{"id":5110,"date":"2010-10-15T14:38:32","date_gmt":"2010-10-15T13:38:32","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=5110"},"modified":"2010-10-15T14:38:32","modified_gmt":"2010-10-15T13:38:32","slug":"domhnall-macauley-charge-the-sick","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/15\/domhnall-macauley-charge-the-sick\/","title":{"rendered":"Domhnall MacAuley: Charge the sick"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg\" alt=\"Domhnall Macauley\" width=\"162\" height=\"110\" align=\"left\" \/>Why not charge people for being ill? <a href=\"http:\/\/www.irishtimes.com\/newspaper\/letters\/2010\/1008\/1224280632687.html\">A satirical letter in the Irish Times<\/a>, recommended a monthly levy on illness. Declan Moriarty suggested a sliding scale so that MS sufferers could be levied \u20ac10 per month, Parkinson\u2019s \u20ac9, Motor Neuron \u20ac8, Friedreich\u2019s Ataxia \u20ac7, Arthritis \u20ac6, and a levy on every other illness of \u20ac5. In the context of prescription charges in Ireland, he thought it might make a more sensible system of tax. So, why does this sound unreasonable?<!--more--><\/p>\n<p>We expect the NHS to provide healthcare to all. If you choose private healthcare, its a personal decision and it leaves more money to provide for others.\u00a0 Treatment may take a little longer and some of the more expensive drugs are limited but, in general, the NHS still provides a good service. But, will it always be so?<\/p>\n<p>The squeeze on costs, rationing or, whatever euphemism you choose, has already begun to restrict the availability of some drugs and treatments. If you want the best available treatment as quickly as clinically appropriate, you might seek a private alternative.\u00a0 We still retain a sense of justice and fair play, however, and are uncomfortable with the idea of charging people for being sick. After all, we wouldn\u2019t unfairly tax the disabled, immigrants, or women. Would we?<\/p>\n<p>There are many inconsistencies in our approach to funding the health service. The biggest problem is that the UK economy can, no longer, afford to provide universal quality health care. We cannot afford the NHS as it was initially conceived. But, what can we do about it?\u00a0 No government dare announce the end of the NHS and hope to remain in power. No opposition could include that in their manifesto. Everyone will fudge, dress it in ambiguity, pass the responsibility of reducing health costs to others, call it choice, a free market, or democracy.\u00a0 But, no one will ever say it straight. Someone has to pay for healthcare.\u00a0 But, if we move from collective responsibility from provision of health care to personal responsibility we will, in effect, be charging people for being ill.<\/p>\n<p><strong>Domhnall Macauley<\/strong> is primary care editor, <em>BMJ<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Why not charge people for being ill? A satirical letter in the Irish Times, recommended a monthly levy on illness. Declan Moriarty suggested a sliding scale so that MS sufferers [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/15\/domhnall-macauley-charge-the-sick\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1287,116],"tags":[],"class_list":["post-5110","post","type-post","status-publish","format-standard","hentry","category-domhnall-macauley","category-editors-at-large"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Domhnall MacAuley: Charge the sick - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/15\/domhnall-macauley-charge-the-sick\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Domhnall MacAuley: Charge the sick - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Why not charge people for being ill? 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