Should smokers/obese people be refused the medical card?

genericguy

Hi all,

With the number of cuts that have been made to the health service due to the current situation (i will not use the 'r' word), I'm just wondering if anyone else agrees that we should deny access to free health care to smokers and the obese?

Obesity-related conditions supposedly cost the health service in the region of 400m each year, whereas smoking-related illnesses cost over 1bn at this stage. Due to the fact that these are preventable expenses, I think those affected should foot the bill themselves, leaving some extra money to shore up the many gaps in our health service for those who don't bring their problems on themselves.

References: (they're a couple of years old but the only ones I have handy)
www.business2000.ie/images/pdfs/pdf_9th/dept_of_health_9th_ed.pdf

http://www.dohc.ie/press/releases/2005/20050516.html

DublinWriter

genericguy wrote: »

With the number of cuts that have been made to the health service due to the current situation (i will not use the 'r' word), I'm just wondering if anyone else agrees that we should deny access to free health care to smokers and the obese?

Feck it, let's go the whole hog and deny it to the elderly and the physically disabled too. Ein Reich, Ein Volk, Ein Taoiseach, etc.

Belfast

We should get rid of medical cards for everyone.
Not just smokers and the obese.

Belfast

DublinWriter wrote: »

Feck it, let's go the whole hog and deny it to the elderly and the physically disabled too. Ein Reich, Ein Volk, Ein Taoiseach, etc.

The Nazis were in favour of the state paying for health care.

Ein Reich,
Ein Volk,
Ein HSE,

MikeC101

genericguy wrote: »

Hi all,

With the number of cuts that have been made to the health service due to the current situation (i will not use the 'r' word), I'm just wondering if anyone else agrees that we should deny access to free health care to smokers and the obese?

Obesity-related conditions supposedly cost the health service in the region of 400m each year, whereas smoking-related illnesses cost over 1bn at this stage. Due to the fact that these are preventable expenses, I think those affected should foot the bill themselves, leaving some extra money to shore up the many gaps in our health service for those who don't bring their problems on themselves.

References: (they're a couple of years old but the only ones I have handy)
www.business2000.ie/images/pdfs/pdf_9th/dept_of_health_9th_ed.pdf

http://www.dohc.ie/press/releases/2005/20050516.html

Smokers would probably be of the opinion that the amount of tax paid by them via cigarettes would more than make up for their cost to the health service. They might be right about that too?

I do remember doing a dissertation on a Philip Morris licensed study that claimed tobacco actually saved money for governments, because smokers died earlier and thus didn't cost as much in terms of pensions etc...

Plus what if a smoker / obese person is suffering from something unrelated to smoking / obesity? Would you treat them for that?

DublinWriter

MikeC101 wrote: »

Smokers would probably be of the opinion that the amount of tax paid by them via cigarettes would more than make up for their cost to the health service. They might be right about that too?

I do remember doing a dissertation on a Philip Morris licensed study that claimed tobacco actually saved money for governments, because smokers died earlier and thus didn't cost as much in terms of pensions etc...

I keep banging on about this fact....prior to the smoking ban Marianne Finucane had a leading Irish actuary on her programme and he stated that smokers do indeed contribute more to society by paying excise duties and dying younger from short term terminal illnesses.

What next? Death to those who don't have excellent .Net and bow hunting skills? Here's a picture of a Liger I drew earlier...sheesh.

DublinWriter

Belfast wrote: »

The Nazis were in favour of the state paying for health care.

...and if your name was Goldstein, that would be terminal health-care?

Hagar

Great idea, as long as we accept it would be unjust to tax/levy PRSI charges on them.

dresden8

And fit people who have sporting injuries should be denied free health-care too, as their lifestyle choice caused those injuries.

Healthy people should be denied health care in their old age as it was their choice to live longer.

And children. If people can't afford to pay for them they shouldn't have them.

We could be onto a winner here.

MikeC101

DublinWriter wrote: »

I keep banging on about this fact....prior to the smoking ban Marianne Finucane had a leading Irish actuary on her programme and he stated that smokers do indeed contribute more to society by paying excise duties and dying younger from short term terminal illnesses.

