Discriminatory Healthcare on Fat or Smoking Guys
A few years ago, the National Health Service (NHS) first considered refusing to treat obese people for lifestyle-related illnesses. In the same vein, the National Institute for Health and Clinical Excellence (NICE), the NHS's guidance body, produced advice that raised the prospect of heavy smokers and obese people being refused healthcare. But that will never happen, many said.
The first problem with this discriminatory policy is that preventing morbid obesity and smoking can save lives but it does not save money. For a very long time, economists have known that smoking and smokers are good for the public treasury, if not for public health. Recently, economic research has shown that the morbidly obese are also net contributors to the Exchequer. It costs more to care for healthy people who live years longer than obese people and smokers(2008). (抽烟和肥胖者实际上给社会省钱)。其他研究Peter Van Doren(1998), Jane Gravelle and Denis Zimmerman(1994, 美国), André Raynauld and Jean-Pierre Vidal(1992, 加拿大)
The second problem with this discriminatory policy is that it is an illegitimate function of the state to penalize individuals for unhealthy behavior. Smokers and others who indulge in risky behaviour are taxed at a disproportionate level to those who choose not to engage in such activities. However, smokers are now liable to be refused some treatments in hospital, including surgery, as a result of their unhealthy habit, as well as some treatments unrelated to their habit. As a means of coercing him or her toward healthier behavior, is undemocratic and borders on tyranny. (该政策以胁迫人健康为理由干涉了个人的基本自由，因为—他不健康没有影响你，反而补贴了你！)
Ironically, this public health prescription neglects the World Health Organisation's definition of health – 'health is the mental, physical and social wellbeing, not merely the absence of disease or infirmity' – by ignoring the social wellbeing of the individual.
作者Basham and Luik的专栏很值得一读：http://www.spiked-online.com/index.php/site/author/Basham%20and%20Luik/P20/
