Don't treat the unhealthy or elderly... ?

[guice666]

Long ass URL

Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.
# Have your say: Should lifestyle play a role in deciding who gets NHS treatment?

Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.

Smoker - Don't treat the old and unhealthy, say doctors
£1.7 billion is spent treating diseases caused by smoking, such as lung cancer and emphysema

Fertility treatment and "social" abortions are also on the list of procedures that many doctors say should not be funded by the state.

The findings of a survey conducted by Doctor magazine sparked a fierce row last night, with the British Medical Association and campaign groups describing the recommendations from family and hospital doctors as "out*rageous" and "disgraceful".

About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.

Managers defend the policies because of the higher risk of complications on the operating table for unfit patients. But critics believe that patients are being denied care simply to save money.
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The Government announced plans last week to offer fat people cash incentives to diet and exercise as part of a desperate strategy to steer Britain off a course that will otherwise see half the population dangerously overweight by 2050.

Obesity costs the British taxpayer £7 billion a year. Overweight people are more likely to contract diabetes, cancer and heart disease, and to require replacement joints or stomach-stapling operations.

Meanwhile, £1.7 billion is spent treating diseases caused by smoking, such as lung cancer, bronchitis and emphysema, with a similar sum spent by the NHS on alcohol problems. Cases of cirrhosis have tripled over the past decade.

Among the survey of 870 family and hospital doctors, almost 60 per cent said the NHS could not provide full healthcare to everyone and that some individuals should pay for services.

One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.

Tony Calland, chairman of the BMA's ethics committee, said it would be "outrageous" to limit care on age grounds. Age Concern called the doctors' views "disgraceful".

Gordon Brown promised this month that a new NHS constitution would set out people's "responsibilities" as well as their rights, a move interpreted as meaning restric*tions on patients who bring health problems on themselves. The only sanction threatened so far, however, is to send patients to the bottom of the waiting list if they miss appointments.

The survey found that medical professionals wanted to go much further in denying care to patients who do not look after their bodies.

Ninety-four per cent said that an alcoholic who refused to stop drinking should not be allowed a liver transplant, while one in five said taxpayers should not pay for "social abortions" and fertility treatment.

Paul Mason, a GP in Portland, Dorset, said there were good clinical reasons for denying surgery to some patients. "The issue is: how much responsibility do people take for their health?" he said.

"If an alcoholic is going to drink themselves to death then that is really sad, but if he gets the liver transplant that is denied to someone else who could have got the chance of life then that is a tragedy." He said the case of George Best, who drank himself to death in 2005, three years after a liver transplant, had damaged the argument that drinkers deserved a second chance.

However, Roger Williams, who carried out the 2002 transplant on the former footballer, said doctors could never be sure if an alcoholic would return to drinking, although most would expect a detailed psychological assessment of patients, who would be required to abstain for six months before surgery.

Prof Williams said: "Less than five per cent of alcoholics who have a transplant return to serious drinking. George was one of them. It is actually a pretty successful rate. I think the judgment these doctors are making is nothing to do with the clinical reasons for limiting such operations and purely a moral decision."

Katherine Murphy, from the Patients' Association, said it would be wrong to deny treatment because of a "lifestyle" factor. "The decision taken by the doctor has to be the best clinical one, and it has to be taken individually. It is morally wrong to deny care on any other grounds," she said.

Responding to the survey's findings on the treatment of the elderly, Dr Calland, of the BMA, said: "If a patient of 90 needs a hip operation they should get one. Yes, they might peg out any time, but it's not our job to play God."

The survey found that medical professionals wanted to go much further in denying care to patients who do not look after their bodies.

Omg yes. Can we PLEASE implement something like that here?! PLEASE!?!?


All I have to say, as speaking as a healthy guy at 31 (ie: biased), I agree with the doctors! I want something like this to happen here.

Yes, I know we don't have free health care, but I do feel this would make a HUGE difference on the current health care costs, both for the individual and the hospitals / doctors.

Phung, as an RN, what do you think of this?

[ryum]

I agree with the unhealthy part to an extent... as in smokers, drinkers, and ect... not someone who has diabetes or something like that

and I really really don't think people should be cut off from health care because of their age.

as speaking as a healthy guy at 25 (ie: biased)

[guice666]

not someone who has diabetes or something like that

Type I, which is hereditary. Type II is developed from poor health.

[Dooyas]

What about the dudes from Jackass?

[Kexel EoV]

Slippery slope if you ask me...

