This is from the UK, but you know conversations like this are going on in the US at HMOs and insurance companies.
Smokers, drinkers and the seriously overweight may be denied medical treatment if their lifestyle makes it ineffective, the Government’s treatment watchdog said yesterday.
The National Institute for Health and Clinical Excellence (NICE) said that doctors who considered that a particular treatment might not be effective, or cost-effective, because of the lifestyle of the patient, may be entitled to withhold it.
My doctor is a fat guy that smokes. Physician heal thyself must no longer apply.
Except in some rare exceptions, the three items mentioned – obesity, alcoholism and smoking – are based on personal behavior, and are only resolvable by personal behavior changes. Why is it unreasonable to expect cooperation from the subject if the subject is demanding treatment? If a person is too obstinate or negligent or selfish to not want to participate in a program that treat an ilness direclty related to their behavior, then that is their choice, but don’t ask to be treated for free for your other ailments. If you weigh 400 pounds, you need to lose weight. No debate.
I insist that any nation that considers itself civilized must provide basic health coverage for all of it’s citizens, but at the same time have personal behavior be part of the coverage equation. Behaving in ways that are unhealthy or involve personal voluntary risk should not be covered by an insurance program paid for by the general population. So for example, getting hip replacement surgery due to arthritis would be covered, but breaking your hip while on a ski vacation wouldn’t. The arthritis just happened, while falling down a slope was your choice.
I agree with Awake,
People come up with excuses all the time for the self distructive things they do to themselves. This is honestly the only stumbling block for me to accept a nationalized health care system.
Why should I pay one dime for someone who listens to no one and then expects thousands if not millions of dollars of healthcare.
How about AIDS or venereal disease treatment for those with lifestyles conducive to their acquisition and spread? How about soldiers who participate in lifestyles that often cause loss of limbs, organs, etc? Coal miners and black lung? Motorcyclists?
(Actually, I think the idea isn’t an unreasonable one, but one must consider the consequences).
OK, so you break a limb from skiing, which could otherwise be considered an active, healthy sport, and you are denied treatment because it’s “your fault”. C’mon, get real. Yeah, if you run right back out to the slopes the next day and do it again, you need more than limbs fixed, you need your head examined. Well, that ought to be covered, too, shouldn’t it?
I hate to say this folks, but you can stop drinking, you can stop smoking, but you can’t stop ingesting food and liquids. The fault isn’t because nearly half of Americans are just lazy slobs who can’t control themselves. We live in a society that encourages lousy eating habits. We make fast food cheap and easy, we work in increasingly sedentary jobs that don’t require leaving your cubicle, let alone your building (and how many folks do you know who eat at their desks?). You can’t walk to the key places you need to visit regularly because of the way we organize our communities. And have you actually tried to “shop healthy” in your average grocery store? Yeah, I’m sure it’s no trick for you average San Fransicans, but it not as easy elsewhere.
Before you folks get all uppity about denying health care to some, let’s examine the more systemic issues and address them. Here’s some ideas: stop growing corn for food. Stop using growth hormones on cattle. Put labels on restaurant dishes that exceed 300 calories, and tax those dishes (I’d be happy to pay more when I’m really hungry and expect more on the plate). And hey, why is sugar so darned cheap?
That being said, I’ve known people who seem like they did everything they could to do themselves in, but really, these are few and far between. More and more people are simply making poorer and poorer choices because its EASY to make them. But the choices regarding medical treatment should be left to the doctors, not the HMO’s, not the insurance companies, and not the government. These groups should be working on the systemic issues, let the health profession deal with individual choices. Let Aetna go after the fast food chains and the tobacco companies, and let my family physician kick my butt about losing 20lbs.
Next topic.
I agree with Awake & Rob and understand James’ concern.
I am a pratical libertarian, and think we have to start somewhere. Pick a couple of glaring examples, those that cost the most (in the aggregate) , and are the most preventable by changes in personal behavior. I’d start with smoking, obesity and possibly alcoholism (all of which I’ve been very guilty of at some point). The give a grandfather type clause, say 5 years to correct your condition. After that, it aint covered.