Yup, if viewed from a strictly financial aspect that seems to be the case (though in some studies it got a little hazey due to factoring in lost productivity due to smokers being absent from work more).

A Dutch study work out that health care costs for smokers were about $326,000 from age 20 on, while for thin, healthy people it came to about $417,000, because they live so much longer.

It's a controversial subject, because a lot of people are uncomfortable with considering the early death of citizens as an economic "benefit", but if looked at from a purely financial point of view it seems to be what the facts point to - smokers are actually subsidising non-smokers in a way.

dresden8

It's not so long ago that Mary Hanafin said that unfortunately people are living longer.

Hagar

MikeC101 wrote: »

A Dutch study work out that health care costs for smokers were about $326,000 from age 20 on, while for thin, healthy people it came to about $417,000, because they live so much longer.

But don't smokers contribute vast amounts to the exchequer through direct taxation of their habit? If those figures above are correct the govt should be giving out free ciggies in the schoolyards.

GhostInTheRuins

Hagar wrote: »

But don't smokers contribute vast amounts to the exchequer through direct taxation of their habit? If those figures above are correct the govt should be giving out free ciggies in the schoolyards.

I think the Chinese might be on to something.

MikeC101

Hagar wrote: »

But don't smokers contribute vast amounts to the exchequer through direct taxation of their habit? If those figures above are correct the govt should be giving out free ciggies in the schoolyards.

Yeah, exactly, in fact it seems like a much bigger difference than I would have expected. Though the government could never be seen to encourage their citizens to smoke on the basis that they'll die off earlier and cost less.

I'll try to dig up some sources for those numbers.

I believe this is the Dutch study those figures come from

Basic summary - obese people cost less in healthcare terms than healthy people, but more than smokers.

An article that was in the Financial Post about the Philip Morris study

Makes for interesting reading doesn't it? When taking into account the extra taxes paid to the exchequer it really appears like smokers are subsidising non smokers...

genericguy

MikeC101 wrote: »

Smokers would probably be of the opinion that the amount of tax paid by them via cigarettes would more than make up for their cost to the health service. They might be right about that too?

I do remember doing a dissertation on a Philip Morris licensed study that claimed tobacco actually saved money for governments, because smokers died earlier and thus didn't cost as much in terms of pensions etc...

Plus what if a smoker / obese person is suffering from something unrelated to smoking / obesity? Would you treat them for that?

they pay the tax because they choose to smoke. why should anyone else have to pay tax contributing to their healthcare? and maybe the fact that they may suffer from unrelated conditions and can't get free treatment might serve as a reminder of the opportunity cost of smoking in the first place?

MikeC101

genericguy wrote: »

they pay the tax because they choose to smoke. why should anyone else have to pay tax contributing to their healthcare? and maybe the fact that they may suffer from unrelated conditions and can't get free treatment might serve as a reminder of the opportunity cost of smoking in the first place?

You seem to be missing the point a little here - they pay a huge amount of extra tax on cigarettes, that would more than cover their cost of healthcare due to smoking reason. Factor in the fact that they die younger and it turns out smokers cost LESS than non smokers to the exchequer.

If you're going to come at it from a cost perspective you can't just ignore all the evidence showing that healthy people cost more in the long run.

cavedave

Having a negative view of old age takes nearly as much off your lifespan as smoking does (here). So saying things that make old age seem bad should be taxed at a high rate?

Belfast

DublinWriter wrote: »

...and if your name was Goldstein, that would be terminal health-care?

I did not say Nazis were good.

They did a lot of socialist stuff.

I think government paid for heath care is a bad idea.

tfitzgerald

i cant understand the coldness of some people its attitudes like that . that causes a lot of problems these days op attitude

Belfast

tfitzgerald wrote: »

i cant understand the coldness of some people its attitudes like that . that causes a lot of problems these days

What attitude or idea are you referring to?

I did not know who or what you you are responding to.

tfitzgerald

Belfast wrote: »

What attitude or idea are you referring to?

I did not know who or what you you are responding to.

sorry i was referring to the op and i dont smoke and i am not obese but these people should not be made suffer just because they are fat no one wants to grow up to be fat so he should give them a break i hope he never needs a bit of sympathy

dresden8

People who get run over by cars should be left to die in the gutter because they shouldn't have walked in front of cars.

