British patients who smoke or are obese will face restrictions on elective surgeries. Photo: CC, Shane Tuck.
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Decision to deny medical care to a portion of the population  is discrimination, pure and simple

For once, fierce debate about equal medical treatment and universal healthcare isn’t being staged in Canada or the United States. Instead, Britain’s health-care system has recently been put under scrutiny.

In a decision made by the Vale of York Clinical Commissioning Group (CCG), British patients who have a body mass index (BMI) of over 30 and/or who smoke will face delays of up to a year in receiving non-life-threatening surgeries—a move described by The Royal College of Surgeons as “the most severe the modern National Health Service (NHS) has ever seen.”

The decision arose amidst what has been referred to as a “funding crisis” for the NHS, who recently admitted to overspending £2.45 billion in 2015–16, a figure three times greater than the previous year.
But rationing access to healtcare is not a reasonable solution to over-expenditure, though it might seem so at first glance.

According to the CCG, patients with obesity-related conditions cost the NHS in the Vale of York £46 million in 2015. Restricting access to costly surgeries thus, in theory, seems like a logical solution to balancing the books.

There also appears to be a medical rationale. As one NHS spokesperson put it, “major surgery poses much higher risks for severely overweight patients who smoke” and that the CCG is “entirely right to ensure these patients first get support to lose weight and stop smoking.”

Quitting smoking is difficult and can often be very painful, but losing weight raises different kinds of challenges, not simply based on lifestyle.

Even if you do eat right, sometimes it’s genetics—not lifestyle—that determines  your BMI.

There are many factors that contribute to weight gain, and yet, with this stance taken by the NHS, it is as though they are viewing obesity as a choice for everybody, regardless of what other factors are at play.

In an interview with the Guardian, bariatric surgeon Shaw Somers, noted that “obesity is an illness,” and denying patients the right to healthcare until they lose weight is not unlike denying patients healthcare on the basis of their race or religion.

Not only that, this policy also discriminates against people based on their socioeconomic status.

There is a proven link between low socioeconomic status and poor dietary habits that leads many down the path of obesity. There is also a link between low socioeconomic status and higher levels of smoking. Thus, restricting surgery for smokers and obese people will disproportionately affect the poor.

This is why, in many ways, denying obese patients access to the same medical treatment as “normal” patients is cruel and discriminatory, just the same as it would be to deny patients who come from an ethnic or religious minority.

With obesity rates continuing to rise in Britain, more people than ever will be affected by these new restrictions.

While this decision may appear to be an efficient way to distribute limited resources to some, at what point does this type of rationing become the norm, and universal healthcare become the exception to the rule?