[Phung Kuu]

How about if they have Diabetes but don't take their meds?

And are continually in the ICU costing the system 20K per day, for week at a time.

6 to 12 times a year.

For 20 years. We have patients like this all the time.

One of my patients last night was exactly like this. Did not take her meds. Went down. Had a stroke. Got rhabdo. No insurance(that she pays for).

You all pay for her actions. You pay for her healthcare. You pay for her mistakes. You pay her doctors, and you pay me.

Because she did not take her Diabetes medications. She is going to cost the system this time around 150K. She is only 54, young. Even if she pulls through, and gets out of the hospital...she will do this again. Frequent fliers.

If I went into any other business, and ran up a 150K tab, and passed that on to you; would you think highly of me, or would you think that I am a thief?

[Senliten]

mmm... Well what about those with life long illnesses..... As in mental stability wise..

Would one consider it useless cause those with ADHD,ADD, and anything in that area of class as unhealthy? If you do it to one you might as well do it to all...

given my own history i would easily be considered an unhealthy/stable person at the age of 20.. If they can consider ones own conditions life long as my own unhealthy. then Aids treatment should just not get funded and stop pre treating patients for it as well.

I hope some see where im going with this... Im going along saying its useless to even take lives of those unfit for it. Just cause a doctor or mere government cant pay there own damn bills... So they decide to shorten lives of those to the unhealthy/elderly/unstable..

Life is precious in its own many ways.. and a doctor to say they wont help... its going against what there whole meaning is... The healers of this day and age.. are turning more corrupt than the government itself.... so to say

[guice666]

People need something to kick them in the ass in order to remain healthy. Back in the day, people stayed fit simply because that was the way of life: mile long walks, constant lifting, etc. Today, technology has made it so we don't have to do those things anymore -- and it's making everybody farking lazy.

What needs to be done is people need to get off their asses. If they know they risk not getting medical attention for being lazy, maybe the will change up their life style and not be lazy anymore? I know, I'm optimistic....

I'm all for refusal of treatment out of pure laziness. This is what the doctors said: The survey found that medical professionals wanted to go much further in denying care to patients who do not look after their bodies.

You only have one body (unless you find the ancient voodoo secrets that allow you to jump bodies): you need to take care of it and stop ripping of the medical industry. :(

[guice666]

New diet everybody should follow: http://www.applegeeks.com/lite/index...mic=2008-01-28 !

^_^

[Phisti]

The argument is not to deny them health care, but to deny them free health care. The doctors go to far when citing the elderly as patients who should not receive free health care as simply a result of age (ie they won't live long - bad investment) whereas I think they do have something going on self-inflicted poor health.

Some examples - person 1 - obese, doctors want to deny them free health care. Slippery case as there is growing evidence that for many obesity is heavily linked to genetics.

Person 2 - 2 pack a day smoker, clearly in these situations it is addictive behaviour that has deteriorated their health. Again it's hard to call as smoking is a contributing factor to many health ailments (heart disease, stroke, respiratory illnesses) it is usually not the only cause. However, the argument can be made that smoking had an impact on their illnesses.

Too often we're jammed in these situations, in the case of the diabetes patient who fails to self-medicate - the health care costs are really the result of self-inflicted health problems, but, had the person forgotten meds would it be the same situation? Three-strikes method appropriate?

I for one am quite sick of paying significant taxes for government funded health care to those who don't take care of themselves, but I know I'd all too happily receive free health care if I was seriously ill.

To put some spin on this - why is it one thing for government funded health care to contemplate not paying for services while insurance companies and private HMOs do it all the time...

[guice666]

Slippery case as there is growing evidence that for many obesity is heavily linked to genetics.

It's been shown, just as much, the other way, too. There is a guy that use to be over 600lbs, something you'd thought could only be genetics. But, he got tired of it and decided to change his life. You can see the summary here: http://bodyspace.bodybuilding.com/David630lbs/

This is a real guy. It is not genetics. People searching genetics are searching for a reason NOT to blame themselves. I'm sorry; if you retain a lot of water, change your diet. As far as I know, water retention is the only genetic "disorder" that can cause overweight. But again, look at the 630lb dude, and noticed he managed to fix that just fine.

[Phisti]

I'm sorry if I didn't state it clearly - yes there are people that are just obese and really have no reason for their physical state other than their eating and exercise habits. However, there are other people who, having done as much as is physically possible, may be able to control their weight to an extent, but can never get to a "healthy" range. My comment above was more about the latter of these two types of obese people.

