUOTE ]

In the UK, most of Europe and quite a lot of elsewhere it is provided by the government at hand from general taxation. In the UK it is provided at no cost to the user, with a few small exemptions. Other places have mandatory insurance schemes etc. In the USA I understand that some forms of medical treatment are also paid for from taxation/madatory insurance.
Whether it ought to be provided at all by the government is a moot point as in most cases it already is.

[ QUOTE ]
The first criteria for expensive/exotic treatments should be that a person can afford to pay for them

[/ QUOTE ]

That, I guess, rules out pensioners, children from the poorer sectors of society, teens/students and the mentally/physically incapacitated amongst many, from receiving expensive medical treatment that might benefit them tremendously. As the vast majority of them will not be able to make a significant contribution to the cost of their treatments.

Also a system such as this is likely to focus all research goals on providing expensive treatments for relatively minor maladies, rather than expensive cures/treatments for those who cannot afford them.
Pretty much the exact same result that we have today.

This is not to say that I don't think that your points have any merit.
In an Smithian sense those rich pioneers will in the long run be making sure we all have cheap variants of their expensive treatments.
But I do think that such a hardline approach cannot succeed because in a democracy people will tend to vote for subsidised or free healthcare. Those that already have it will have a strong tendancy to vote against any party that seriously threatens such a system however poorly run/thought out.

[ QUOTE ]
I think it should go to the patient to whom it would be most useful, not the patient who "deserves it most".

[/ QUOTE ]

This would pretty much guarantee that in any treatment suffering a scarcity of some kind, say a liver transplant, the younger the recipient the higher up the list they must naturally be, regardless of the cause of their problems, because of their better survival chances following major surgery and longer natural life expectancy.
One example, a mid 30s drug addict with an occasional job in his local McDonalds who has led a 10 year career of debauchery destroying his liver through wilful overindulgence will come before a 70 year old former captain of industry, because the 30 year olds life expectancy can be expected to be much longer following a successful transplant, not to mention that he would probably have a much higher percentage chance of survival in the days following the transplant.

If cause is ignored and the cause is willful then the chances are that the treatment would be wasted. As in the case of the late George Best, a football star in the 60/70s in the UK who desroyed his liver through drink, received a transplant to save his life and then proceeded to destroy that one also.

Maybe though, you would actually agree with me that the hypothetical drug addict should be classed as having less use for the new liver than the retired CEO due to his likelihood of setting about destroying it as soon as he was well enough to do so?

Of course I am picking an extreme example where I think a gulf exists between the real utility of the treatment.

Maybe a more interesting case would be two 30 year old women, one a married mother of two the other a high flying single career woman with no children, both having late discovery breast cancer.
Who is judged as being most deserving, to use my terminology, or would find most useful, to use yours, to have access to a limited stock of a powerful exotic anti cancer drug, assuming both can afford the treatment and both have an equal chance of survival and life expectancy if the treatment is successful? And an equal certainty of death if they don't receive the drug.

I think such a case would come down to a value judgement about who is/is likely to, give the most future benefit to society.

It would be a moral judgement about who deserved it most, and one I am glad that I don't have to make.