The Cost Of Living - Alcohol And The NHS Funding Debate

First topic message reminder :

This blog - different to my usual blogs - has been written in partnership with the author Mark Pearson. I hope patients will read Mark's account of his transplant as a cautionary tale to the damage that alcohol can cause, and that Doctors will read it and gain an insight into patients' mindsets, and how we can better try to help this group earlier on.


Money. It's all about money. There is never enough in the NHS, and funding cannot match the new technology and ever-increasing cost of new drugs, let alone the challenges of an increasingly unwell and growing population.
The debate on NHS care - free at the point of contact for all patients, versus privatisation - where everything is paid for, continues. Various models have been proposed, and the current series on NHS funding decisions NHS: £2billion & Counting on Channel 4 has highlighted some of these. Novelist Mark Pearson was featured in the first show. He went from receiving international media coverage as a Sunday Times bestselling author with James Patterson, to two years later being admitted to hospital for an alcohol-related liver transplant.

Mark is the new type of alcoholic patient that doctors now see. The image of all alcoholics as dishevelled down and outs, swigging vodka or extra-strength cider on a park bench are no longer accurate. As well as increasing numbers of younger patients developing issues with their liver as a result of binge drinking, there is a group of patients whom Mark represents. These are often middle-aged individuals, many of whom do not consider themselves to be alcoholics. They have drunk moderate amounts, consistently, for most of their adult lives. Sometimes socially; often a (generous) glass or two or more with dinner each night. Because they do not wake up craving a drink, and their drink of choice is "palatable" alcohol, they do not associate themselves or conform to the normal perception of an alcoholic. These patients present with raised blood pressure, or raised cholesterol levels. They might have this picked up on an annual check-up, or a work medical. As part of these, patients are asked how much they drink.

Most patients underestimate their alcohol intake, and the concept of units of alcohol is poorly understood. Home measures are inevitably more generous than pub measures. Sometime validated screening questions are asked to try and pick up this group:
"Have you ever felt you should cut down on your drinking? Have people annoyed you by criticising your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves, or to get rid of a hangover?"

Answering yes to two or more of these questions, indicates a potential problem, and is more accurate at detecting alcohol excess than some of the blood tests used. If these questions aren't asked, or the patient doesn't give honest answers, they are often reassured by blood tests done as part of the routine health check. This includes liver function tests - but tellingly does not include the most sensitive test for alcohol related liver damage (γGT) - unless it has been specifically requested by the doctor. So being told your liver function is "normal" doesn't mean it has not been damaged by alcohol. It usually means "you've told us nothing to make us think you have a drink problem, so we have done the standard liver test which won't always pick up alcohol related damage - and that's come back fine". And so the problem goes undiagnosed. Mark had drunk for most of his life, usually beer, sometimes 4-5 pints a night, sometimes only at weekends.Two years before his liver failure was diagnosed, he had some blood tests done which showed a mild anaemia. But his liver function was reported as normal. He had already started to reduce his drinking by then from previous levels, but more because of some weight gain than any worries about his drinking.

"I had gone weeks without drinking. I guess there are lots of definitions of what an alcoholic is. Was I addicted? Not physically, not really mentally. I was habituated that was for sure; I abused alcohol that is also for sure. If the test for addiction is measured in withdrawal terms then I would say I wasn't addicted. The main thing is people seeing that not considering yourself an alcoholic and still drinking enough to kill yourself is possible. It is important to remember that alcohol can play a part in health problems and ultimately death in a myriad of ways. Initially after what I thought was a stomach bug was getting worse, I phoned NHS111 who assured me to just stay in take plenty of fluids and rest up. I hadn't taken any alcohol since before the sickness started and didn't feel any urge to do so. When my symptoms didn't improve after about 10 days, I phoned my GP who sent me for a blood test. Later that afternoon, the phone rang. A phone call that was to change my life. My GP told me how concerned he was about the level of anaemia I was presenting with. I was admitted to hospital and after lots of tests, advised that my liver wasn't working well. I was discharged and told to radically change my lifestyle or there would be serious consequences. At this stage, no mention was made of whether a transplant was in the frame. When it became apparent my liver was continuing to fail, and jaundice levels rising even after eight months with no alcohol, I came to the point shown in the programme. My fiancée had never considered my drinking to be a huge issue either. She was shocked, horrified and completely supportive. Neither of us had any idea I was walking over a cliff."

Mark volunteered to go on the Channel 4 programme, knowing it would trigger debate:

"I felt it was fair for the public to form an opinion. Even if I didn't like what they had to say. Everyone has the right to join in the vital debate about our NHS. It is too simplistic to think it is simply a matter of party lines - as some would have us believe. So if my filming, and the others who agreed to take part in the programme, stimulates useful discussion then it has done a good thing. I knew I was putting myself up as a bogeyman, but the transplant unit asked me to do it, and I was happy to be able to do something for them, however little, in the grand scale of things, it was. If I helped raise awareness and possibly some people considered joining the organ donation scheme - then it would be very churlish to refuse the man, who if it turned out I needed it, would be saving my life. As it turned out that was exactly the case."
What about the issue of money? Does Mark feel he deserved the NHS to pay for his treatment?