It's difficult to argue that this guy is obese due to genetics, and this guy is obese due to sloth, one gets free treatment, the other doesn't. (Unless of course they develop some form of genetic testing for obesity prior to treatments... yikes).

[guice666]

That's my point; I hadn't actually met or seen anybody that's obese due to genetics. Everybody I know, even my mother and her husband, are overweight due to sloth: but a doctor would tell you its genetic.

I have not seen any genuine chases for "genetically overweight." People are genetically bigger, endomorph body types, but bigger doesn't mean overweight. And these people, you can tell if they work out or not.

[Phung Kuu]

Originally Posted by guice666

but a doctor would tell you its genetic.

What doctor?

[Wilzerd Balefire]

So where are all my 'free health care' socialists now? Not out screaming the advantages of the system?

This is what government run health care will get you.

But not me. I will always be able to afford my own health care. While you die from someone else's choice I will be receiving the absolute best medical care my dollar can afford.

Remember... that's 'Vote for Hillary and Socialized Medical care (depending on your lifestyle!) in 2008!!' Call now - operators are standing by.

[Phung Kuu]

No need to worry any longer about my patient above. She won't cost you any more.

[Braincandy999]

Originally Posted by guice666

I have not seen any genuine chases for "genetically overweight."

I want to see a genetically overweight chase! That would be awesome. Cmon FOX network, don't let us down!

even better!

Obese Obstacle Course! The O.O.C.

[Mailon]

Genetically overweight my ass.

Ever see a fat guy in a concentration camp?

out of uniform, smart ass.

--Edit

Obesity is hereditary in that you learn how to eat and how to be active from the people you live with early in life. Similar to the way that economic status can be hereditary.

[guice666]

Originally Posted by Mailon

Obesity is hereditary in that you learn how to eat and how to be active from the people you live with early in life. Similar to the way that economic status can be hereditary.

/100% agree

Until somebody can prove any different, this is exactly right. There is no such thing as hereditary obesity.

[ryum]

Originally Posted by Mailon

Genetically overweight my ass.

Ever see a fat guy in a concentration camp?

thats the best, and worse thing I ever read

[Phisti]

The argument relating obesity to genetics is founded primarily around studies of various tribal groups in North America.

Essentially what has been discovered so far is that certain individuals have a variable metabolic rate which allows for thrifty use of food energy during lean periods. The issue is of course, in a modern society there are effectively no lean periods.

What was published in the International Journal of Bioinformatics Research and Applications established that there were distinct links between obesity in people with these thrifty genes since, even though food was available their body did not metabolize it in the same manner as the general population.

This is but one study of many that indicates there may be a portion of the population that is predisposed to obesity.

And I'm not normally a really serious person, but the comment about obese people in concentration camps was just so disgustingly low-brow. C'mon guys.

[guice666]

So, let me get this right: the study found that people with low metabolisms tend to be fatter?

[Phisti]

Not really. People with low metabolisms are everywhere. The study indicated that particular groups have exceptionally low metabolisms - like to the point where they could not eat for extended periods but not consume any significant quantities of their body fat either.

Most people with low metabolisms are generally larger but not obese as a result of their metabolism it's a combination of factors. Whereas specific groups are 200x more likely to be obese because they have ridiculously low metabolisms as an evolutionary survival trait (mostly desert tribesmen and their descendants).

[guice666]

Alright, exceptionally low. That's fine. Now, did you know that you can control your own metabolism?

Yes, there are hereditary factors involved; however, you can increase and decrease your metabolism. It just takes more work the lower your metabolism, but its possible.

I still don't buy "naturally obese" argument.

[Suzuka Twilight]

Originally Posted by guice666

Alright, exceptionally low. That's fine. Now, did you know that you can control your own metabolism?

Yes, there are hereditary factors involved; however, you can increase and decrease your metabolism. It just takes more work the lower your metabolism, but its possible.

I still don't buy "naturally obese" argument.

Yep, if you don't exercise, like a lot of people do. You will have slow metabolism. You see those people with headaches, frequent cold catchers, irritable, stressed? The most likely cause is their lifestyle. Many jobs nowadays are stressful/tiring for your brain, but sadly it doesn't burn many calories yet people get habitually overeat compared to what they need and their bodies get used to it and you get artificial cravings. So the older they get the more they spiral down. Also widely available drug, called coffee/sodas. While in moderation is actually ok to drink(coffee only), but sadly most people aren't strong willed.

