Visit The Pub Curmudgeon site

You often hear suggestions in the media that people admitted to A&E with drink-related injuries should be required to pay for their own treatment. This idea has occasionally cropped up in the comments here as well. The same principle is then easily extended to expecting smokers and fatties to pay for treatment of related medical conditions.

But this opens up a very dangerous slippery slope. Many health conditions are to some extent caused or exacerbated by lifestyle choices, and many injuries result from from activities where people knowingly accept a higher than average level of risk. Should we be refusing to treat any injuries resulting from rugby, or hang-gliding, or leisure motorcycling, and requiring anyone doing those things to have comprehensive private medical insurance? What about sexually-transmitted diseases acquired through risky sexual practices? Or health problems resulting from the abuse of illegal drugs? It is impossible to draw a hard-and-fast moral line.

There is also the question of what you do with people without the means to pay. People of social classes D and E drink no more on average than those in classes A and B, but they are six times as likely to be admitted to A&E with alcohol-related injuries or conditions. Many of them will be men and women of straw who live from week to week and have minimal savings. You can’t just turn them away untreated, so someone else is going to have to foot the bill, and if people who do have some financial means are at the same time funding the health care of the penniless through taxation, yet being refused the same free treatment themselves, they will be understandably resentful.

While the funding and organisation of healthcare are the subject of legitimate political debate, however much people’s injuries and health problems are caused by their own behaviour, it goes against basic human decency simply to turn the other cheek and let them die in the gutter. This doesn’t happen in the USA (despite what some claim) so why should it be considered remotely acceptable here?