British MP Recommends Patients Pay For Drugs Used to Treat "Lifestyle Diseases"

Conservative MP Phillip Lee has caused quite a stir this week with his suggestion that patients suffering from so-called "lifestyle diseases," such as type II diabetes, pay for their own prescriptions rather than claim free or subsidized drugs from the National Health Service (NHS).

Lee made the comments as part a Free Enterprise Group panel aimed at producing proposals for reducing the UK government's spending. His suggestions come as part of a larger shake up of the NHS designed to deal with spiraling costs and decreasing standards. Lee argues the NHS requires fundamental reform or it faces certain "collapse" in the future. Whilst the system could "probably limp on for the rest of the decade," pressure from an aging population of baby boomers and a rise in younger patients has resulted in a mounting strain on resources.

Lee proposes to remove the right to free prescriptions for those with illnesses that are self-inflicted through particular lifestyle choices, type II diabetes being an obvious example with its strong correlation with obesity. He praised the Danish system of giving patients a modest budget for their prescriptions that they then have to top up themselves if they exceed. He estimates, according to Freedom of Information requests from the Department For Health, that such a scheme could save the NHS upwards of £400 million.

Speaking at London's Institute of Economic Affairs Lee argued;

It's time we actually got quite realistic about this because if we don't we are going to lose what most people would want in this country which is access to care when you need it irrespective of your means. In which case, if we don't start reforming now…then we are going to end up with collapse and the free for all and the pretty disgraceful situation you find in the US.

The Tory MP insists the proposals are not part of a desire to privatize health care or prevent it from being free at the point of access.

I just think that we have got to have an affordable system that rewards individual responsibility. If you want to have doughnuts for breakfast, lunch and dinner, fine, but there's a cost.

Comments

[HazelMeade]

This is a much better idea than the ObamaCare method, where you let insurers charge people more for only certain specific things (i.e. tobacco use).

Although (sinister plan) if only we could get them to add more and more stuff to the list of things you can vary rates for....

But letting tobacco users pay for their own treatment entirely is even better.

[Randian]

Although (sinister plan) if only we could get them to add more and more stuff to the list of things you can vary rates for...

Hm. Well thought-out.

[Sevo]

HazelMeade| 11.26.12 @ 3:39PM |#
"...But letting tobacco users pay for their own treatment entirely is even better."

I think it was last week where a H&R article pointed out that smokers actually cost less; they kick off earlier.

[Rick Santorum]

To complement the various "get out the vote" activities, Obama administration is considering funding a "get out and smoke" campaign.

[neoteny]

Partly; another aspect is that smokers already pay a tax premium on their habits. Plus the tobacco companies were hit with multi-hundred-billion-dollar "contributions" to healthcare costs, ostensibly for the increases of treating smokers.

So the cat is already being skinned multiple times...

[Brutus]

But they're still politically vulnerable, so it's back under the knife again for kitty.

[Warty]

A bit of Mark Twain comes to mind.

It was believed afterward that the man was a lunatic, because there was no sense in what he said.

[Pro Libertate]

I suggest what I like to call a "free market" in medical services and health insurance.

[PapayaSF]

That's crazy talk!

[Pro Libertate]

I come from a long line of crazy people.

[Episiarch]

Yes, Micks are very crazy.

[Pro Libertate]

You realize that Scottish people are insane in an entirely dangerous way. Unlike the Irish, who are dangerous to themselves more than to others.

[Brett L]

Once we get all our family disputes settled, watch out world!

[Episiarch]

I thought they were just really, really cheap.

[Pro Libertate]

That's why they invented the free market, because it makes things cheaper.

[Episiarch]

For you, Prol.

[Pro Libertate]

I love that sketch.

Lend us a quid till the end of the week.
If you could see your way
To lending me sixpence
I could at least buy a newspaper.
That's not much to ask anyone.

[Almanian.]

First, there were the Scots who kept the Sabbath - and everything else they could lay their hands on;
Then there were the Welsh - who prayed on their knees and their neighbours;
Thirdly there were the Irish who never knew what they wanted - but were willing to fight for it anyway.
Lastly there were the English who considered themselves self-made men, - thus relieving the Almighty of a terrible responsibility.

/from a framed needlepoint on my library wall

[SugarFree]

It's about 64 years too late to suggest anything that looks like personal responsibility in British healthcare.

This is just like the the idiots with a hard-on for Obamacare complaining about the "freerider problem."

[PapayaSF]

This sounds fine to me, in theory. One of the problems with government aid to the sick is the eternal principle that you get more of what you reward and less of what you punish. Governments are always in danger of a positive feedback cycle (the bad kind) in which they encourage more of whatever problem they are trying to alleviate, while paying for it with taxes, which discourage whatever is taxed. Obviously you can't tax the sick and poor and subsidize the well and rich, but this sort of thing seems like a step in the right direction.

