I met a chief executive the other day who refuses to employ smokers. Not out of personal antipathy to the habit, but on purely commercial grounds. He has a lot of employees in the US, and offers medical care as part of their remuneration package. This is more expensive if they are smokers.
He made an interesting suggestion. It is increasingly obvious that we cannot afford to maintain the National Health Service in its current form. The drugs are getting more and more expensive, people are living longer and requiring more treatment. This is a fact. The NHS is not, a couple of decades hence, going to be able to continue as it is.
Something will have to be done, and it will require a departure from the founding principles of “free at the point of delivery”. Why not, my chief executive suggested, charge people according to the extent that their lifestyles, smoking, drinking, obesity, whatever, contributed to their need for treatment?
If you are treated for a smoking-related condition, you get charged for treatment. Ditto all those other bad lifestyle choices. Lead a blameless life, as healthy as possible, and you don’t get charged when you need the NHS.
There is one counter-argument. If you smoke, you and your fellows already contribute billions in taxes to the State to help fund the NHS, among others. One Nobel prize winning expert suggested the other day this was the real reason why tobacco had not been banned along with other dangerous substances.
Plus, if you smoke you probably die earlier, and do not create such a burden for the NHS as you grow older. Earlier, and often very quickly.