Mumsnet Talk

I should start by saying that yes, I think it is brilliant to have free at the point of use health service and that the medical staff I have been in contact with have always been of a very high standard. This is in no way an NHS bashing thread!

I read the following news report this morning

www.reuters.com/article/2013/03/05/us-global-britain-idUSBRE92400J20130305

and it got me wondering, if we didn't have the NHS and had to 'pay as you go' for treatment, would we take more responsibility for having a healthier lifestyle?

God no, the US certainly doesn't!

No. What a ridiculous idea. Should we charge people for getting childhood leukaemia, multiple sclerosis or rheumatoid arthritis? No amount of 'taking responsibility for having a healthy lifestyle' is going to prevent people developing these kind of conditions.

I see what you're saying- that the fact that it's free at the point of use means that people don't take responsibility for their own health. The big money problems we have- lung cancer, copd, diabetes etc. are largely self inflicted.
I don't know if introducing charges would change that though.

Probably not for a lot of people. People don't think health related problems will happen to them. There's proven links between smoking and lung disease, drinking and liver problems but it doesn't stop people doing them - its not going to happen to them!

NO NHS in the US doesn't seem to make any difference to the health choices of the fattest nation on earth but, the NHS by international standards is poor and getting worse.

No NHS does NOT mean US healthcare. Look east, not west.

Smoking increases chances of getting cancer. Death doesn't deter smokers so why do you think that having to pay for possible cancer treatment will?

I think obesity rates in the USA indicate that having to pay for your lifestyle choices doesn't necessarily make people make healthier choices.

It wouldn't make a difference I think - and you'd end up having to charge people for things that can't be prevented by a healthy lifestyle (e.g. congenital illness, accidents etc) which just seems wrong really.

I think the only difference would be a reluctance to seek help for issues until they become a matter or life/death. I'd worry that rates of illness and disease would end up soaring especially amongst those on lower wages/state benefits as they wouldn't be able to afford insurance or decent medical treatment.

I also don't think people consciously decide to live an unhealthy lifestyle thinking "Oh it doesn't matter if I end up severely obese, good old NHS will help" - I think people end up living such lifestyles as a result of their life circumstances/choices and it's lucky the NHS are there to help. I think they'd make the same choices whether the NHS were there or not; the only difference is that without the NHS things are more likely to have drastic consequences. E.g with an obese person, the GP can monitor weight and prescribe lifestyle advice/dietary advice before the person becomes too big; yet without the NHS we might see people not seeking any help (or being offered any help) until they're wheeled into A&E with a stroke or heart attack.

Good healthcare should never be a luxury reserved for those with the means to pay for it, just as with education etc. The benefits of free at the point of use service are huge, it would be awful to lose them to a service where users have to pay at the point of use.

I'm probably not making much sense but I know what I'm trying to say!

Be glad of the NHS.I lived out of the UK for years, then you realise how great it is.When you pay to see a GP and then for your meds-which a priced not a one fee like we have here.I paid over £100 to get the implanton fittted. Then the same to get it out.
I worked in the US at one point and had excellent insurance which meant I had great care, not at all the case for everyone.Esp in min wage jobs or the elderly.
But that said the fact that it's all free does seem to lead to abuse of it too.Esp calling an ambulance etc.-Any one read that ambulance drivers blog?

I can see what you are saying, however look at obesity in America you could say that huge swathes of the American population do not take responsibility for their health, and they pay through the nose for healthcare.

Not all of the 'big money problems' are 'lifestyle diseases' though. There are c. 10 million people with arthritis in the UK (not all of them are 'old' either; the average age of onset for many inflammatory arthritises is much younger than most people would imagine). It costs a lot to treat this over a patient's lifetime.

Diabetes costs the NHS a lot (and it is not always a 'lifestyle disease') but the majority of that cost (about 75%) is in managing the complications of diabetes not treating the immediate problem. If the disease itself were better managed (and diagnosed quicker), presumably the cost of treating the complications would also reduce.

I don't think it would make people more responsible for their health. For some it would do the exact opposite. I stayed with friends over in the US a couple of years back. One of their friends was saying that she'd been having really bad headaches over a period of weeks after hitting her head but had never even had it checked out as she was afraid of the cost. She was in a fairly low paid job and had no health insurance.
We surely don't want that for this country.

To answer the question in the thread title: yes.

And the one in the OP: no.

HTH