If private insurance companies want to offer coverage, fine, but the general taxpayers should have nothing to do with it.
Yes, I know that people will generally get the level of care that they can afford, but public health care money (like ALL gov’t money) is limited and we have to best decide a fairness level that we all can live with.
kzoo…I agree. The weight on people that we are seeing was UNHEARD OF prior to the introduction of hydrogenated oils (1921 was the debut year for Crisco, took 50 years for the junk to be in every food imaginable). And, honestly, it’s not that we get so much less exercise than the average housewife did in the 1960’s!! Consider this: What was a size 12 in the 1940’s is now a size 8. We’ve supersized the clothing to fit our overly ample frames.
There was never, and has never been a study to determine if hydrogenated oils CAN BE used by the human body. That extra atom of hydrogen changes what it is, and who knows what the body does with it. It’s not the same fat. (Just like what happens when you add an extra atom of oxygen to water H2O…you can have hydrogen peroxide H2O2!! Try drinking that when you’re thirsty!)
The fatties may not be fat because of a personal choice, but because the manufacturers, advertisers, and government lack of oversight has allowed almost everything to contain hydrogenated oils, cheap sugars, and soy protein extenders. It’s obvious to ME that these foods are killing us. Look around…..used to be that the ultra-obese were oddities, now they are everywhere!!! And, even BIGGER than the carnival sideshow fat-lady freaks from the early 20th century! (A weigh in of 400lbs was average for these “freaks”.)
….I can’t see how Americans can be penalized for bad health caused by current manufacturing practices that poison us! Make the big conglomerates pay for our health insurance if they insist on foisting this faux food on us!
I think a tax on refined sugar is a splendid idea. It’s very cheap at the moment, so even a substantial tax wouldn’t make it so people couldn’t afford to have any. It would really just be making it as “expensive” as it is in the natural world, where you have to pick the berries from between the thorns or fight the bees. That’s where our instinct to highly value sugar came from. So we can balance our instincts with the modern world, while simultaneously funding government.
I completely disagree that people don’t deserve medical care if they’re X, Y or Z. Nobody wants to need medical care; nobody tries to be sick. Disease is by its nature what happens when things go wrong, when there are problems and mistakes. We should treat everyone who’s sick, and we should feed everyone who’s hungry.
You simply can’t buy private health insurance above a certain BMI unless you pay astronomical prices. Many carriers will deny you period. If you have preexisting conditions you’ll have a handful of riders. There is a dichotomy in this country that needs to be settled. Are destructive behaviors a disease or not? No one chooses to be morbidly obese, or chemical addictions. With every policy cost increase you hear from angry people that are healthy and dislike paying for less healthy individuals. News flash to them, distributive risk is the nature of any insurance. My group plan rate has increased for 5 years, and the deductibles and out of pocket has gone up the last 3 years. By the way most heart transplant candidates will be kicked off the list if they test positive for nicotine a few times.
Wow what a breath of fresh air. People need to take responsibility for their actions – that include eating, smoking, and drinking too much. I won’t treat patients if they have certain habits because I would be doing them more harm than good and wasting time, money and other resources. The healthcare system will implode soon with the baby boomers swamping the system. Something needs to be done. “It’s not my fault” doesn cut it anymore.
abInteresting…I guess, but I guess I’m kind of selfish because I can’t stop thinking about myself (and millions of other Americans) that don’t have any insurance, bad or otherwise, and can’t really foresee any situation as long as I live, where I would be covered.My only hope is that the medical industry will price itself out of its current business model (ie: $5000 a day in the hospital, $100 for an aspirin, etc).
If I did have some coverage, I guess I wouldn’t jeopardize it by virtually killing myself in the first place with tobacco, and awesome fatness, but then since I actually like being alive, healthy, and being able to tie my own shoes, I tend that sort of stuff already.
There are a number of laws that would be passed along these lines if national health care passes. A court upheld a nonsmoking requirement for employees(at home), because of health care costs.
When a girl dies of complications due to anorexia ppl say “poor girl, she died trying to be pretty.” But when a girl dies because of obesity problems ppl say “thank God that cow died!” Think about it.
