Smokers receive little sympathy for their habit and its consequences. Some of that is warranted, as I’ve told both of my brothers who smoke. It’s a stupid habit that’s known to cause serious health problems. Who in their right mind would start today, knowing what we know. But there are no apparent bounds to human stupidity, so smoking survives¹. That informs the public debate, but should not dictate it. It does, though, an it will increase if we move to a single-payer health care system. Are we immune to liberty-despising lunacy like this?
Smokers who refuse to give up the habit should be denied some types of surgery, a respiratory expert says.
Matthew Peters said denying smokers joint replacement surgery, breast reconstructions and some other types of elective surgery was justified because the operations were more risky and costly when performed on smokers.
“In healthcare systems with finite resources, preferring non-smokers over smokers for a limited number of procedures will deliver greater clinical benefit to individuals and the community,” Associate Professor Peters said in the latest issue of the British Medical Journal.
“To fail to implement such a clinical judgment would be to sacrifice sensible clinical judgment for the sake of a non-discriminatory principle.”
To be fair, in the context of a silly idea, it has its logic. But the rules must be convoluted to get there.
To Mr. Peters, greater clinical benefit to individuals results from denying procedures to smokers. I’m quite certain that the smokers will not derive greater clinical benefit. What Mr. Peters really means is the community. There is no individual in single-payer health care, just a utilitarian cost-benefit analysis where the parameters are set by an outside party. Perhaps the smoker values hip replacement surgery enough to pay for it himself, where the non-smoker will only have it done because it’s paid for by the government. There are only two people who can make that decision, and the bureaucrat isn’t one of them.
In a private market, the smoker would pay the added insurance expense for his habit, and would weigh the risk decision with his physician. All people are not alike, so it’s feasible that smoker X will have a different risk than smoker Y. Again, who is better qualified to make that individual decision, based on relevant facts, the doctor or the bureaucrat?
“Therefore, so long as everything is done to help patients stop smoking, it is both responsible and ethical to implement a policy that those unwilling or unable to stop should have low priority for, or be excluded from, certain elective surgical procedures,” he said.
I have no interest in seeing this in America. I don’t smoke, I don’t drink, and I’m a vegan. According to the standards of a bureaucrat, I probably come out alright, unless a bureaucrat deems insufficient milk intake a danger to bone health, for example. Then, like everyone else in America who isn’t perfect, I’m screwed. Should I be sent for dairy re-education to make sure my bones don’t become brittle? Extreme, yes. Impossible, no. “So long as everything is done to help patients stop …” and “those unwilling or unable to stop” are the clues.
I’ve determined the possible effects of my health choices. I understand what I could face and I’ve compensated as well as I can. And I’m willing to pay for the consequences, both in health and dollars if I’m wrong. That individual calculation gets pushed aside in the world of single-payer health care. Liberty demands that we not embrace that nonsense, but economics and quality of care dictate the same. Pick your preference. Unless you hate both, the choice is easy.
¹ I’m not talking recreational smoking, although that’s dangerous. I’m talking about addiction. When smoking begins to cause serious health problems and the smoker can’t quit, that’s the where stupidity can lead. Or should I say excess stupidity. And yes, as the rest of this entry will show, people are entitled to what is in my opinion excess stupidity to harm themselves.