The cause is that Tiny Tim already has an illness, and it's getting worse over time. If Scrooge doesn't pay Bob Cratchit enough money, Tim might get so sick that he might possibly die. The effect is that the family doesn't have enough money to pay the doctor, so he ends up dying. Scrooge could've helped Tim survive by maybe supporting Bob's family, and paying him more. I can relate to this because I know what it's like to lose someone close to you. My two best friends, Parker and Faolan both committed suicide. Faolan had been dealing with clinical depression for some time, and was getting bullied at his school. Parker had an eating disorder and her father beat her. He also said that she was an accident, and that he'd wanted to get rid of her since she was born. So on November 14th, they both committed suicide, they hadn't told me what was going on at the time, but their parents let me know over the phone. Let's just say I had a mental breakdown, and still haven't gotten over it.
Person Vs. Self - Scrooge contemplates after seeing the ghosts, whether or not he should becoma a better person. In the end, he finally realizes that he should change his ways, because well, he kind of wants to live.
Person Vs. Supernatural - Scrooge meets all of the ghosts, and they all show him bits and pieces of his life that weren't that good.
Person Vs. Society - Everyone despises Scrooge, or is scared of him. Scrooge realizes this, and decides to change his ways.