Smokers and obese people will be refused surgery in UK. Agree or disagree?
If someone has a BMI of 30 (which isn't that fat) or above, many parts of the U.K. will refuse surgery to the unwell person for one year, after which time the patient needs to have lost weight and/or quit smoking. This is being done in an effort to cut back on costs for things like knee surgery and pretty much anything else. Your thoughts?
On the one side, why should tax payers pay for the consequences of people who live in health harming ways. On the other side, thinking that health care can be "free" could only result in a move like this. It's probably important to remember that this move is the tip of the ice berg. Too old to suit those who make the decision? No health care. Too handicapped? No health care. Too ...? No health care.
Guess free medicine is "relative" for some unwell individuals who have to pay with their lives. Thanks for commenting, RTalloni.
Multitudinous questions, angles of the issues have many facets, in other words, it's indeed complicated. Lumping all in a uniform system dismisses the uniqueness of each case. Quality of life is usually determined by us, yet, we all die eventually.
Indeed, and we may be the next nation to fall into that type of system, only for us it will be far worse, because our number of working compared to those who don't work is far different than say Canada or even the UK. Those excluded will be higher.
They're not that different, but socialized healthcare in the U.S. is not the answer.
http://www.economicmodeling.com/2013/04 … economies/
I have seen somewhat different stats in regards to official working numbers (went and dug them up myself and didn't rely on any article that may be misleading to support a position). CAN has over a 50% employment rate, USA 33% based on FT lvng wages
The US unemployment rate is at 4'2%, according to DOL, but that probably includes PT workers. The unemployment rate has dropped all year.
True, but those numbers are very misleading because they do not count anyone who has 'dropped out' of the workforce for over a year, and that is literally tens of millions of working age people not included in the 'official' government UE numbers.
I have mixed feelings on this matter. Losing weight/quitting smoking reduces the risks associated with anaesthesia and surgery, and hastens recovery. I speak from experience, having lost around ten pounds prior to a total knee replacement. I was nevertheless still slightly overweight and it took a very long time to recover, compared to my skinnier acquaintances. My former husband, now deceased, had terminal throat cancer and eventually died of a third heart attack. His own worst enemy, he continued to smoke until his death. It may be harsh, but some might question why, with increasingly long waiting lists for non-urgent operations, the NHS should fund people who won’t help themselves and are possibly going to have a poor outcome from surgery.
It's great to encourage people to live healthier lives, but I'm against punishing people, and withholding medical care, to force them.
I'll use your example of knee surgery: how is a person who is overweight supposed to lose, if their knees aren't working properly? Most doctors would recommend a better diet, but diet doesn't work without exercise. Without good knees, walking, running, and most cardio is off the table. How does someone get their BMI under 30 in that situation?
Bad plan. If people need medical care, don't make them suffer for a year.
The bottom line is that there isn’t enough money in the NHS, and there aren’t enough beds, to meet the needs of everyone and priorities have to be set. The ageing population puts added pressure on services. The only answer is to increase taxation.
Another good point, Glenix. The money isn't going to appear out of thin air. On the other hand, how much higher can taxes get before it's a burden to live comfortably, sick or not? It's a tough situation all the way around.
I think it’s a slippery slope and probably not going to be a super effective motivator for people to lose weight/quit smoking for minor surgeries. Being obese or a smoker is already a strain on one’s health, every single day. If being healthy in general was a motivator then they would have changed their lifestyle already. If the surgery is something that they need to survive then it’s a) unethical to withhold it for any reason, b) sometimes exactly the kind of motivation that someone needs, to know that their health is so bad they could die without it, but you need to give them the surgery in order to give them the chance to use that motivation to change their lives.
Plus there are plenty of unhealthy habits and lifestyle choices beyond being obese and smoking. How far do they take it? Anyone who eats more than 5 processed meals a week gets reduced access to healthcare? People who are stationary for a majority of the day? What if you have more than 2 units of alcohol per day? You can have a normal BMI, never have touched a cigarette, and still make choices that result in being very unhealthy overall.
So true. I know a skinny man whose main food staple is movie popcorn (plenty of fake butter) hamburgers and twizzlers. He looks great, but isn't he just as "guilty" as the obese person or the smoker. Still, in the UK, the issue is lack of money.