"Katie Hopkins made a point on Twitter that people like me who could afford to have caused damage to myself through alcohol, or drugs, or overeating, or smoking, could also afford to pay for the help they consequently need. The issue she raises is one of responsibility and she is right to raise it. In my case it was quite simple, if you drink any alcohol again you will never be put on the transplant list, and if you drink after being transplanted your liver is very much on its own. It's fair! I am not sure how funding will change for the NHS in the future, but at the moment there are only three options - the NHS pays, the NHS doesn't pay and you don't have it done, or you pay privately. The latter is not an option for organ transplants obviously. If a means-tested system allowed for some contribution, to whatever percentage, to the cost of such an operation, few would turn down the opportunity In my case I certainly couldn't have afforded private care even if it was available for transplants. But if there was a choice between having to pay for it or die, then I of course would have sold my house, anything, to have the treatment I needed."

How did Mark feel when he got the call that there was a liver for him?
"I was extremely relieved and extremely saddened. The abstract concept of receiving a donor's organ was abstract no longer. Someone had died and that gave me the chance to live. Strangely I didn't feel scared anymore. I was aware, from being on the assessment process, how much care was going to be taken care of me and how brilliant, dedicated, driven and genuinely caring all the people in the transplant unit are. From Paul Gibbs the Clinical Director, to Neil the Healthcare Assistant. One of the things that became very clear to me very quickly was the shortage of organs that are available. I wasn't a donor card carrier myself for many years and so have no soap box at all to stand on with this issue. In Holland and other countries it is the rule that you choose to opt out of donor schemes rather than in. It is of course for individuals to make their mind up on these issues and it would be hypocritical for me to say what is right or wrong. So I won't. We are all, hopefully, capable of making our own decisions."
And now?

"The silly thing is I have learned that I am no less sociable and gregarious than I was when I was drinking. I still go to the pub and laugh and enjoy people's company. I don't drink but I don't laugh any less, or love any less, or care for people any less. I do still feel guilty, but guilt without action can lend to self-indulgence. So I am doing what I can and doing it as best as I can to make the donor's family not regret their gift. Not drinking for me, and I know I am only speaking for myself, is genuinely the easiest part of the process. Looking back now I can see how stupid I have been. I was aware of the drinking limits but in my opinion they were set very low deliberately. I know I am not alone in badly drinking above the guidelines. But for me I was stupid. Arrogantly so - for example I was aware that GPs sometimes prescribe double the dose of painkillers. So at home I was regularly taking double the dose of Paracetamol that the box stated. I just thought I was doing what the doctors would have done anyway. Not a good thing for your liver either to be put it ridiculously mildly. No excuses. Stupid. It is no exaggeration to say it was the most humbling and yet uplifting experience of my life. I feel a 100% guilty and ashamed, and a 100% grateful and life affirmed. The donor and his family have given me my life and the transplant team made me able to accept that gift. I truly hope they are not disappointed that it was me, should they learn so, and I will do absolutely everything to both treasure and nurture the gift I have been given."

Every patient has a responsibility to safeguard their own health. There are a million ways to find out how to do this, but the NHS cannot enforce healthy living. Ultimately it is the responsibility of each individual. Ignoring the advice on weight, alcohol, smoking, and exercise is no longer an option. In order to continue providing a basic service, tough funding decisions have to be made. It is not only a small group of patients - drug users, alcoholics, whoever you deem it to be - who drain NHS resources; it is all of us by our actions every day. At the current rate, the great NHS safety net may not be there when you need it, or you may find yourself on the receiving end of a decision not to fund your care, based on your health choices. The NHS is a very fragile glass house and no one can afford to throw too many stones.
Mark before
And after his transplant

Veya- I wouldn't ban them from treatment, I would just make them pay for whatever they receive. If they are going to be a burden on the system they should expect to do so- it was their choice.

Cass wrote:sorry Didge I sort of agree with Irn to an extent about being proud to be British. I hate the American health care system so much. it has hurt so many people and all because of money. people have gone bankrupt had their credit history ruined list their houses or have suffered pain and sickness unnecessariky because they didn't or don't have the money to pay for treatment or insurance premium.

I'm off to the docs tomorrow - will cost me £27 just to elwalk in the door and that's with insurance. if I need blood tests which I suspect I do, and a cortisone shot in my shoulder and others meds then it will go up and up and up. I'm just lucky I can afford it.

There is nothing wrong with being proud to be British Cass, the point was more on Irn just singling out the British for care when we have many failings in this country on care. That is not to mean many do care, of which many do , but to me to make a point on one set of people is wrong to me when we should be looking to care for those not just in this country. So I understand your point Cass, but even with our free system, to me we are letting many children in care down and the elderly, when the first point of duty of care should come from the families..

Eilzel wrote:Veya- I wouldn't ban them from treatment, I would just make them pay for whatever they receive. If they are going to be a burden on the system they should expect to do so- it was their choice.

well it is fair, IF every athlete that hurts themselves THROUGH their choice of playing a games that Everyone knows are going to dramatically increase your chances of injury ALSO has to pay for their treatment

STDs no longer covered as they are spread by someone CHOOSING to have unprotected sex.

