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Well the NHS is like an insurance, so like drivers, if you aren't cautious with how you look after your car, where you keep it, having an MOT etc the premiums will vary and if you decide to drive into a wall because you had an urge for a thrill the insurers would probably be very reluctant to pay out even if you had paid your premiums. Everybody pays their tax and NI but this shouldn't give you unlimited entitlement to services that are due to not taking care of yourself. There could be a standard cover for medical issues, but get wasted on a Saturday night and fall over yourself breaking your arm, you pay