If you have a system of government run healthcare as in the UK, rationing is inevitable therefore the government has the power of life and death. It's a recipe for tyranny and corruption as in any socialistic type government arrangement.
To answer the question, I would say that I neither agree or disagree because having the government choose who lives and dies is diabolical but I am for personal responsibility also.
I wondered if anyone would mention the other elephant in the room---socialized medicine and it's slippery slope. Thanks for bringing it up wba108.
The health services of both Britain and Australia were excellent under the public heath system. But they were gradually undermined by infiltration of the American private money model. Privatisation has ruined them. Big Money and greed corrupts.
Some folks prefer their private healthcare in the UK. Free healthcare is no longer sustainable on the UK. I don't know how privatization enters into the equation since owners of private insurance pay. I would have to look into your assertion.
Alcoholics and drug addicts should also be refused surgery. People do have to take some responsibility for their own health and well-being and not rely on healthcare professionals to sort out their health problems if they continue to harm themselves with unhealthy lifestyles. If they are considerably overweight or smoke too much to the point that their health is suffering, they have only themselves to blame. If they are knowingly putting themselves at risk and not doing anything to reduce that risk, then being refused surgery is not unfair or unreasonable. There is always a greater risk for an obese person under anesthesia so they wouldn't be doing themselves any favours if they refused to lose weight prior to an operation. My mother was told to lose two stone in weight before a hip operation and she manged it as she understood it would involve less risk. Having said that, I think that an assessment would have to be done on an individual basis depending on the urgency of the treatment required.
Well, that's one way to save money, and teach the "riffraff" a lesson. Two birds with one stone. Nevertheless, I appreciate your having shared your honest view. I'm glad your mother is doing better.
You're assuming someone is overweight by choice. Some medical conditions (like knee problems) come with weight gain due to less activity---and some medications (like the cortisone used for knee pain relief) also come with weight gain. Vicious circle.
That's the thing. Weight gain is a complicated issue, especially in lieu of all the medication some people need. And there are a plethora of other reasons why people gain weight that don't involve too much dip & chips, pizza, etc.
The hospitals here in America are filled with Drug Users, most of them don't work or contribute to the system, also a good number of patien are overweight, I know plenty of nurses, and the stories of 500 pound people who can't get out of bed is many.
Its cost-cutting at best and corruption at worst. End of the day one has to ask who gets benefitted from the #Pounds saved by such curbs? The obvious answer being, definitely not the people.
I do not have a thorough understanding of this but I am pretty sure that NHS, the Health Department, and other stakeholders would have had discussions for months before putting forth such a proposition. Did they also propose cutting taxes that they collect from the sale of these harmful tobacco products or food products that are more likely to promote obesity? Unrealistic! But I am just saying. Healthcare is publicly funded and the tax-payers have every right to question. Drinking, smoking, and perhaps even over-eating are rife in the society. Forget the civilized west, even our restricted third world societies have indulgence at par. Would people go cautious? Would government check the same? Again the answer is obvious.
Cause and effect analogies can be twisted and turned in several ways to put across a point even if it doesn't make sense. End of the day the authorities will always have a way of shoving it down the public throat.
If the population of the UK is similar to America, I'd imagine that would cause a substantial amount of people to be 'set aside' for a year.
This probably would not be such a problem If they hadn't had such a drastic upswing in immigration (up 71%) since 2001, the estimates for 2015 show that one in seven (13.6 percent) of the usual resident population were born abroad, that is 8,570,000 people according to their own Annual Population Survey which puts pressure on all support systems, including healthcare, to handle the influx.
This is also probably going to effect the native born UK members over more recent arrivals, as it is far more likely that they are the ones who are obese. Over-eating and having access to large quantities of processed (fattening and unhealthy) foods is more of a 'Western' problem.
In a Social Welfare Healthcare system, one with a finite amount of resources and doctors, rather than one based on profit and giving service to who-ever can pay, these types of decisions MUST be made.
And part of the reasons why such decisions must be made, is that the system, and those who paid into the system to create it, is set up for a certain sized population, and that population has now had millions of people added to it in a short amount of time, that never contributed into it (and probably still don't).
