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 non-smokers.
To what extent do you agree with this statement?

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.

"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.