Slippery slope mate.
every action in life is a choice
AND discriminating against one group because of 'lifestyle choices'.. I should not have to tell you why that is wrong and how open to abuse that precedent obviously is.

Generally athletes will be healthier however, and since doing sport and encouraging it will lead to an overall fitter and healthier society you cannot truly compare with smokers, drug users, the obese and drinkers.

STDs- well in fairness you are right, if people didn't protect themselves then yes they should pay- if there is a clear case of repeatedly making the same mistake. The only difference here is that you can get an STD from One mistake. Obesity, drug abuse and drinking all leave plenty of opportunities to STOP harming yourself with your actions- so again it isn't like for like.

And I don't care for the term 'lifestyle choice'. It is wrongly used when associated with homosexuality (which is neither a lifestyle nor a choice). But some choices are self evident and if you repeatedly make the wrong one for your health- then we have to draw a line somewhere.

Eilzel wrote:Generally athletes will be healthier however, and since doing sport and encouraging it will lead to an overall fitter and healthier society you cannot truly compare with smokers, drug users, the obese and drinkers. NOPE Athletes cost more in medical care than Obese. Obese die, Athletes cost $10,000's in joint reconstructions arthritis and whole bunch of other things Athletes are the most expensive individuals for the health care system

STDs- well in fairness you are right, if people didn't protect themselves then yes they should pay- if there is a clear case of repeatedly making the same mistake. The only difference here is that you can get an STD from One mistake. Obesity, drug abuse and drinking all leave plenty of opportunities to STOP harming yourself with your actions- so again it isn't like for like.
Identical You are Taught BOTH in school

And I don't care for the term 'lifestyle choice'. It is wrongly used when associated with homosexuality (which is neither a lifestyle nor a choice). But some choices are self evident and if you repeatedly make the wrong one for your health- then we have to draw a line somewhere.

AND plenty of psychological studies show there is genetic predisposition to addiction(let alone the victims of child abuse etc). sorry but for some people it is not a choice either.

I do not support making people pay in anyway shape or form, as far as I'm concerned the pile of money is there for those that need it
the Whole argument about it costing too much is a lie, it only cost too much if you think the rich need tax breaks

I would prefer both- that the rich pay more but also the health system not have to support recklessness.

And I'm sure professional athletes treatment costs a lot but do we need to go into just how much they pay into the system via taxes? And again overall the encouragement of sports IS beneficial overall.

And no STDs are not totally identical- again due to the number of times you need for harm to be caused. You know after one drink the affect alcohol is having you physically have to drink again and again for it to become a problem.

And being predisposed to addiction stills requires physical choices and decisions. Ultimately its down to individual responsibility.

Professional Athletes? What about the hundreds of Near professional athletes that hardly ever make anything and Still cost the same
That is Why Statically Athletes ARE the most costly individuals There is more fat people or drunks etc (so a greater cost of Total expenditure) BUT fat Drunks actually pay more tax than average athletes.
Let alone all those sports that just never pay that much.


And the exact same can be said about homosexual intercourse, you CANT expect someone to deny their chemical wiring.
And STILL SLIPPERY SLOPE that should not be considered at this point.

Apparently Indigenous Australians living in poverty is a “lifestyle choice”

Australia’s Prime Minister, a man who told you he would be the first "prime minister for Aboriginal Affairs" and would regularly visit Indigenous communities, has now said Indigenous Australians have made “lifestyle choices” to….well, live in poverty and have zero access to services and basic living conditions.

"What we can't do is endlessly subsidise lifestyle choices if those lifestyle choices are not conducive to the kind of full participation in Australian society that everyone should have."

http://www.thevine.com.au/news/life/10-things-indigenous-poverty-is-a-lifestyle-choice-20150311-296964/?utm_source=thevine&utm_medium=content-list&utm_campaign=internal-testing

too dangerous to even consider letting pollies say this 'lifestyle choice' is no longer covered

Cass wrote:

eddie wrote:Cass, I firmly believe that as people get older they take the piss more than when they were a kid.
Know why?
Becasue they can.

Think about that.
What would happen if we all knew that we only had that one chance (then one final chance?)

I think they'd be more successful cases of people giving up for good.

Want do we have now???

It's called tough love and it works.

The advice is you live with a druggie or an alcoholic is to not keep on helping them as you're actually creating and helping them stay hooked.

One chance and one chance to slip.
If people knew that that's alll they had - they may take it more seriously.

Not sure why people fidn that hard it understand.

Because I am not simply prepared to write off other human beings when I don't know what they have been through. I am not perfect and neither is anybody else. How do you know that they don't take it seriously even if they have failed? Who are you to judge them and tell them how much better you are as a human being (not your per se but in general context) and that they must live up to your expectations? And what if somebody had called you on some things that you have done in your past and said whoopsie, that's your lot used up cause you made a mistake? What if someday regardless of how you teach them and bring them up, your children become alcoholics? What would you do then?

Start of the slippery rope if you ask me....first you have one chance only for sobriety, next it will be well we are overcrowded so everyone only gets 1 kid, or you have cancer again? too bad you already had chemo....

committing a crime whilst under the influence is a totally separate matter though.

CAss all I know is......IT ISNT WORKIGN NOW IS IT??