Lifestyle choice.

Belfast

tfitzgerald wrote: »

sorry i was referring to the op and i dont smoke and i am not obese but these people should not be made suffer just because they are fat no one wants to grow up to be fat so he should give them a break i hope he never needs a bit of sympathy

I can understand that.

Making moral judgements about who should get health care biased their lifestyle is not just cold but is also unjust.

I broke by leg in Wales in the 1988 sky diving.
Marsden hospital treated me with contempt because it was a sports injury.
They made moral judgements about patients by dividing them into those who were sick and it was not their fault and those who were a waste of NHS resources.
There was 2 guy in the hospital for 6 week after a motor cycle accident and they were very hostile to them and called them a waste of NHS resources.

They did not like me as I had a sports injury(waste of NHS resources) and being an Irish resident they could not charge me for the stay there as they did with other foreigners.

dresden8

Belfast wrote: »

I can understand that.

Making moral judgements about who should get health care biased their lifestyle is not just cold but is also unjust.

I broke by leg in Wales in the 1988 sky diving.
Marsden hospital treated me with contempt because it was a sports injury.
They made moral judgements about patients by dividing them into those who were sick and it was not their fault and those who were a waste of NHS resources.
There was 2 guy in the hospital for 6 week after a motor cycle accident and they were very hostile to them and called them a waste of NHS resources.

They did not like me as I had a sports injury(waste of NHS resources) and being an Irish resident they could not charge me for the stay there as they did with other foreigners.

Good enough for you. (If I was a right winger)

And cyclists who get run over by trucks should be left as a stain on the road as a warning to others not to make lifestyle choices.

mikemac

dresden8 wrote: »

0

And cyclists who get run over by trucks should be left as a stain on the road as a warning to others not to make lifestyle choices.

Strong words. And if it's the trucks fault?

Sure why don't we all drive SUV's and if you don't then it's your fault if you die in an accident....

cavedave

mikemac

Sure why don't we all drive SUV's and if you don't then it's your fault if you die in an accident....

SUV's nearly double your chances of killing someone. Evidence here and here.

Statistically 17-24 year olds are 7.7 times more likely to be involved in a fatal or serious injury collision

At half the legal limit, drivers are twice as likely to have a collision and at the legal limit drivers are six times more likely to have a collision.

So being young seems to be as dangerous as drink driving. Surely statistically it should be illegal also?

dresden8

mikemac wrote: »

Strong words. And if it's the trucks fault?

Sure why don't we all drive SUV's and if you don't then it's your fault if you die in an accident....

The trucker made a lifestyle choice to avoid death in accidents. A proper free-marketeer.

SUV's are inherently dangerous. Very unstable in high winds and in turns at high speeds. Jaysus, if you're in one of those don't expect the ambulance to stop. Proper order. Scum, expecting me to pay their medical expenses.

dresden8

cavedave wrote: »

So being young seems to be as dangerous as drink driving. Surely statistically it should be illegal also?

So, young people should be denied medical care.

How many billions have we saved so far?

c-note

I'LL give up any rights i may have to a medical card as a smoker, if the revenue give up vat and excise on cigarettes,

i'm guessing at least 80% of the price of a pack goes to Brian L.
thats about €6.50 a day for a 20 a day smoker

over a smoking lifetime of say 50 years thats about €120,000 to the rev for the privilage of smoking.

if that (along with all the other taxes non smokers pay) dosnt buy me a few free trips to the gp in my "dying dirty smoker" days then i dont know what.

also if i die in a plane crash look at all the rev have profited?

as for the obese...
we could put a similar tax and excise on hydrogenated fats.
put the price of a mars bar up to €6 and the price of a big mac up to €35.
also calculate a persons paye income tax rate based on their salary and the BMI. and give tax deductions for gym memberships?

to be fair i see the point of the arguement. but i think it would be better to outlaw cigarettes.

cavedave

dresden8

So, young people should be denied medical care.

How many billions have we saved so far?