(In pre-revolutionary France, aristocrats and others were exempt from many taxes, while it was considered good for the peasants to tax them more, on the theory that it made them work harder and strengthened them, like pruning a tree.)

[Loki]

In pre-revolutionary France, ... it was considered good for the peasants to tax them more, on the theory that it made them work harder and strengthened them, like pruning a tree.

Then why were their peasants so revolting? *rimshot*

[NL_]

It might sound fine to you in principle, but it presumes that the government is good at figuring out who deserves to be reimbursed and who doesn't. In reality, this will just be an exercise of social judgment and societal pressure.

People who drive cars a lot are not expected to bear extra risk paying for their injuries in car accidents because driving is considered normal, acceptable behavior. People with diabetes will be rationed and limited in their access to care, because the societal impression is that a (type II) diabetic is basically gluttonous.

Of course, there's plenty of research suggesting that the underlying process of t2 diabetes is insulin resistance. The body compensates with additional insulin. Since insulin promotes weight gain and promotes hunger (both at once, by stealing energy from the body and storing it in fat cells), there's good evidence that type 2 diabetics are victims of biology, not of old-testament sins. Whereas one could easily avoid driving more by living in a different location or taking up a different job or different personal habits.

This is really just a way to express good old-fashioned moral condemnation under the guise of cost-savings.

[Pound. Head. On. Desk.]

I just think that we have got to have an affordable system that rewards individual responsibility. If you want to have doughnuts for breakfast, lunch and dinner, fine, but there's a cost.

Sound a lot like the free market... But we can't do that!

The problem with judgements like this comes with people who don't have access to wonderful pastries or any other luxury foods, eating a calorie count that classifies them as undernourished, yet they are obese, diabetic, hypertensive, etc. Clearly, something else is going on but Mister Lee is too shallow to investigate and think it through before making pronouncements.

[Fist of Etiquette]

Have they considered a soda tax?

[BoscoH]

then we are going to end up with collapse and the free for all and the pretty disgraceful situation you find in the US.

The free market works pretty well for dental work, you petty, ignorant, little fuck.

[Pro Libertate]

Until things got all hyper HMO-ey in the U.S., I didn't have problems getting whatever medical services I needed.

Yeah, it's fucking government intervention that's the problem. Again. Like always.

[Auric Demonocles]

Is it government spending that's an issue?

[Pro Libertate]

No, not this time. Why do you ask?

[Auric Demonocles]

I wasn't sure what we would do with it.

[Pro Libertate]

We'd cut it, you fuck.

[Pro Libertate]

Wait, that's not right. I'm foggy after my vacation.

[Auric Demonocles]

Where'd you go?

[Pro Libertate]

Nowhere. That's why I'm foggy. Last year, we went to the mountains for Thanksgiving.

[Auric Demonocles]

I was up at my parents in the Vermont mountains. It snowed every day but Thursday.

[Pro Libertate]

It's nice up there. Was it too snowy or nice holiday snowy?

[Auric Demonocles]

Too snowy for the running I tried to do 3 days in a row. Nice holiday snowy for inside mealtime.

[Jordan]

Dental care is just as foreign to Brits as the free market is.

[Rick Santorum]

The free market works pretty well for dental work

Dental work is ridiculously expensive when paying out of pocket.

[Almanian.]

Yep - I've spent several grand over the last couple years. Dentist has to make a "living wage" to pay back those dent school loans, right?

*shrugs shoulders*

Of course, when your dentist knows you're paying cash, they tend to work with you on what the "usual and customary" price is. If they don't - dump 'em and find one who will.

[Loki]

Is dental work all that free market though? Most jobs that offer medical insurance also offer dental and vision, so there's still the issue of third party payers (although they tend to only cover a portion of the bill as opposed to the entire thing, less a tiny out of pocket co-pay).

[Randian]

Dental and vision is premium for some people, and yes, your parenthetical changes the calculus immensely. IME, dental covers a yearly visit and some cavity filling and vision covers an annual visit and a pair of eyeglasses. You're on your own for the rest.

[Butler]

Plastic surgery might be a better example of free market medicine. Plastic surgery is nearly all paid for out of pocket, and costs have been falling relative to inflation over the past 20 years, while quality has improved over that same time period. Who would have thought?

http://www.ncpa.org/pub/ba731

[Almanian.]

the free for all and the pretty disgraceful situation you find in the US

Funny - I've always thought of the medical care in England as the "disgraceful situation". How's your cancer survival rate and access to advanced treatment, Mr. Lee? Oh - I'm sorry - not you PERSONALLY, but the fat lass on the dole eating the donuts.

