To think we shouldn't be funding this on the NHS?

Free at the point of need. The end.

Smokers are net contributors as a group in any case. They die early and pay a fortune in tax. Yes YABU

So?

OP,

I am curious on your views on IVF for people 35+?

That is pretty expensive and, arguably, self inflicted?

Ultimately, I would far rather economise on IVF, gender surgery and cosmetic surgery than treating people who are seriously ill, regardless of how it came about.

My husband recently went on a litter pick at our local hospital - most of it was cigarette butts

You do realise that smokers have more than payed for their care with the 90% tax they pay on each pack of cigarettes, whereas the obese patients with heart disease, diabetes and all the other issues caused by obesity haven't so should we stop treating them aswell?
If you want to denigh people treatment for 1 type of self inflicted diseases then you need to do it for all.
Or if you really want to save the NHS money you could ditch all gender ideology, so training, flags, walkways etc and then theres the all the unnecessary cosmetic surgery and repairs/corrections for botched surgery abroad, add the salaries of the managers and the ott pension contributions way above and beyond any other public or private sector plus the cost of the PPI taken out under Blair, if you end all of the above you could have a well funded NHS that was fit for purpose.

Well, insurance companies, lawyers and privste hospitlas would make a fortune if we decided not to treat self inflected medicls problems. I'm sure years long legal battle when NHS decided not to treat someone and when court and experts decide that it was in fantastic not self inflicted won't cost a penny.

I had a skin cancer removed when I was 10. My parents did use sun cream but how do you prove that? Should I have been left untreated?

That’s a very black and white way of looking at things. YABU. Perhaps recognising your privilege would be a good start for you OP.

As PPs have pointed out, the taxes brought in from smoking are far higher than what it costs to treat those with smoking related diseases. And those people are likely to die far younger than those who don’t smoke, generally speaking. So they’re really not using as much of the NHS budget as you might think.

I’m not being deliberately obtuse but from my experience the nurses were indeed taking the patients outside to smoke. I don’t judge them for this. But this was absolutely happening.

By the time you exclude:

Smoking
Drinking
Drugs
Obesity
Living in polluted areas
Dangerous activities
Dangerous driving (bad weather/ice/fog)
Pregnancy with underlying conditions
Insufficient exercise/bad posture
Insufficient use of sunscreen
Pregnancy past a certain age

I suspect your department for administering who is qualified for free healthcare would be as big if not bigger than the clinical staff.

On the plus side, you'd be spending very little on the actual healthcare side. The rich wouldn't care, as they'd get private health insurance, so it's only those who can't afford it who would be screwed.

You could also go all the way, and refuse to pay for any costs associated with genetic conditions which could have been detected in pg.

But is that the world we want to live in? Where do you draw the line?

👏

YABU. Healthcare is a human right. Everyone is entitled to it even if they are ill or injured as a result of choices they have made. Otherwise there’s an equally sinister argument for saying we shouldn’t fund care for people who eat processed food, or are overweight, or ride motorbikes, or drive cars, or don’t wear their bike helmets.

People who smoke need support and resources to assist them in quitting. They don’t deserve to be left to die because you’ve made an arbitrary moral distinction regarding which people are worthy of healthcare.

When the NHS no longer exists as free at the point of delivery which will happen one day though everyone on this forum may be dead by then. It will be replaced with maybe a mixture of free care and insurance and what will happen is like any other insurance your payments will be based on your risk.

The unpalatable truth is people live too long with conditions that not that many years ago would have killed them and people don’t look after themselves. I’m not agreeing with the op but it’s why the NHS is on its knees as well as the fact it’s run so badly. My brother died of type 2 diabetes complications. We all know our family history. He made no effort, he ended up on dialysis 3 times a week for a number of years. He was ultimately really selfish making no effort.

The affection for the NHS which is sometimes misplaced and the lack of personal responsibility will kill it off whether we agree with the op or not.

There’s genetics and second hand smoke that cause illness. It’s not always from first hand smoke. I’d put a huge tax on tobacco and vapes to pay for smokers treatments.

But THEY are funding more towards the healthcare of others as a result of that choice. That’s the point.

How do you draw the line?

5 cigarettes/vapes a day? Patient pays whole cost of any illness treatment including broken leg?
20 cigarettes/vapes a day?
BMI of 30+ patient pays whole cost of any treatment including cut to head that needs stitches?
BMI of 40+ ?
Anyone with drugs or alcohol that shows up in blood tests pays for all their treatment?
People who are injured playing football/rugby/cycling/running pay the bills for their sporting injuries to be treated?
Diabetics who do not manage their glucose levels by drinking lots of alcohol, not managing their eating and suffer other conditions because of that?
Trans surgeries?

We all make choices that affect us - where are you going to draw the lines?

Who is to say whether a high cholesterol level is caused by amounts of fat eaten on someone who happens to be pre-disposed to high cholesterol (as many people who eat healthily are)?

Are committees going to go through every case and decide? Individual Drs?

I understand you Op, but where does it end?

I think we need a radical overhaul of the health system in this country.

I think means tested health insurance would work. You already see health insurers giving better rates to those that wear smart watches, so it’s starting… if you smoke, you pay more. You eat too much? Pay more. Drink too much? Pay more. Take part in extreme sports? Pay more!

I say this as someone who does sports that do cause injury and I probably drink too much… incentivise people to get well and if you don’t take responsibility then you pay more. It’ll never happen, but the current system is broken. The people who use it the most and probably get hundreds of thousands a year aren’t the people paying into it.

I know three people who died of lung cancer who never smoked. My mother had COPD. She never smoked.

How may cigarettes would someone have to smoke in their lifetime to become unworthy of treatment?

You don't have a clue about health inequalities you really don't.

Agreed that people smoke illegally on hospital grounds , but they won’t be nurses and the nurses won’t be pushing them there because it would , in this day and age , be a disciplinary issue .

Stop helping people with mental health issues. They should just get over it and pull
themselves together.🤔

I agree. Trouble is that "risk" is too complex for lots of people to understand. Because "some" people get lung cancer having never smoked, they justify the exceptions as being reasons for carrying on doing unhealthy/risky things themselves. The old "My great Aunt Edna smoked all her life and lived to 100" story. They don't understand that lifestyle choices increases/reduces the risk of things happening - they don't understand the very nature of risk and probability which is the there will always still be exceptions but that doesn't negate the basic premise.

Trouble is with the NHS that people are given the green light to make unhealthy choices in the knowledge that the NHS will be there to bail them out, so it actually encourages poor behaviour and poor decision making.

More bullshit. Try thinking more critically about the hypocrisy of governments who lecture people about the dangers of smoking, drinking, eating unhealthily and yet still allow the offending products to be sold because they want the tax revenue. And your comments about MH are ignorant and offensive.

Oh agreed. Also anyone over a BMI of 25. Anyone who does any kind of risky sport - including rugby, football, skateboarding, climbing etc.
Also anyone who has a baby over the age of 35. Anyone who drinks alcohol. Anyone who takes drugs - or who has ever taken drugs.
Anyone who doesn’t eat mainly a plant based diet.
all those fuckers are unnecessarily risking their health. In fact. The NHS should really only be for the well.

Sounds like the OP would like an insurance based system where you have exclusions for various things. You know. Like they have in the US.

I wonder how many more of these posts we'll see popping up suggesting that we're all being somehow fleeced by paying into the NHS and really wouldn't it be super if we had an insurance system which excludes the undesirables.