I honestly can't see how anyone can think abortion is wrong and not also think that it is one of the most important political issues in the country today. To vote for parties on grounds of how they treat the comparatively poor (for example) ignoring how likely they are to reduce the number of abortions seems like voting for the Nazis because they were good at law and order.
The question came up today about whether the government should pay for treatment for self-inflicted illnesses (such as smoking-related diseases, obesity, self-harm, parachuting injuries). My opinion is that there should be a compulsory healthcare insurance, the premium for which is dependent upon lifestyle factors but not on genetic factors (including gender, race, etc). Some basic level could be paid for out of general taxation to ensure that the poorest are provided for. So basically it comes out as an NHS which doesn't provide for lifestyle-linked stuff except in emergencies, but where insurance e.g. for riding a bike is readily available (thought it might of course require wearing a helmet). [ETA - I'm going off this idea; see comments. But I stand by the first one.]
7 comments:
I'm guessing that under your scheme, builders would pay a rather high insurance. As would most people who have some sort of physical job. The upshot of that could be that many of those on relatively low pay would pay a higher insurance premium, while rich businessmen in offies would pay less. Since many 'lifestyle choices' aren't actually to do with choice but just with earning a living, I'd prefer to stick to the current taxation system.
Also, there's a danger that insurance premiums (should that be 'premia'?) would more closely reflect a perception of danger than actual danger in people's lifestyles. Because I cycle on roads a lot, and have MTBd a lot in the past, you may label my lifestyle as more dangerous than normal, if not by much. However, far greater than the chance of me getting hit and requiring lots of medical care (ignoring personal circumstances!) is the chance of me affected by heart disease and all sorts of other conditions, to a much lesser extent than many people - so saving the NHS money. Yet I suspect that under your scheme, I'd pay a higher premium.
Do I take it that your scheme would, like tax, only apply to wage earners?
I'd take you up on the abortion point, except that I don't know nearly enough about your view on the matter. Do you feel like dedicating a blog post to it sometime?
I was hoping that the health benefits of an active lifestyle would have a compensatory effect by reducing the insurance. But as you point out, people are fallible and people's lives are too long to make a study of the risks sufficiently accurate.
In the case of builders, I think the effect would be to increase the price of hiring a builder. Except then you'd get some Somalis who would willingly do the work for less but without insurance, and you'd end up exploiting their health. Hmmmm.... I see why this isn't going to work.
I used to cycle a fair bit - I think my peak was 14½ miles per day; I suspect you do more than that. A decent cyclist is at much less risk than an incompetent one, but if the insurance system was insufficiently nuanced, I can see that being a big problem.
14.5 miles a day? Impressive. Since I currently live next to campus, and my job is on campus, I don't have any 'regular' cycling. My average is currently probably around the same, but only because I've got a couple of silly long rides coming along to boost it. Then it'll go down in term time :(
I don't think I've cycled in a year or so though - I kind of gave up when my last bike tried to kill me then got nicked.
And yes, I know that the chain suddenly jamming so that I manage to catapult myself over the handlebars on a main road is possibly due to a low quality of bike and bad maintenance...
The 14½ miles a day was on an old clapped out thing too. I put on a couple of stone when I stopped doing that ride to work...
I think lifestyle factors would definitely have to exclude occupation. Arguably, one chooses one's occupation, but it's not quite the same as whether one chooses to smoke or go sky diving.
The only reason I'm mentioning this is that I've been wondering lately whether anyone's ever done any long term studies on the health of people who work in labs doing medical research and are thus more likely to be exposed to carcinogens/toxic nasties etc. Perhaps we'd all rather not know!
Presumably that would depend in part how willing they were to make themselves guinea pigs for their own experiments...
I'd have thought that those people getting regular excercise, like cyclists and maybe builders are going to be not only fitter, but more productive in their work. I used to ride my bike a lot, now that I don't my stomach has grown, my sleep sucks, any clarity of thought that I used to have has turned to mud and I can't keep focused on the job in hand as well as I used to.
I now pollute more with my car (tyres, noxious fumes, polishes etc), I also heat my home more because i'm not outside as much and my metabolic rate has dropped.
So, the lazy and maybe the unfit should pay the premium, cause those who are fitter and healthier might be polluting less and require less health care when they do get ill, fall off or get run down by a truck while on their bike. ;)
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