The problem is precisely that some people here are trying to make our health care system more like yours.

to be the wrong strategy for financial recovery. Regarding the health programs, you might be
correct in that regard.

England and the U.S. have been in lockstep for years. It's like they are the same corporation with two locations.

In a society with social medicine, it's everybody's responsibility to stay as healthy as possible so scarce resources can go as far as possible and everyone benefits.

The premise is not equating smoking with being fat.

and people with genetic predisposition towards breast cancer who do not get their breasts removed.......or people who try to commit suicide, or people with high blood pressure who eat any salt, or say, astronauts, police, and firefighters who deliberately expose themselves to all kinds of risks.

suddenly, I'm not liking the idea of single payer medicine.

62 years of unquestioned single payer medicine= this sort of issue doesn't happen.

2 years of a Tory-dominated government trying to semi-privatize the NHS, AND to make disabled and chronically ill people look like welfare scroungers = it starts being raised.

There are two different issues that are being conflated. One is that obesity and smoking may make certain procedures more dangerous, or less likely to work. It has always been the case that doctors tried to persuade obese patients to lose weight before non-emergency operations, and in some cases refused to do the operations until some weight was lost. This is because in some cases, the risks of the surgery if one is obese may be greater than the risks of not undergoing the surgery. Ditto for smoking, and other lifestyle issues that can affect the prognosis for a treatment.

The other issue is whether patients whose problems are seen as 'self-inflicted' are perceived as less 'deserving' of treatment. I am quite sure that a majority of doctors do NOT hold this view, and that most of the doctors who answered 'yes' to the question were considering benefits vs risks of the procedure. However - until recently almost no doctor in this country would have admitted to the 'deservingness' view; but sadly, now the view is becoming slightly less unthinkable. Right-wingers in the government and the media are re-introducing the pre-welfare-state concept of the 'deserving' versus 'undeserving poor'; and while this is mostly applied to welfare benefits, the vile Torygraph journalist Cristina Odone recently wrote an article about how the 'undeserving', especially the fat, should be put at the end of the queue for treatment.

For 60 years of a fully public NHS, such opinions were seen as unthinkable; but now that partial privatization is being considered, it is accompanied by the rise of some nasty views of this nature on the Right. This sort of view is not the feature of a so-called 'nanny state', which may indeed exert pressure toward certain lifestyles, but does not withdraw services as a result of nonconformity; but the view of so-called 'compassionate conservativism' which basically takes the view: 'Help for the needy is a matter of charity, not an entitlement; our providing help is conditional on your changing your behaviour in the ways that we consider to be good for you!#

more out of the remaining 99%, there will be more and more division between those who a deemed "deserving" and those who are deemed "unacceptable"--whether judged by someone as undeserving or simply a "higher risk of success".

.....an attitude needed for culling the population.

That was a much more eloquent version of what I wanted to say.

but you said it much better than I could have.