That's all we keep doing in this country! Throwing the same solutions at the same problems and it isn't working.

People are just taking the piss, and sorry, people can give up and will give up but the want isn't there unless you take away the fact that you only have a couple of chamces!

I can tell you now Id chuck my son or daughter out if they became heroin addicts. Id tey and give them help of course at first, but if they didn't want to or just kept failing.....well the general advice is of you're not helping you're actually aiding them to stay on the stuff.

I have family personal experience of this. Unless you've seen it first hand....you will never ever get it.


Are you actually saying that if a person sits in their house and doesn't work and can't work due to say, overeating, then we should PAY them to??? Give them disability allowance? So they can keep saying "Oh I keep trying but I can't seem to stop....I'll try again tomorrow"

Wtf???? How many chances and how much money do we keep throwing at them??

I have a feeling none of you live in a world where this happens around you!!
It's easy to have these opinions from inside your comfy bubble.

Eilzel wrote:I would prefer both- that the rich pay more but also the health system not have to support recklessness.

And I'm sure professional athletes treatment costs a lot but do we need to go into just how much they pay into the system via taxes? And again overall the encouragement of sports IS beneficial overall.

And no STDs are not totally identical- again due to the number of times you need for harm to be caused. You know after one drink the affect alcohol is having you physically have to drink again and again for it to become a problem.

And being predisposed to addiction stills requires physical choices and decisions. Ultimately its down to individual responsibility.  

I agree. Which is what this op started off saying....it's about people's choices

If someone sticks a needle in their arm they are choosing to go down that path.

Troubles with being too open? We let the wrong stuff in.

One last thing to consider:

You do know that you have to WANT to give up yes?
So to keep throwing money at someone who's not ready is just a waste.

You keep saying that, but what exactly isn't working?  The NHS is now getting LESS money per head of the population, it is losing money because it is paying private firms more than it would pay if the NHS did it, it's just had £780million handed to private companies because of the underfunding and you keep blaming people who have problems and saying it's not working.  Actually, considering the underfunding it's working bloody well.  It's not the NHS's fault that this goverment, after promising not to interfere before the last election, promptly interfered big time and cut funding.  Oh they will tell you that they didn't, but the figures prove otherwise.   And instead of blaming them, you start of the little people at the bottom of the chain.  In fact, alcohol addiction is one of the things that people can't get treatment for, and if you are a teenager with mental health problems, forget it, they end up putting you in a police cell overnight because it is so underfunded.    What is this puritan streak that means anyone who is not perfect better go jump in the river and die.   Do you understand the complexities of addiction Eddy?   Are you an authority on the subject?  No you are not, any more than any person on this forum is, but without understanding the complexities of it and why people very rarely succeed first time, you are prepared to say they are not worth anything, get rid, chuck out, give up on, they are not worth the trouble.  How bloody authoritarian and soulless is that!

Oh, and BTW



So let's blame addicts for the problems shall we?

risingsun wrote:You keep saying that, but what exactly isn't working?  The NHS is now getting LESS money per head of the population, it is losing money because it is paying private firms more than it would pay if the NHS did it, it's just had £780million handed to private companies because of the underfunding and you keep blaming people who have problems and saying it's not working.  Actually, considering the underfunding it's working bloody well.  It's not the NHS's fault that this goverment, after promising not to interfere before the last election, promptly interfered big time and cut funding.  Oh they will tell you that they didn't, but the figures prove otherwise.   And instead of blaming them, you start of the little people at the bottom of the chain.  In fact, alcohol addiction is one of the things that people can't get treatment for, and if you are a teenager with mental health problems, forget it, they end up putting you in a police cell overnight because it is so underfunded.    What is this puritan streak that means anyone who is not perfect better go jump in the river and die.   Do you understand the complexities of addiction Eddy?   Are you an authority on the subject?  No you are not, any more than any person on this forum is, but without understanding the complexities of it and why people very rarely succeed first time, you are prepared to say they are not worth anything, get rid, chuck out, give up on, they are not worth the trouble.  How bloody authoritarian and soulless is that!

Sassy I would bet all my life savings I have far far more insight into addiction of alcohol and drugs than you. And of the average working class junkie

That's all I will say.

I've made my point and a lot of my questions weren't even answered.
I'll leave you to it.

Well said Eddie.

eddie wrote:One last thing to consider:

You do know that you have to WANT to give up yes?
So to keep throwing money at someone who's not ready is just a waste.

Hi Eddie

Was going to write a long reply even though I have good understanding here but it is not how you view or see this and why some experts is needed here to aid the debate:



Whether we like to admit it or not, we all have our own ideas of what an addict looks like. We have our beliefs about why they engage in the behaviors they engage in and why they just won’t quit.
This is also true for addicts themselves. Often it is difficult to overcome addiction because of the perception of what addiction really is.
But the truth of addiction is sometimes hidden behind common, long-standing myths. So here are some of those common myths — and the real truth — about addicts and addiction.

• Addicts can stop if they really want to.Research shows that long-term substance use alters brain chemistry. These changes can cause intense cravings, impulse control issues, and the compulsion to continue to use. Due to these chemical changes it is very difficult for a true addict to quit solely by willpower and determination.
  
