Here is an excerpt from a speech ACC Minister Maryan Street delivered on Saturday.
I believe there is a legitimate place for the use of law as a lever for achieving better health outcomes, but there also have to be boundaries - and the truth is that we usually decide where those boundaries lie on a case-by-case basis.
And when I say “we” I mean the Government. I believe Parliament is the most appropriate place for these types of decisions to be made. With all due respect to the lawyers, officials and academics in the room, who may well make more rational or scientific decisions than we politicians, it is appropriate that politicians, who are ultimately accountable to the people, decide the extent to which the state will limit individual decision-making.
I should also say that I do not believe these types of decisions can be appropriately made by “the market”. For example, the makers of “fast food”, tobacco or alcohol will say that people should have the right to buy their products wherever and whenever they choose. Sometimes the freedom to do so is escalated into “the democratic freedoms for which wars were fought”.
The problem is that right now we are seeing whole communities suffering unacceptable levels of obesity, diabetes, lung cancer and other preventable diseases. They were given the freedom to choose but not the information to make an informed choice. So I believe Government has a vital role in ensuring people have the information they need to make informed choices. How should this reality be balanced against the individual freedom argument?
The “individual freedom” argument does not address the issue of collective consequences. When a young person chooses to drink and drive and consequently injures or kills someone else, who pays? When someone chooses to smoke and develops lung cancer, who pays? The answer is invariably the rest of us. And I’m not just talking about the financial cost to organisations like my own ACC or the public health system but also the impact on the families, communities and employers of the people involved. So for generations now, governments have made decisions to use the law to limit individual freedoms and thus reduce the collective consequences.
I take issue with that last sentence. The law has indeed been used to limit individual freedoms but that hasn't reduced collective consequences. Collective consequences increase under collectivism. That is because there is no incentive to avoid risky behaviour when someone else will pay. For instance why do we have over 130,000 people on sickness and invalid benefits when just thirty years ago there were only around 18,000? And it isn't to do with the size of the population. It is partly to do an expectation that the state will support people regardless of the reason for their incapacity. It wasn't always that way and in the past people had to exercise a good deal more personal responsibility in their actions.
The other statement Street makes here is something of a worry;
With all due respect to the lawyers, officials and academics in the room, who may well make more rational or scientific decisions than we politicians, it is appropriate that politicians, who are ultimately accountable to the people, decide the extent to which the state will limit individual decision-making.
This is a worrying admission. According to Ms Street MPs do not make the most rational or scientific decisions. Nevertheless they are still the best people to do so because we voted for them. I didn't vote for you Maryan. And I am sure that you do not feel any need to be accountable to me. Ultimately you will be accountable to your own conscience and ideas. Not a prospect I relish.
Subscribe to:
Post Comments (Atom)
5 comments:
It's a bit ironic that a Labour Minister is advocating user pays in health.. as in full pay if the drunks etc are booted out of the health system. Why, even the unhealthy might get the boot!
But lets take another tack.. there are tens of thousands of men and women out there who have smoked and drank unwisely and it will cost them and us in the long term, but for 30-40 years they earned the average wage, paid their taxes, raised hundreds of thousands of kids who are now tax payers. The kids are younger, better informed about health and no bother to the health system.. but being tax payers, they expect the health system to pay for their parents.
And then there's the hundreds of thousands who have private health insurance (35% and growing?), who likewise have been little bother to the health system but now cannot afford the premiums in their old age, many of them have been unwise with their health but they've been double taxed all their working lives over their health costs.
Then there's that group of rough men and women who were hell raisers in their day, but they created the deer industry, carried out the dangerous jobs of farming, forestry and logging, the work of soldiering, of flying on the fertiliser, work in the oil industry etc. These are our modern day pioneers who created the wealth we experience today.. do we ignore them too?
Finally, there are the people who did the dirty jobs of society, the policemen, garbage collection, did things with sewerage, dug drains, laid pipes, worked in the freezing works etc.
There are lots of drinkers and smokers and over eaters and gamblers here, and they paid for their addictions and pleasures with punitive taxes that the Govt collected against the day these people came and presented their health bills. And it's from this same group of people that we draw our hundreds of thousands of volunteers that work for the charities and who are the first to put their hands in their pockets to make a donation.
So Ms Street can start the sly process of herding these people out of the public health system with her oh so virtuous words but it's pure bullshit. We owe these people for their decades of service and that's that.
JC
About 20% of taxes collected are spent on health. I'm more than happy to withdraw utterly from the public health system in exchange for getting a 20% tax rebate. I'd top up my private health insurance and have a fair bit left over. I'd also then like to be exempt from all government moralizing about consumption habits.
Of course the non smokers use the health system to - maybe ultimately costing more than the smoker who dies at 65 of lung cancer. Instead they may require 10 years intensive treatment for Alzheimer's disease.
The only thing that is certain is that we all ultimately contract a fatal disease and that for most a significant part of the health budget consumed comes in the last four or so years of life - whenever that may be.
It is also highly selective to withhold treatment from those who you perceive contracted their illness through behavior you disapprove.
Fine it is a smokers fault they got lung cancer, a drinkers fault they got cirrhosis of the liver.
But can you conceive Ms Street saying the same of those who contract AIDS?
Lindsay - a politician saying that she knows best for us. What is new?
Brian Smaller
Post a Comment