At a health tech pitch event last year a group of guys were presenting a new app they had created – a way for you to challenge four mates to achieve a health goal and bet on who will win. The first person to achieve the goal won the pot of cash or it went to a nominated charity.
In behaviour change terms this is a neat app. It won’t appeal to everyone but for those that it does it’s a great little tool. When asked how they were going to fund it going forward they stated they were looking to public health because this sort of thing was the Governments responsibility.
I was annoyed. Our personal health is our responsibility. Why should the Government pay for my poor life choices? Is it the Government’s role to interfere in every aspect of our health? What happened to individual responsibility? Should the Government fund everything to do with health? If they did would it actually encourage us to get healthier or would it have the opposite affect?
I firmly believe every aspect of our health should not be outsourced to the Government. But we are several generations into a tax funded health system that has impacted on our health behaviour, both positively and negatively. We seem to rely on the fact that however we treat our bodies at some point the NHS will pick up the resulting problems. The Government has never really excelled at preventative health. Once there is a problem to treat it is engaged, but developing services to help us avoid those problems or stopping our own behaviour exacerbating our poor health condition, in this it is less skilled. No surprise, preventative health is hard and expensive, you have to cast the net wide to have an impact because you are trying to stop things from happening rather than treat something that exists.
So should the Government be telling us how much to drink? Well it comes back to the life choices argument. We do expect the Government down the line to pay for the choices we make about our diet, drug taking, extreme sports and stupidity. But the Government also has a responsibility to balance the budget and prioritise how the allocated cash will be spent. So whilst we make individuals choices the final bill for the health impact of that choice is funded through a tax pot we all contribute to. The Government, therefore, does have an interest and legitimate role in sending big messages that they think will change behaviour and reduce demand or allow them to sift priorities. Setting alcohol drinking unit limits may not be the most effective behaviour change technique, but as far as Governments can nudge our behaviour guidelines certainly have their role. Their primary aim is to reduce long term demands on the NHS.
Whilst I don’t personally like being told what to do by the Government I do want there to be enough budget for an improved NHS that is here for the long term. So I have to take on the chin that it is within their responsibilities to send out messages about our use of a widely used substance that impacts on nearly every short and long term health condition going – from our poor quality sleep through to increased cancer risk. If the guidelines impact on just 2% of the drinking population (which is 85% of adults) then the financial saving is significant. It is a preventative message aimed at nearly everyone to hopefully impact on a few.
So whilst I would always encourage individuals to take responsibility for their own health you still have a personal choice. You can listen to guidelines or your can listen to your own body and common sense – the chances are you know deep down if alcohol is having a negative impact on you. If not for yourself then consider your own health in the context of helping manage the long-term costs of the NHS. You would certainly be more likely to take notice of that financial cost of you were paying a premium to an insurance company that reduced your fee based on your lifestyle choices.