All joking apart if drink driving is illegal at the point where you become 6 times more likely to crash then average then surely any activity that makes you this much more likely to crash should also be illegal? If so this seems to include driving while young, driving an SUV at half the legal limit and other such statistical murders.

colly10

genericguy wrote: »

Hi all,

With the number of cuts that have been made to the health service due to the current situation (i will not use the 'r' word), I'm just wondering if anyone else agrees that we should deny access to free health care to smokers and the obese?

Obesity-related conditions supposedly cost the health service in the region of 400m each year, whereas smoking-related illnesses cost over 1bn at this stage. Due to the fact that these are preventable expenses, I think those affected should foot the bill themselves, leaving some extra money to shore up the many gaps in our health service for those who don't bring their problems on themselves.

References: (they're a couple of years old but the only ones I have handy)
www.business2000.ie/images/pdfs/pdf_9th/dept_of_health_9th_ed.pdf

http://www.dohc.ie/press/releases/2005/20050516.html

No, smokers probably pay for their own health care many many times over, at a guess id say theres about 6 euro tax on a 20 box so someone smoking 20 a day will pay a substantial amount of tax over 30/40 years as a smoker

Also smokers don't be in bits all the time like some would have you believe. I smoked for 10 years, I got off them last year and starting training 4-5 days a week, I got sick less as a smoker. I used to take the piss out of muppets who went on about my health by pointing out they got sick far more than me.

Bottom line, they pay enough in tax, it's their body, leave them to it, I would hate to see the state interfere in peoples lives like that, it's none of their business is someone likes cake a bit too much either

Would you bring in this for people who have too many pints at the weekend too, or maybe people who don't excersise enough or have too much salt in their diet

c-note wrote: »

I'LL give up any rights i may have to a medical card as a smoker, if the revenue give up vat and excise on cigarettes

+1 on this, im now a non smoker but still find the self righteous bull**** from some non-smokers such as the op irritates the hell out of me, take the tax off them and then ye can take back the medical card

thebman

I think there should be extra tax put on food with a disproprionate amount of fat content similar to how cigs have extra tax placed on them although not to the same level as you need a certain amount of fat and some kinds of fat aren't bad for you and should have probably be excluded. Leave that one to the doctors.

Fast food outlets especially should have extra tax on their products to encourage healthier menus IMO and more prominent display of percentage of calories each meal contains for your recommended daily intake should be displayed on the signs of meals when ordering.

That is just my opinion though.

Macha

colly10 wrote: »

No, smokers probably pay for their own health care many many times over, at a guess id say theres about 6 euro tax on a 20 box so someone smoking 20 a day will pay a substantial amount of tax over 30/40 years as a smoker

I'd say they don't. Cigarettes/boxes etc make up a very large proportion of street rubbish so we're not just looking at medical costs but also waste costs.

colly10 wrote: »

Also smokers don't be in bits all the time like some would have you believe. I smoked for 10 years, I got off them last year and starting training 4-5 days a week, I got sick less as a smoker. I used to take the piss out of muppets who went on about my health by pointing out they got sick far more than me.

Sorry but I'll accept official scientific stats over your anecdotal evidence any day. You seem to be trying to insinuate that cigarettes don't make people sick.

colly10 wrote: »

Bottom line, they pay enough in tax,

You have yet to prove that.

colly10 wrote: »

it's their body, leave them to it,

Do you also want us to leave them to it when they're dying of lung cancer or other related illnesses?

colly10 wrote: »

I would hate to see the state interfere in peoples lives like that, it's none of their business is someone likes cake a bit too much either

As long as smokers pay for themselves and do not overly impact on other people, fine. At the moment, it is not clear whether they externalise certain costs to the rest of society or not.

colly10 wrote: »

Would you bring in this for people who have too many pints at the weekend too, or maybe people who don't excersise enough or have too much salt in their diet

It's certainly something to be considered. Whatever about the concept of a social welfare state to support people who fall on difficult times (financially, medically, etc), I'm not in favour of giving hand-outs to people who intentionally damage their own health and then hold their hand out for free medical care.

colly10 wrote: »

+1 on this, im now a non smoker but still find the self righteous bull**** from some non-smokers such as the op irritates the hell out of me, take the tax off them and then ye can take back the medical card