The English continue to prove that the US decision in 1776 was the correct one.

[fish]

The English continue to prove that the US decision in 1776 was the correct one.

We haven't "missed teh stupid" we've merely deferred it!

[Loki]

Stupid Limey fuck is stupid.

[[e-mail]]

Great constructive criticism there!

[aix42]

They cannot have it both ways. Of course authoritarians like to give 'free' healthcare to all and tell you that because of this you can't do that and that and that.

[Warty]

I can't be joggin' and flippin' tapes and drink my sip.

[Tonio]

Tennis Elbow? Lifestyle-related. And so on. See how that works?

[BC]

This sort of thing drives me absolutely shithouse.

Look, Mr. Lee: If you don't want to pay for the healthcare costs incurred by people as the result of their possibly-irresponsible lifestyle choices, then don't. Abolish the NHS; take yourself off the hook.

But if you insist on providing care to all comers, then stop fucking whining about it when the costs of that care get shifted back to you. That's what you signed up for.

[T]

So does this mean NHS is no longer paying for dentistry? I mean, if they were ever.

[NL_]

Not really appropriate to consider Type 2 diabetes a "lifestyle" disease. The strongest factor in contracting it is family history and genetic predisposition. Which is why the number of obese people without type 2 far outmatches the number of obese people with type 2. If it's a simple matter of "fat = diabetes" then why in a world full of overweight people do we not see ten times as many diabetics?

The other main factor in contracting the disease is age, which is why a huge bulk of type II diabetics are in or approaching old age. Is living to an older age a lifestyle problem?

The fact that so many type 2 diabetics also have hormonal and dietary disorders, like hypothyroidism and celiac, further suggests that it's an underlying hormonal disorder. It's more plausible that diabetes causes obesity than the other way around. The early stages of diabetes often involve ever-increasing insulin levels, and insulin leads to both weight gain and hunger (since it packs energy away in fat cells before it can be used, leaving someone bigger but perversely hungrier). Some twin-concordance studies suggest a higher genetic basis for type II than type I. Type I is supposedly the "good" diabetes.

Maybe instead of trying to figure out whether somebody "deserves" a disease or illness, then heaping judgment on them, doctors can focus on treating it and the rest of us can mind our own fucking business.

[NL_]

I guess I should point out that I was very obese for years and never diabetic or approaching it. I lost the weight (low carbing) and still not diabetic or anything approaching it - closer to the opposite, in fact, with a hyperactive insulin response. If diabetes is just karma for fatties, then I got off easy.

There are far too many fat non-diabetics for it to be as simple as "fatties kill themselves with diabetes." Fucking childish belief in karma. Keep your ghost stories and your fables out of science and medicine.

[Auric Demonocles]

Did SugarFree pay you to say this?

[Warty]

why in a world full of overweight people do we not see ten times as many diabetics?

We do, dude. We absolutely do.

[ABG]

Most overweight or obese people aren't diabetic, though, and a sizable portion of Type 2 diabetics aren't overweight at diagnosis. That's the point, I think. If fat is the cause, Type 2 diabetes rates should be much higher than they are because so many people are overweight or obese in the US and the world. Instead, what we have is a weak correlation, and the correlation isn't that fat causes diabetes, but rather that most Type 2 diabetics are fat when they're diagnosed. That's not a causal link. In fact, if anything, that only tells us that if there's some sort of causal connection between the two, it's probably the other way around.

[NL_]

I asked why the number of diabetics is not ten times higher than it is. If X is the number of diagnosed diabetics, then I asked why the number isn't 10X. X cannot equal 10X without being recursive.

[steve walsh]

This Lee guy is batshit crazy! The way to do this is you charge the healthy people more to pay for the higher cost of treating the unhealthy ones. The healthy folks generally have more free cash - because they don't spend it on donuts, cigarettes, and other unhealthy items - and they live longer!

[Stormy Dragon]

He praised the Danish system of giving patients a modest budget for their prescriptions that they then have to top up themselves if they exceed.

Isn't this completely bass ackward from how insurance is supposed to work? You should expect people to pay a reasonable amount of the health care expenses up front, and then provide coverage when a catastrophic event causes them to go way over the normal amount.

[Auric Demonocles]

Liberals don't care what insurance means. They want free stuff from evil corporations.

[Chris Mallory]

Is he also suggesting that idiots who ruin their knees by running pay for their knee replacement surgeries? After all, exercise is a life style choice.

[waaminn]

lol the got some real stupid people over there in the uK lol

http://www.Tru-Privacy.tk