Many get caught by things called "diet" without realizing it is the biggest scam in the world to keep their metabolism down and keep repeating, thus filling scammers pockets.

Basically, there is no such thing as free when it comes to your body. Hard work over time brings results, there are no real short cuts yet.


As for OP post. I do feel that in some cases it may be justifiable to bring those measures that doctors want in effect to life, however at this time I don't think we have sufficient knowhow to tell apart one from the other to the % that would seem fair.

[Phung Kuu]

Absolutely we have the knowhow.


And to a certain degree with regard to healthcare, we already do this. We already decide your healthcare by your lifestyle.

If you smoke, you can't really get on a donor list.
If you drink, you can't get on a donor list for a new liver.
And if you do get on the list, odds against odds, your children have better odds of getting new parts than you do, because you are such a low priority. You might get some cadaver skin to cover your trach hole, though.

Anyway, YOU may not have the knowhow. But I assure you that we do.

[Bolehcim]

Wow, I typed a long post. Guess I have an opinion about this, so I will just state what someone earlier said.

Slippery slope material...

[NilremWoW]

2-Tier FTW!

[Phung Kuu]

Originally Posted by Bolehcim

Wow, I typed a long post. Guess I have an opinion about this, so I will just state what someone earlier said.

Slippery slope material...

If I walk into your grocery store, and am obese, and buy a lot of food, and have to pay for all of it, does that make you a bad person for charging me for everything I want.

If I drive my German import into your shop, and have to pay more for all my parts and service, than the guy who takes his car into the Japanese Motors shop next door.

If you click 30 On Demand, pay per view movies, each month, do you complain that my cable bill is less than yours, because I don't use any.

The slippery slope has been the making of healthcare different than any other goods or service(It is not). If you use more, you should pay more.

Most of my patients are patients because of their lifestyle and life choices. Obesity and smoking leading the list. Alcohol follows, we are always detoxing some drunk in DTs.

People should be responsible for their own bills, whether that is the car shop, the grocery store, the cable company, or even the hospital.

The slippery slope has been the detachment of your hospital or doctors bills from EVERY other kind of service you use.

Not making people pay for their own shit is what is wrong, paying for your own stuff is just right, and has been since the beginning of civilization. Having the rest of us pay for your obesity, because you can't stop eating, paying for your COPD, because you can't stop smoking is JUST NOT RIGHT.

When it started to be ok to be fat, that was the beginning of the slippery slope. When we have to use buzz words like obese, when the person is FAT. You are not thick, big boned, high BMI, you are FAT.

And because you are FAT, does not mean that the rest of us have ANY obligation to take care of you because you are too lazy not to be FAT. Rather, pay for your care.

OBTW, the FAT patients are the biggest bunch of whiners, passive aggressive, and lazy. That is how they got that way, not genetics.

[guice666]

Yeah, I'm siding with Phung on this one. Sorry. I'm not fat, but I make it a point not to be. Once I saw myself get a little flabby around the mid, I immediately changed what I was doing (downing lots of protein shakes and not working out ^_^).

I refuse to let myself get fat in any fashion.

[ryum]

yeah... I have always been thin but also always been active

almost all the men on my dad's side of the family are obese or borderline obese...
At thanksgiving dinner who gets all the kids up and throwing the football, frisbee, whatever so they run around and what not? ME, and possibly a few of my cousins (I am 25 now so mostly wrangling the majority of my cousin's kids since most of us are pretty grown up)

the big guys of the family eat then sit and chat then nap or go to bed early...

that is a polaroid of exactly why I am thin and in shape, and why the big guys in the family stay big.

I have weighed bout 165-175 since HS, this last fall I was a stay at home dad/student... and I was literally unable to get out of the house for days at a time and shockingly shot up to 185 then from thanksgiving to christmas I lost it all.
And I eat just as much, if not massively more than my family and friends that are big, and they just say (and I let them) he has a fast metabolism, and all that stuff... right now I am in horrible shape, I never have time to jog or anything but I still stay active chasing my kid around, hell carrying him around has made my arms stronger than they have ever been... (unfortunatly I don't gain bulk) but the other day moved a 35 inch glass screen TV solo... and I have had that TV for over a decade and always needed help with it before.

I just don't understand how people who have desk jobs and ect who then come home and watch tv then sleep the majority of the night can possibly expect to not gain weight..
Even when I worked the night shift doing tech support, and was full bore raiding wow I still got outside or atleast ran up and down stairs if I was getting flabby

[Bolehcim]

See... My comment about slippery slope came from a different angle...