• Addicts can’t be productive members of society.Many often believe that addicts are unemployed, involved in criminal behaviors, homeless, and have a host of interpersonal issues. While this is sometimes true, there are many addicts that continue to “function” in society by remaining employed, providing for their families, being involved in family activities, and not appearing to be an addict.
  
• Addiction only affects those who are weak, uneducated, or have low morals.Addiction does not discriminate. Addiction affects the lives of people of all ages, ethnicities, cultures, religions, communities, and socioeconomic statuses. Addiction is not a result of low morals. Often addicts behave in ways that violate their personal beliefs, values, and morals. Addiction is an equal opportunity disease.
  
• Addiction is a disease, so there is nothing you can do about it.If your doctor told you that you had cancer, would you not begin necessary treatment and making the necessary lifestyle changes? Addiction isn’t much different if you believe in the research that suggests that addiction is a disease of the brain. Just because you have the disease of addiction doesn’t mean you throw in the towel. Research shows that the brain damage resulting from substance use can sometimes be reversed through abstinence, therapy, and other forms of treatment.
  
• Addicts who relapse are hopeless.Addiction is a chronic disorder. Just as a pathological liar has to work continuously on honesty, an addict has to commit to working on not using. Addicts are most prone to relapse in the first few months of being clean and sober. A relapse does not constitute failure. Processing the events surrounding a relapse can be healthy and aid in preventing future relapses.
  
• Alcohol and drug use cause addiction.There are several factors that contribute to a person becoming addicted to substances. While alcohol and drugs may trigger a substance use problem for some, there are those who can drink alcohol and experiment with drug use and never become addicted. Factors that contribute include environment, emotional health, mental health, and genetic predisposition.
  
• Addicts should be excused from negative behaviors.Some may believe since addiction is a disease addicts should not be held accountable for their actions. This is not true. An addict may not be responsible for their disease, but they are responsible for their choices and their recovery.
  

It is easy to judge and criticize what we don’t understand. You don’t have to walk a mile in addicts’ shoes to understand addiction and addictive behaviors. If someone you know is struggling with an addiction, consider learning more about addiction and extend a helping hand instead of hurtful words.

http://psychcentral.com/blog/archives/2013/07/17/they-could-stop-if-they-wanted-to-common-myths-about-addicts-addiction/

eddie wrote:

risingsun wrote:You keep saying that, but what exactly isn't working?  The NHS is now getting LESS money per head of the population, it is losing money because it is paying private firms more than it would pay if the NHS did it, it's just had £780million handed to private companies because of the underfunding and you keep blaming people who have problems and saying it's not working.  Actually, considering the underfunding it's working bloody well.  It's not the NHS's fault that this goverment, after promising not to interfere before the last election, promptly interfered big time and cut funding.  Oh they will tell you that they didn't, but the figures prove otherwise.   And instead of blaming them, you start of the little people at the bottom of the chain.  In fact, alcohol addiction is one of the things that people can't get treatment for, and if you are a teenager with mental health problems, forget it, they end up putting you in a police cell overnight because it is so underfunded.    What is this puritan streak that means anyone who is not perfect better go jump in the river and die.   Do you understand the complexities of addiction Eddy?   Are you an authority on the subject?  No you are not, any more than any person on this forum is, but without understanding the complexities of it and why people very rarely succeed first time, you are prepared to say they are not worth anything, get rid, chuck out, give up on, they are not worth the trouble.  How bloody authoritarian and soulless is that!

Sassy I would bet all my life savings I have far far more insight into addiction of alcohol and drugs than you. And of the average working class junkie

That's all I will say.

I've made my point and a lot of my questions weren't even answered.
I'll leave you to it.

I bet you don't.  Because of her pain my daughter was given very high doses of painkillers.  In the end she was completely addicted to oxycotin, prescribed by her doctor, and struggled like hell to get off it.       I had a friend who died from alcohol poisoning, he had been abused for years as a child, went through rebab and stayed off for years and then started getting flashbacks to his childhood and couldn't cope, reverted to alcohol.   We carried on helping him, but it won.

The struggles addicts go through are never ending because of the reasons behind the addiction.

eds

and in the good old days before the NHS people just died earlier - gin especially was cheaper than food - but hey it culled the herd.

I do not live in a bubble and talk from my armchair. I have close family and friends experience of this thank you very much so yes I do know what I speak of.

I forgot to say...

you seem annoyed that no one has answered your questions....go ahead and list them and I will try and do my best, but it may be not be right away that I can answer oh bearded one

well now....supposing we try to define "life style choices" shall we....


BECAUSE

at its loosest

then every pregnant woman should pay...(having children IS a "life style choice")

every spotsman professional and amateur should pay (playing sports IS a life style choice)

probably every road user injured (certainly in the case of vehicle users)

etc etc etc

moreover lets examine the plight of the obese

given that for many obesity IS a result of life style choices.....who is going to weed out those for whom it isnt

those with medical problems (some of which are intractable)

now theres NO way their GP would be trusted is there...I mean the cons wont take any heed off even your consultant, preferring instead a semi trained simian working for ATOS (or its "inheritor")
So it is an absolute certainty that ALL obese folk will pay...


then we have all those people suffering from work related stress.....

the work you do is again without doubt a "lifestyle choice" I mean its not like there is any shortage of jobs ....is there didge...you keep telling me how the job market is positively awash with opportunities so id what you are doing is stressing you...change it...

this whole debate is symptomatic of the greedy ME ME ME generation.....maggies "greed is good brigade" and YES eil I do include you in that....on the basis of your posts here.....