Angel, NOBODY says that. Deathe due to eating disorders is bad either way.
I’m tired of all this crap from insurance companies about the cost of people being fat or smoking. OK in a world where nobody smokes or over-eats we all still die of something. You still spend you final days being treated for geriatric disease or cancer. And the treatments for that are MORE expensive than the treatments for heart-attacks (smoking and overeating kill most commonly by heart attack according to the AHA) Its all a crock to get more federal money. Don’t forget they a private “for profit” companies.
The botton line is that health and longevity have improved dramatically in the last 50 years. This is all a way for insurance companies and employers to big deal their way out of covering perceived risk groups. AND – It is only a small step from this to pre-employment DNA screening. Realize that much of the pressure for age descrimination on the job comes from “benefit providers”.
What an oximoron that term is.
I guess my wife and I qualify as a pair of those big fat slobs that almost everyone here is railing on about. Between the two of us we must weigh in excess of 1200lbs. Two of our three children are morbidly obese and I admit that we eat far too much. We’ve all been on every diet imaginable and none of them have give us any lasting results. Most people have no idea what it is like to be so big that the simple act of being in public becomes a nightmare. People stare are rude and downright inconsiderate of our dignity. My wife who is a teacher was recently pushed to the grownd by several female students just so they could make fun of her because she was too heavy to get up unaided. I’ve been the brunt of every fat joke imaginable throughout my life and even my young daughters have been cruely and sometimes violently taunted by classmates and even adults on occassion. I guess what I am trying to say is that just because we are fat and we eat too much at times we are no less human and being so we are deserving of basic human services the same as everyone else. I’m sick and tired of being everyones fat whipping boy while individuals that drive recklessly, dable in illegal drugs, engage in unprotected sex and so on, and doing so rack up millions in hospital bills yearly, are basically given a free pass. This is unfair and only exists because we fat people are the safest and most convienent target for your misplaced predjudice.
#17 – Jim Scarpille
The best thing you guys can do is to lose weight. I’m dead serious.
Nice cameltoe on the left-hand gal.
This whole “deny treatment for lifestyle choices” is one big slippery slope.
It’s easy to pick on 700-pound people, 4-pack-a-day smokers, and winos.
But allowing hip replacements for arthritis, but not for skiing-induced injuries? Asking for trouble here.
What if the arthritis is a result of years of marathon running? If you get hit by a car riding your bike, is that a “lifestyle injury”? If you get salmonella from eating fresh vegetables? Skin cancer from working outdoors? A heart attack doing step aerobics? Carpal tunnel syndrome from too much time at the keyboard?
All of these health issues could have been prevented by changes in “lifestyle”.
Slippery, slippery slope.
#20 – Bobbo
>>Nothing is more responsible or fair than
>>making choices with identified consequences
What about people with metabolic syndromes who are morbidlyl obese in the absence of overeating?
What about the marathon runners? The bicyclists? The landscaping guys? The step-aerobicizing soccer moms? The typists?
Should they be putting money in the jar too, to cover health issues that may result from their “lifestyle choices”?
Don’t be a coward, Bobb. Going after the stereotypical 700-pounder who has Big Macs for breakfast and Whoppers for lunch and dinner.
Most health problems result from something less clear-cut, if identifiable at all.
Ah, Bobbo. You’re such a simpleton.
Sure, the alkie who spends every night at the bar waiting for his second liver transplant should be turned down.
How about the woman that took birth control pills and gets a blood clot? Or the landscape guy who develops skin cancer after he’s moved on to another job? The marathon runners? Tennis elbow? Shark bites from swimming in the ocean?
The list of “lifestyle choices” that can incur medical costs is endless.
You keep harping on the extremes, but that’s not where the abuse is going to happen. It’s the middle two standard deviations in either direction who are going to get fucked.
And that’s even in a country with “socialized medicine”. Imagine what will happen here where medical care is bottlenecked by the denial-of-health-care industry. You’ll be denied treatment for lung cancer because you ate lunch in a park where people were smoking.
Bad, BAD idea.