Does this mean we stop treating "your mom" that caused car accidents because she was stupid, and should have driven better?

Do we stop treating "your brother" that get an STD, because he was stupid and had sex with a condom that broke?

Do we stop treating child athlete that a was injured, because they should have known better?

Do we not treat the "fit, non-smoking" idiot that stepped out his door and got struck by lightning "because he should have known better?"

Once you take it away for a "should have known better" reason, that opens it up for alot of interpertation... And abuse... And it's a great idea, until it happens to you, or someone you love.

[cessate]

It is slippery slop material. Judging on lifestyle choices does depend on criteria set. If it is solely on money, that only the wealthy can be unhealthy, you could argue that sports/activity injuries also cost, are they to be restricted?

It’s not the example of obesity in this thread that gives concern. It’s the selection of what is and is not a fashionable lifestyle, and subsequently what does and does not merit approved healthcare.

Eating disorders leave me feeling this subject shouldn’t be a simple case of causality, and does stomach food for further thought.


ohh I'm not new, of fat. Just a long time lurker who occasionaly comments.

[guice666]

Originally Posted by Bolehcim

See... My comment about slippery slope came from a different angle...

Does this mean we stop treating "your mom" that caused car accidents because she was stupid, and should have driven better?

Yup. She caused the accident, the bill should be much larger for her.

Originally Posted by Bolehcim

Do we stop treating "your brother" that get an STD, because he was stupid and had sex with a condom that broke?

Yup, he's the dumbass. You learn from your mistakes. He's paying full price now.

Originally Posted by Bolehcim

Do we stop treating child athlete that a was injured, because they should have known better?

Nice vague question there. You didn't make any indication as to what they "should have known better."

Originally Posted by Bolehcim

Do we not treat the "fit, non-smoking" idiot that stepped out his door and got struck by lightning "because he should have known better?"

And you just keep getting more outlandish....

Originally Posted by Bolehcim

Once you take it away for a "should have known better" reason, that opens it up for alot of interpertation... And abuse... And it's a great idea, until it happens to you, or someone you love.

You're overweight, aren't ya? Because these arguments of yours are extremely outlandish in attempts to derail the "fat people should have known better" argument.

[guice666]

You know, I just don't see how people can argue being fat is okay. Please explain that to me?

I may sound quite hostile towards overweight people, but it's not because they are overweight. It's because they feel it's "okay" to be overweight and the world should conform to them (large plane seats, bigger seats in trains, wider doors, etc).

Then you have studies trying to show a genetic link to obesity which is complete bullshit.

You're fat. You should NOT expect health care on the same grade as somebody who's fit. You should NOT expect the rest of the world to increase their chair sizes because you can't fit into one. You should NOT expect any sympathy from the rest of the world.

You're overweight by your own accord.

Now, if you're overweight, but want to (genuinely) loose the weight, I'll give you all the support I can. But, if you make no attempts, you're not getting my sympathy.

[Phisti]

Slight twist to the argument...

http://www.cbc.ca/health/story/2008/...thy-study.html

[ryum]

"You should NOT expect health care on the same grade as somebody who's fit"

that's not what I am saying... All I am saying is that If I am in shape and take a physical and they see I have not been to a doctor in over a year, and almost never get sick, and all that good stuff my insurance and ect should be hell of a lot less than soandso who is at a higher risk of needing to go to the doctor more often


Kind of like car insurance I have not been in an accident when I was behind the wheel since I was 16... No speeding tickets for 5 years... and my insurance is hell of a lot less than anyone else I know my age.

[guice666]

Originally Posted by Phisti

Slight twist to the argument...

http://www.cbc.ca/health/story/2008/...thy-study.html

It's not a twist. It's incomplete and not done right. For starters:

The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.

Plus, it says it's cheaper to live for only 77 years than 84 years. Hum .. no shit? That's like saying it's cheaper to pay on your mortgage for only 20 years than 30. If you really want to cheapest route, just go stand in front of a running train now. By god, it's the absolute cheapest not to live at all! I mean, absolutely no living expenses!

[ryum]

"By god, it's the absolute cheapest not to live at all! I mean, absolutely no living expenses!"

someone doesn't want a nice coffin

[guice666]

Originally Posted by ryum

"By god, it's the absolute cheapest not to live at all! I mean, absolutely no living expenses!"

someone doesn't want a nice coffin

Cremation: just get it over with.