Great answer. I too wondered about the influx of foreigners and how this has affected the NHS decision. Fact is, drastic times sometimes require drastic measures.
There are huge issues to discuss re this topic and this is an important addition. The questions re an influx of immigrants is often missed in such discussions.
Excellent addition to the discussion. Is the influx of immigrants overtaxing the system to the point of hurting everyone legitimately paying into it? U.S.A. take heed!
"....to large quantities of processed (fattening and unhealthy) foods is more of a 'Western' problem..." Not to mention that it's been American commercialism which has pushed such pseudo-foods, and commercialised medicine. Not good!
Well if all people risking their health should be refused then we can enlarge this group.
A huge group of people visits a doctor on Monday with sport injuries.
Should we still start rescue operations for sailors or mountain climbers?
All this people take risks too is proven by history.
If a child gets an accident because parents didn't check the lights of the bike?
It's a discussion with a lot of aspects
I have no problem with doctors being given more leeway (as long as they have more legal protections from malpractice suits) for determining that a surgery is not absolutely necessary, if it can be alleviated by lifestyle changes; or if they feel the surgery will be more complicated unless the patient makes a life style change. However, I would be against a blanket refusal or delaying of surgery merely based on the fact of any single characteristic without evaluation of the patient. There are several surgeries which doctors feel will need to be performed multiple times, as weight may cause an issue to reoccur. In this case, going after the cause of the issue prior to surgery may give the person more incentive to lose weight. The issue I have with it in the U.S. is that I would hate to see doctors follow a "recommendation" from the AMA, and then find themselves subject to increased lawsuits.
I believe that this should be in effect. If someone who is overweight is needing surgery for what every reason, then they will be required to loose some type of weight. Someone's body who is overweight can not bare to go under anesthesia for to long, they can go under heart failure, or even die. But I do have mixed feelings about this.
I'm not even from the UK and can see the error in this. I can see them trying to push this with "If you're smoking or obese, your unhealthy lifestyle is part of the reason you're unhealthy. Take some initiative to fix yourself before we fix you." However, what if the issue with the person has nothing to do with smoking or obesity? What if it's genetic, environmental, or an old injury causing damage?
I would still think it's BS, but would see what they were going for if they diagnosed the issue as something dealing with smoking or obesity then gave you a year to correct it before helping you, but to just deny medical care because of your body weight or just because you smoke? Did you just start smoking? Are you genetically predisposed to be a heavy person? Sounds like a form of discrimination to me by assuming because of your body type and habit it's directly linked to what you need surgery for. And a panel of health professionals KNOW this. Looks like a new level of selling one's soul to the almighty dollar.
Yes, I agree there is no need for surgery. It needs only self control in on our eating habit and reduce in our cigarettes gradually. We need diet.
I don't understand your answer. What do you mean no need for surgery. Do you think arthritic knees can be avoided in old age by self control? I don't think so. What about lung cancer in a nonsmoker?
That is one more reason to be proud of being an American. Our healthcare system is far from perfect, but they haven't sunk that far yet. Isn't that discrimination?
If you are addicted to alcohol and you suffer from chronic liver disease (CLD) then unless there is a period of alcohol abstinence for three months you are not eligible for a liver transplant because it is presumed that the patient does not have the necessary will power to quit and will follow his previous lifestyle as far as alcohol is concerned thereby defeating the whole purpose for which the transplant was done.
A similar rationale may be extended to knee transplant because if you don't lose weight then the prosthetic joint will not last long or if you are a COPD patient and unable to quit smoking then medicines and respiratory devices won't be of much help.
However such patients are never denied surgery or medical benefits of current medical knowlege on these grounds alone. It is just not possible anywhere in the world because it is unethical to do so.
if you where the minister of health, the smokers and obese will not be exist
You mean only "healthy" people will be operated on? sounds impractical doesn't it?
And what would happen to the taxes these people have paid? will the government stop charging them taxes?
by chigoiyke 8 years ago
yes they should also try to help obese people like the disbale ones, in airports, malls etc.but at the same time it is time for a serious regulation of corporations like Mcdees also,,,fat foods regulation
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