Should government pay for the medical care of irresponsible people?
This is a tough question, especially where funds are limited. DA leader Helen Zille has called for a public debate on the effects of personal "life-style choices" that burden our medical resources to the detriment of others who need care through no fault of their own (see here)
She noted that 80% of the public health budget is spent on irresponsible behaviour ranging from unprotected sex, to alcohol and drug abuse, and the resulting trauma and violence.
A recent case in Northern Ireland highlights the dilemmas even in a wealthy society with a state health system.
The family of 19-year-old Gareth Anderson campaigned for him to have a liver transplant when he was at death's door after several drinking binges. Doctors said he could not be put on the transplant waiting list until he was alcohol-free for six months. He did not help his case by leaving his hospital bed and crossing the road to order a drink at a local pub.
Our former Minister of Health Manto Tshabalala-Msimang set an appalling example with her drinking habits, and seemed to jump the queue for her liver transplant.