As I said the genuine booze addict (the alki the derelict ) is thin on the ground

the biggest expense is the moronic youth who's idea of a good night out is to get trashed to the point of injury ...

now THEY should pay....why...because unlike the alki or even the average druggie..... those twats are deliberately and maliciously (and thus negligently) getting sick/injured.... they are NOT "compelled " like the true addict
they do it because they can and "no one can stop me, I can do as i like"....

in short they are anti social little tits....

darknessss wrote:this whole debate is symptomatic of the greedy ME ME ME generation.....maggies "greed is good brigade" and YES eil I do include you in that....on the basis of your posts here.....
As I said the genuine  booze addict (the alki the derelict ) is thin on the ground
the biggest expense is the moronic youth who's idea of a good night out is to get trashed to the point of injury ...
now THEY should pay....why...because unlike the alki or even the average druggie..... those twats are deliberately and maliciously (and thus negligently) getting sick/injured.... they are NOT "compelled " like the true addict
they do it because they can and "no one can stop me, I can do as i like"....
in short they are anti social little tits....

Blimey Victor promting progression, now there is a first.
Has nothing to do with Maggie in regards to greed, which has been within humanity since civilizations began and I think you will find there is as much me, me ,me within any generation from the past. The only difference today is that there is lots more objects available to keep everyone entertained and occupied. So its not so much of the me, me, me, but more now today where we have so many distractions, families, friends etc are becoming increeasing less social. In the past people had little else but to be social in company, but today, have so many things at their fingertips to keep them occupied. Now that reall is a problem where material objects are more impprtant to many people.
Also binge drinking has been around for about 2,000 in this country, which means we would need to change this British culture, which I agree is constantly out of control. I agree to higher taxes on beer and if people become injured uncer the influence of alcohol (bar being assualted) then they should also have to pay emergency Hospitall fees. This would still fall within the concept of equality. You will need to find better ways though for people to let off steam. As this is what in many cases is why many people go out or stay in getting smashed off their tits, as people in this country have done so for 2,000 years
So it shows that you do not have cultural Pessimism on a British tradition of loving drink to the point of binge drinking, making you a progressive Victor.

http://thinkprogress.org/health/2015/03/12/3632978/depression-obesity-and-poverty/

If left untreated, depression can exacerbate the risk of poor nutrition and obesity among low-income people who live in food deserts — neighborhoods with limited access to healthy food and fresh produce — a recent study has confirmed.

Researchers followed more than 600 participants in a Pittsburgh food assistance program who bought food for their families. They found a strong correlation between depression, poor nutrition, and high body mass index — the estimate of the body fat based on the height and weight. The study, however, didn’t explicitly show that depression caused unhealthy eating habits.

CAN ANY SAY DISTRACTING FROM THE REAL PROBLEM

this whole debate is just to distract you from the Pollies rich mates pulling the money from your pocket. ALL studies have show increase the expense of healthcare and you either have to just let people die in the street OR you have people with minor cheaply treated aliments leaving it until it is life threatening cost emergency.
the very premise behind the ideas have been proven Wrong already. IT will not save the taxpayer money You will just have less health care and the Rich guy will have a little bit more money.

Brasidas wrote:

Irn Bru wrote:

Brasidas wrote:

All humans have the capability to care, it does not stem from being British which your view point was on British people, where again many humans care. Now the country as a whole lacks in care, where we have countless youngsters in care homes, where many have been constantly let down over decades, which really as a nation shows that our care has limitations and it does not reach out to everyone or that the care provided is inssuffcient. The point is to say British, is nothing many than a concept and the point should be on people helping and caring more.
The last part you just invented Irn off your poor last point. I get what you meant. just you could of put it better across as you did in your latest post. But again this nation has a long way to go to claiming it really cares as the most many people do is pay into a system and allow others that responsibility, when more should be done by people themselves.

Yes, I know all that and there is plenty room for improvement but we would never, ever refuse treatment to anyone whoever they are or whichever country they came from or if they had any money in their pockets to pay for it. Money is not a priority in this country when someone is ill and needs help and I'm bloody proud that I live in a country that is like that.
You appear to want to make out that there is something wrong in what I said and that it is a poor racial view to hold as if that is something you would get in other countries in the world without question.
So why is what I said a poor racial view?

It is a poor view point to make a view on the concept British when again caring for people is a human issue.
You made a view around the British being as this country is so diverse, where that is just a name to identify under the country, where it has no meaning to the point on humans caring. In fact we are getting very poor at caring in this country where there is now a view to ship off those who raised us into care homes when they are old and need care, where many do not take in their parents,

Your view was this:
I’m not for giving up on them and I’m sure our medical practitioner’s wouldn’t give up either because this is Britain, we are British and in the main we are not like that


What relevance did the point on British people be relevant to a debate on responsibility?
Even more so when a third of our doctors are forign>
It is if you are only making out British medical staff care and make no mention of the countless foreign medical staff that care.
Hence the point of British was racial, as many ethnic groups care and where we have many foreigners now also who are not British who do a wonderful job. British is agaiin a concept Irn, it is humans that care.

