We need Balls not Shoulders

I just heard Ed Balls on BBC Radio 4 saying: “those with the widest shoulders should pay the most for the NHS”. As someone who has always been prone to physically broad shoulders, I resent this metaphor. I am certainly happy to pay my fair share: but what about those with the widest stomachs?

We need people to look after themselves in the first place. So what about this, your council tax is linked to some agreed annual metric of health: perhaps: VO2 max (fitness), Waist circumference/hip ratio, and resting heart rate.

If the cost of the NHS continue to rise as they are, it will bankrupt the country. But the cost of the medication is incidental. The REAL cost is time.

The true cost is paid by the ill in lost years of healthy living. People want to be fit, healthy and empowered. They want to be in control of their own bodies.

It seems much better to me to use money in the short term as a big stick to give people the motivation to look after themselves.

Talking about where the money is going to come from after the event, is like throwing gasoline all over your house and asking your partner if we are up to date on the insurance payments? Because we are going to need some cash to pay for a hotel”: Far better to leave the petrol in the can and not light the match in the first place?

Health risks

Societies ills

In the developed world the most common causes of bad health are self-inflicted.

Shared responsibility for health is humane, cost effective and maintains people’s dignity.

I don’t want my credit score checked before an ambulance is willing to take me to hospital. Nor do I want that for anyone else.

The key word is responsibility. You are free to smoke as much as you want: To eat badly, and to drink like a fish. Some people will get away with that life style, but most won’t.

Why not ask the people who we can see, through measurement, are rolling the dice with their health to put their hands in their pockets and dig a bit deeper, to hedge against their current life style?

I don’t think there even needs to be compulsion: If you don’t want to play by these rules: Opt out. Eat what you want, drink what you want and never break a sweat. Just don’t expect everyone else to pay for your meds, implants, and monitors.

Then we can have a real discussion about public health. We can talk about the route, rather than the proximate causes of bad health. Perhaps we need to tax sugar and some fats. Perhaps we should subsidies fresh vegetables. I am pretty sure a pending massive counsel tax bill will get people focused on their health. It could be the best thing that ever happens to us. Terning a long term public health issue into a short term personal financial issue is the best way to get everyone to cut down on the pork pies.

Before after

Me: Now and Then

I will never forget my harajuku moment that led me to lose 3 1/2 stone. It is personal to me, but it was the result of measurement and observation. Sometimes the bravest thing you can do is tell a friend what they don’t want to hear. It has been convenient to dodge the rising tide of obesity & diabetes. The proposed mansion tax is yet another stalling tactic that avoids us having the necessary awkward discussion.

I am all for redistribution: When there something heavy to carry, as a guy with big shoulders I am the first to throw it on my back. It makes me feel happy and valued to help others.

But health isn’t one of those examples: this problem isn’t being shared its being duplicated. In general the poor pay first with their bodies, and we hope we can get the rich to pay later with their wallets.

Shoulders: Is the wrong part of the Male anatomy to use as a metaphor. When talking about the NHS, really we need to be talking about testicles: Having the Balls to say to people, don’t smoke, don’t eat like an idiot, don’t drink like a fish do get off your arse and on your bike from time-to-time, it’s in your long term interest.

Not having an honest debate about the causes of ill health is patronizing and massively underestimates people’s capacity to change. Most ordinary people have an extraordinary capacity to change their lives. That’s not sophistry: Most people have the capacity to astound you. It’s tragic to leave that human potential untapped because of a few difficult conversations.

The NHS must always be there at the point of need. I don’t want to have to swipe my card, to make the back doors of the ambulance open. There is no need for that to ever happen.

An ambulance is acute medicine. It isn’t the golden hour of acute health care that is crippling the NHS: it’s the mounting cost of chronic long term illness. We can’t let scare mongering about acute situations; prevent us from having honest discussions about chronic and preventable illness.

So sure, fund the NHS with new counsel tax bands, but here’s an additional idea that will reduce the bill and prevent all the suffering and drug side effects in the first place. Make the new counsel tax bands waist bands. Oh and don’t spend the money on drugs in the future, (jam tomorrow). Spend it on fresh vegetables today.


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