1. Smokers can cause themselves serious health problems. The choice to smoke is made freely and with knowledge of dangers.
Smokers should therefore expect to pay more for medical treatment than nonsmokers.
Everyone has the choice of being a smoker or not. The people who choose to smoke do so knowing there is a risk of causing harmful damage to themselves. However, I do not entirely agree that these people should have to pay more to receive all the medical treatment they need.
I think there are many situations in which a medical problem has nothing to do with whether a person smokes or not. In these cases, where an illness has no relation to smoking, then I believe that smokers should not be required to pay more than other people for their medical treatment. Most car accidents, for example, have no connection with smoking, and the people who are injured ought to have the same medical help, regardless of the cost. And what about the common flu – it does not seem justifiable to me that a smoker should have to pay more to see a doctor for an illness we can all contract.
On the other hand, I agree that a smoker should pay more than a non-smoker for the necessary treatment of any condition which has been caused by smoking. The principle that people should take responsibility for their own actions is a good one. Consequently, if a person chooses to smoke knowing that this habit can cause serious health problems, then there is no reason why the community or an insurance company should have to pay for medical treatment for an illness which could have been avoided. In many countries, cigarette packets have a clear warning that smoking can cause health problems and so no smoker can claim not to know the danger. Lung cancer is sometimes a fatal disease and the treatment is both lengthy and expensive, and it is unfair for the smoker to expect the hospital or the community to carry the cost. In fact, it could also be argued that those who smoke in public should be asked to pay extra because of the illness caused to passive smokers.
In conclusion, I feel that smokers should pay more in cases related to smoking, but for any other illness they should pay the same as anyone else.
2. Should parents be obliged to immunise their children against childhood diseases?
Or do individuals have the right to choose not to immunise their children?
Sample Answer 1
Some people argue that the state does not have the right to make parents immunise their children. However, I feel the question is not whether they should immunise but whether, as members of society, they have the right not to.
Preventative medicine has proved to be the most effective way of reducing the incidence of fatal childhood diseases. As a result of the widespread practice of immunising young children in our society, many lives have been saved and the diseases have been reduced to almost zero.
In previous centuries children died from ordinary illnesses such as influenza and tuberculosis and because few people had immunity, the diseases spread easily. Diseases such as dysentery were the result of poor hygiene but these have long been eradicated since the arrival of good sanitation and clean water. Nobody would suggest that we should reverse this good practice now because dysentery has been wiped out.
Serious diseases such as polio and smallpox have also been eradicated through national immunisation programmes. In consequence, children not immunised are far less at risk in this disease-free society than they would otherwise be. Parents choosing not to immunise are relying on the fact that the diseases have already been eradicated. If the number of parents choosing not to immunise increased, there would be a similar increase in the risk of the diseases returning.
Immunisation is not an issue like seatbelts which affects only the individual. A decision not to immunise will have widespread repercussions for the whole of society and for this reason, I do not believe that individuals have the right to stand aside. In my opinion immunisation should be obligatory.
Sample Answer 2
The issue of whether we should force parents to immunise their children against common diseases is, in my opinion, a social rather than a medical question. Since we are free to choose what we expose our bodies to in the way of food, drink, or religion for that matter, why should the question of medical ‘treatment’ be any different?
Medical researchers and governments are primarily interested in overall statistics and trends and in money-saving schemes which fail to take into consideration the individual’s concerns and rights. While immunisation against diseases such as tetanus and whooping cough may be effective, little information is released about the harmful effects of vaccinations which can sometimes result in stunted growth or even death.
The body is designed to resist disease and to create its own natural immunity through contact with that disease. So when children are given artificial immunity, we create a vulnerable society which is entirely dependent on immunisation. In the event that mass immunisation programmes were to cease, the society as a whole would be more at risk than ever before.
In addition there is the issue of the rights of the individual. As members of a society, why should we be obliged to subject our children to this potentially harmful practice? Some people may also be against immunisation on religious grounds and their needs must also be considered.
For these reasons I feel strongly that immunisation programmes should not be obligatory and that the individual should have the right to choose whether or not to participate.
3. “Prevention is better than cure.”
Out of a country’s health budget, a large proportion should be diverted from treatment to spending on health education and preventative measures.
To what extent do you agree or disagree with this statement?
Of course it goes without saying that prevention is better than cure. That is why, in recent years, there has been a growing body of opinion in favour of putting more resources into health education and preventive measures. The argument is that ignorance of, for example, basic hygiene or the dangers of an unhealthy diet or lifestyle needs to be combatted by special nationwide publicity campaigns, as well as longer-term health education.
Obviously, there is a strong human argument for catching any medical condition as early as possible. There is also an economic argument for doing so. Statistics demonstrate the cost-effectiveness of treating a condition in the early stages, rather than delaying until more expensive and prolonged treatment is necessary. Then there are social or economic costs, perhaps in terms of loss of earnings for the family concerned or unemployed benefit paid by the state.
So far so good, but the difficulties start when we try to define what the ‘proportion’ of the budget should be, particularly if the funds will be ‘diverted from treatment’. Decisions on exactly how much of the total health budget should be spent in this way are not a matter for the non-specialist, but should be made on the basis of an accepted health service model.
This is the point at which real problems occur – the formulation of the model. How do we accurately measure which health education campaigns are effective in both medical and financial terms? How do we agree about the medical efficacy of various screening programmes, for example, when the medical establishment itself does not agree? A very rigorous process of evaluation is called for, so that we can make informed decisions.