It has relevance in every single aspect because this is Britain and it is in Britain that people will receive healthcare no matter who they are, where they are from or if they have any money to pay for it or has that escaped your notice? A friend of mine went to Guernsey for a holiday where he fell and hurt himself. He was treated for it in hospital but his girlfriend had to go home whilst he remained in hospital and then go back with money to pay for it all. He had healthcare insurance but he still had to pay for it and reclaim the money from the insurance company who dragged it out for months requesting hospital statements and a whole load of other documents to support the claim that the accident was not as a result of negligence on his part.

You mentioned responsibility and asked what relevance does free healthcare in Britain have in this debate? That Didge is the very essence of what we are debating – free healthcare in Britain.

And yes we have foreign healthcare staff and they can practice here and care for people in this country without having to ask them for money to do so when that may well not be true in the their country of origin where the sick and the needy get nothing or else they may have to fall on charitable contributions for help if at all possible. It’s the system they work under (a British NHS) not the nationality of the healthcare professionals who administer the treatment.

The standard of healthcare here is not the issue, it’s whether it is free at the point of delivery to all mankind no questions asked and in this country it is because this is Britain. Are you for giving up on that?
So are you really not proud of the fact that Britain offers that kind of service to all whilst they are here no matter who they are - seriously?

The NHS is a British institution set up to provide healthcare for all something you appear to have forgot because anyone attempting to divorce the word British from the NHS should just follow Dan Hannan who did a great job of rubbishing it across the pond..

Here's tae us -
Wha's like us -
Damn few -
And they're a' deid -
Mairs the pity!

Robert Burns

Irn Bru wrote:

Brasidas wrote:

It is a poor view point to make a view on the concept British when again caring for people is a human issue.
You made a view around the British being as this country is so diverse, where that is just a name to identify under the country, where it has no meaning to the point on humans caring. In fact we are getting very poor at caring in this country where there is now a view to ship off those who raised us into care homes when they are old and need care, where many do not take in their parents,

Your view was this:
I’m not for giving up on them and I’m sure our medical practitioner’s wouldn’t give up either because this is Britain, we are British and in the main we are not like that


What relevance did the point on British people be relevant to a debate on responsibility?
Even more so when a third of our doctors are forign>
It is if you are only making out British medical staff care and make no mention of the countless foreign medical staff that care.
Hence the point of British was racial, as many ethnic groups care and where we have many foreigners now also who are not British who do a wonderful job. British is agaiin a concept Irn, it is humans that care.

It has relevance in every single aspect because this is Britain and it is in Britain that people will receive healthcare no matter who they are, where they are from or if they have any money to pay for it or has that escaped your notice? A friend of mine went to Guernsey for a holiday where he fell and hurt himself. He was treated for it in hospital but his girlfriend had to go home whilst he remained in hospital and then go back with money to pay for it all. He had healthcare insurance but he still had to pay for it and reclaim the money from the insurance company who dragged it out for months requesting hospital statements and a whole load of other documents to support the claim that the accident was not as a result of negligence on his part.

You mentioned responsibility and asked what relevance does free healthcare in Britain have in this debate?  That Didge is the very essence of what we are debating – free healthcare in Britain.

And yes we have foreign healthcare staff and they can practice here and care for people in this country without having to ask them for money to do so when that may well not be true in the their country of origin where the sick and the needy get nothing or else they may have to fall on charitable contributions for help if at all possible. It’s the system they work under (a British NHS)  not the nationality of the healthcare professionals who administer the treatment.

The standard of healthcare here is not the issue, it’s whether it is free at the point of delivery to all mankind no questions asked and in this country it is because this is Britain. Are you for giving up on that?
So are you really not proud of the fact that Britain offers that kind of service to all whilst they are here no matter who they are  - seriously?  

The NHS is a British institution set up to provide healthcare for all something you appear to have forgot because anyone attempting to divorce the word British from the NHS should just follow Dan Hannan who did a great job of rubbishing it across the pond..

Here's tae us -
Wha's like us -
Damn few -
And they're a' deid -
Mairs the pity!

Robert Burns

What a load of complete bollocks and even more racist than a pathetic little man could ever be not understanding that British is just a concept.
I could not give a shit about your made up story about some invention.
Seriously did you even address aby of the points I made?
No. What is worse is yhou have to invent things and side track the debate, because you know what I am saying is true.
Responsibility has everything to do withg this debate and this starts wikth the individual.
Or do you not even realise this?
You now attempt to make this into some other argument because your point was stupid and it was racist.
Hey ho it is fun watching you squirm ha ha

Brasidas wrote:

Irn Bru wrote:

Brasidas wrote:

It is a poor view point to make a view on the concept British when again caring for people is a human issue.
You made a view around the British being as this country is so diverse, where that is just a name to identify under the country, where it has no meaning to the point on humans caring. In fact we are getting very poor at caring in this country where there is now a view to ship off those who raised us into care homes when they are old and need care, where many do not take in their parents,

Your view was this:
I’m not for giving up on them and I’m sure our medical practitioner’s wouldn’t give up either because this is Britain, we are British and in the main we are not like that


What relevance did the point on British people be relevant to a debate on responsibility?
Even more so when a third of our doctors are forign>
It is if you are only making out British medical staff care and make no mention of the countless foreign medical staff that care.
Hence the point of British was racial, as many ethnic groups care and where we have many foreigners now also who are not British who do a wonderful job. British is agaiin a concept Irn, it is humans that care.

