The Ranting Kraut

19.3.2006 – 27.9.2010

The Liberal Democrats are having a daft idea

Posted by rantingkraut on September 14, 2007

… well there is nothing new or original in that, but this one has to be one of the least thought through policy proposals in a while. The Lib Dem health spokesman Norman Lamb argued:

“If you go out on a Friday or a Saturday night and get very drunk and you end up in accident and emergency, and you are foul and abusive to staff who are already overstretched, then is it right that you should get that care entirely for free, or are there consequences to your actions?

And I think there is a case for saying that someone in those circumstances should be asked to pay for their care.” (Source)

Let’s leave to one side the question of what kind of behaviour should be punished by the NHS. (Simply removing misfits from the premises clearly isn’t always feasible in healthcare.) Let’s just look at the incentives implied by this proposal.

Lamb wants to deter abusive behaviour by threatening some kind of financial penalty. That makes sense. Normally, the amount of the penalty would depend on the severity of the offence, implying a stronger penalty for more outrageous behaviour. By asking patients to pay for their treatment, however, the extent of the penalty is made dependent on something beyond the patient’s control.

If you just got your nose punched, your medical bills would presumably be relatively low, so you can afford to spend your time slapping nurses’ backsides, vomiting in the corridor and swearing profusely. Somebody with multiple bone fractures shouting out “oh f***! that hurts!” could by contrast facing exorbitant medical bills.

The NHS, on the other hand, would have an incentive to ‘punish’ even the most accidental use of foul language, the more so the more expensive the treatment. –It all makes sense to a politician.


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