I'm an ex-smoker too but I don't really see what your problem is with someone not wanting to carry the can for other people. What I find more irritating is the sense of entitlement of some people (including some smokers) that they can carry on as they like (don't dare tell them what to do) with everyone picking up the pieces, literally, behind them.

saol alainn

I disagree. First it's the smokers and obese, then alcoholics (whether weekend ones or otherwise), then those who don't exercise, then the elderly, then those who have multiple conditions because they cost too much, then whoever's next on the list. And then when it's our turn, we'll say "but..but...!" As in everything, once you're on that road, it's rolling downhill all the way. Healthcare isn't free anyway because patients pay their taxes and PRSI to access the service. There's the risk that we're being prepared to take the blame for something which we had no hand in. Even during the good times, while consultants were being paid how much exactly?, their patients had to wait several months to be seen, if not misdiagnosed, and people were on trolleys in the corridors.

greendom

Not really an issue as they'll be dead by the time they receive one

halkar

Remove the taxes and vat on cigs, remove health leavy for smorkers, special prsi reduction, extra allowance from tax and as a smoker I be happy enough to give up medical card and use private insurance. I may even have some change in my pockets.

Question is, how will Mary keep the hospitals open

eamonnm79

Well its a fairly simple choice.
Do you want to live in a civilised compasionite society or do you want to live in the freemarket of unfettered capitalism.

Or do you want to keep the status quo of State Capitalism?

mikemac

thebman wrote: »

Fast food outlets especially should have extra tax on their products to encourage healthier menus IMO

It was widely reported that a McDonalds salad has more calories then a big mac.
So onto your next point

thebman wrote: »

more prominent display of percentage of calories each meal contains for your recommended daily intake should be displayed on the signs of meals when ordering.

Agreed, I do know Subway have booklets you can take with you

Macha

mikemac wrote: »

It was widely reported that a McDonalds salad has more calories then a big mac.
So onto your next point

So obviously they aren't healthier meals. Thebman's point was that they should provide healthier meals. The fact that the meals they have marketed as healthier at the moment aren't healthier, doesn't invalidate the concept.

taram

Techincally obese people would be buying more luxury goods at the higher rate of tax (biscuits, chips, chocolate etc) so are contributing more tax than those who eat a fresh food diet? :P

thebman

taram wrote: »

Techincally obese people would be buying more luxury goods at the higher rate of tax (biscuits, chips, chocolate etc) so are contributing more tax than those who eat a fresh food diet? :P

Yes but the point of raising taxes on these foods would be to act as a disincentive to rely on these food groups to make up your meals in the day.

Not saying they should be at an unaffordable level or anything as I eat unhealthily more often than I probably should myself (although I'm far from obese). I don't think there is anything wrong with enjoying this food but not being solely reliant on it for your diet.

It isn't about paying your way, it is about encouraging healthy lifestyles and taxing unhealthy choices but giving the people the freedom to choose them if they still want to but at a higher price in the hope they will do so less often. I think it is also important we encourage the companies to come up with healthier tasty snacks rather than relying on salt, sugar and fat to make up the flavor.

CAPSLOCK365

I'd be in favour of denying medical cards to people who hold chronically stupid opinions on who should or should not hold a medical card.
And then taxing the living the shi*e out of them.

tattoodublin

CAPSLOCK365 wrote: »

I'd be in favour of denying medical cards to people who hold chronically stupid opinions on who should or should not hold a medical card.
And then taxing the living the shi*e out of them.

Hahahaha VERY GOOD! I agree completely.

"lets just tax the ****e out of ourselves and throw ALL our freedoms to the wind..... for our own good" huh? huh? huh?

People need to get a grip that they are being played like a deck of well worn cards.

You know? There is a fabled land, where people have free medical and free education for all, where the leader doesn't have a personal bank account ( or even a personal wardrobe, let alone make-up artists and speechwriters and such payed with public tax money... nothing but actors reciting lines ) and despite criticisms of that country and its economy, which never seem to take into account the 50 years of embargos they have endured... and they are still providing free education and health care to their people, even if they DO smoke big Havana cigars

Good on you Fidel!