It has relevance in every single aspect because this is Britain and it is in Britain that people will receive healthcare no matter who they are, where they are from or if they have any money to pay for it or has that escaped your notice? A friend of mine went to Guernsey for a holiday where he fell and hurt himself. He was treated for it in hospital but his girlfriend had to go home whilst he remained in hospital and then go back with money to pay for it all. He had healthcare insurance but he still had to pay for it and reclaim the money from the insurance company who dragged it out for months requesting hospital statements and a whole load of other documents to support the claim that the accident was not as a result of negligence on his part.

You mentioned responsibility and asked what relevance does free healthcare in Britain have in this debate?  That Didge is the very essence of what we are debating – free healthcare in Britain.

And yes we have foreign healthcare staff and they can practice here and care for people in this country without having to ask them for money to do so when that may well not be true in the their country of origin where the sick and the needy get nothing or else they may have to fall on charitable contributions for help if at all possible. It’s the system they work under (a British NHS)  not the nationality of the healthcare professionals who administer the treatment.

The standard of healthcare here is not the issue, it’s whether it is free at the point of delivery to all mankind no questions asked and in this country it is because this is Britain. Are you for giving up on that?
So are you really not proud of the fact that Britain offers that kind of service to all whilst they are here no matter who they are  - seriously?  

The NHS is a British institution set up to provide healthcare for all something you appear to have forgot because anyone attempting to divorce the word British from the NHS should just follow Dan Hannan who did a great job of rubbishing it across the pond..

Here's tae us -
Wha's like us -
Damn few -
And they're a' deid -
Mairs the pity!

Robert Burns

What a load of complete bollocks and even more racist than a pathetic little man could ever be not understanding that British is just a concept.
I could not give a shit about your made up story about some invention.
Seriously did you even address aby of the points I made?
No. What is worse is yhou have to invent things and side track the debate, because you know what I am saying is true.
Responsibility has everything to do withg this debate and this starts wikth the individual.
Or do you not even realise this?
You now attempt to make this into some other argument because your point was stupid and it was racist.
Hey ho it is fun watching you squirm ha ha

Ah, the usual battle cry from Didge - liar. Coming from a liar that is a classic.

It's true and if you knew anything about healthcare in Guernsey you would know that's what the situation is .Shame you couldn't be bothered to check.

Well next time I see you arguing the point that the British Army are the best and the best trained I'll be entitled to call you a racist because there are plenty of people serving in our army who are not British. And after all, as you say British is just a concept so there you go you little racist that you are.

Talk about PC bullshit - you're a master at it.

lol and we are back to the commie trying to avoid the points again.
Sorry you do not want top understand responsbility that is because of your history and your inability to be responsible in life and now coming up with things German, PMSL
Never miind let me kbow when you want to answer this.

Brasidas wrote:lol and we are back to the commie trying to avoid the points again.
Sorry you do not want top understand responsbility that is because of your history and your inability to be responsible in life and now coming up with things German, PMSL
Never miind let me kbow when you want to answer this.

Ah, I see where you are going wrong Didge. You thought I was talking about Germany. No, it was Guernsey and the one and only time I was there which was many years ago I believe all the German soldiers who had occupied the Island during WWII had left by then.

Now stop all this PC bullshit nonsense stating that the NHS being British is in some way a poor racial view and move on.

Irn Bru wrote:

Brasidas wrote:lol and we are back to the commie trying to avoid the points again.
Sorry you do not want top understand responsbility that is because of your history and your inability to be responsible in life and now coming up with things German, PMSL
Never miind let me kbow when you want to answer this.

Ah, I see where you are going wrong Didge. You thought I was talking about Germany. No, it was Guernsey and the one and only time I was there which was many years ago I believe all the German soldiers who had occupied the Island during WWII had left by then.

Now stop all this PC bullshit nonsense stating that the NHS being British is in some way a poor racial view and move on.

Still unable to move on I see.
Try again

Will look in tomorrow to see if you are capable.

Brasidas wrote:

Irn Bru wrote:

Brasidas wrote:lol and we are back to the commie trying to avoid the points again.
Sorry you do not want top understand responsbility that is because of your history and your inability to be responsible in life and now coming up with things German, PMSL
Never miind let me kbow when you want to answer this.

Ah, I see where you are going wrong Didge. You thought I was talking about Germany. No, it was Guernsey and the one and only time I was there which was many years ago I believe all the German soldiers who had occupied the Island during WWII had left by then.

Now stop all this PC bullshit nonsense stating that the NHS being British is in some way a poor racial view and move on.

Still unable to move on I see.
Try again

Will look in tomorrow to see if you are capable.

You do that