Health issues

[Rapscallion]

http://www.bbc.co.uk/news/uk-england-devon-30318546

In short, if you're in a certain area of the UK there are plans to encourage people to lose weight or stop smoking or not get medical treatment. I've heard of similar in the US with the vagaries of insurance companies, but this is the first I've heard whereby the NHS is considering such as this.

I pay regularly via National Insurance for treatment when I need it. However, if this were to come in around me and I would be affected by it, should I be able to claim a discount and/or back income from the system?

Should health insurance/nationalised health be partly down to personal responsibility for your own health?

If so, should we clamp down on the less healthy food out there and the merchandising thereof?

Rapscallion

[Andara Bledin]

I have to agree with the statement from the Royal College of Surgeons:

The need for an operation should always be judged by a surgeon based on their clinical assessment of the patient and the risks and benefits of the surgery - not determined by arbitrary criteria.

Losing weight, or giving up smoking is an important consideration for patients undergoing surgery in order to improve their outcomes, but for some patients these steps may not be possible.

A blanket ban on scheduled operations for those who cannot follow these measures is unacceptable and too rigid a measure for ensuring patients receive the best care possible.

Honestly, this is a poorly thought out measure intended to reduce costs that will only result in increased costs down the line.

What they should be doing is increasing education and encouraging all regular visits so that the more preventable and easily treated when caught quickly issues are actually caught quickly when they will cost less to everybody involved.

[BlaqueKatt]

A ban like this would've killed my 68 year-old mother.

She smokes, is diabetic and at the time of her surgery was overweight.
Her large intestine exploded due to diverticulitis and she required a colostomy.
And the only controllable risk factor is eating a high fiber diet, which she did for most of her life, her diabetes, smoking, and weight had exactly zero to do with her condition developing, and so are irrelevant to her need for surgery.

Her diabetes is managed well with diet, and she's lost over 100 pounds since the surgery, so by giving her the surgery she's become healthier.

[Andara Bledin]

Actually, your grandmother would have gotten the surgery she required.

Emergency situations have no change. It's only surgeries that can and already have scheduling delays (such as knee/hip replacement) that get deferred for such issues.

Which is still incredibly stupid since reduced quality of life leads to an increased desire to engage in the very activities that are the problem, making it more difficult to change the behaviors than otherwise.

I mean, how much sense does it make to go, "Oh, hey, you can't really walk because your hips are shot, but we're not going to let you have that replacement surgery until you drop that extra 25 lbs despite exercise being extra difficult to do with your condition."

[Seshat]

My biggest problem with the medical community putting restrictions on people unless they do X (lose weight, stop smoking, whatever); is that they rarely actually help the patient do X.

Despite working at it her whole life, my mother was overweight - until she was FINALLY referred to, and treated by, an endocrinologist. Fix the problem, and the excess fat finally responded to diet/exercise as it 'should have' done all her life.


I know some people - perhaps many people - smoke because they want to, overeat because they want to, and so forth. But if you're a doctor, you can't just assume it. And you can't make medical decisions that have such a severe influence on people's lives without at least having a colleague check.

Or at least, in my opinion you shouldn't.

[HYHYBT]

You shouldn't. But it's the same argument, or at least one of them, people use when complaining about fat people riding the electric carts in stores.

[s_stabeler]

it's extra stupid when they're using BMI as the way to tell if you are overweight- BMI is NOT an accurate measure of if you are overweight or not- because muscle is denser than fat, so for two people of equal size, the body-builder will actually be heavier.

also, apparently a board of clinicians will be able to agree a case is exceptional- yeah, as if that won't mean that someone who is rich, famous or the case is high-profile won't be able to get treatment, while someone who needs it more, but isn't as high-profile won't be able to. (I may be about over-sensitive about this, because my Gran used to be in a nursing home that the NHS refused to contribute towards the costs, despite the fact she was bedridden and needed help with just about everything. Therefore, we had to pay for the nursing home when arguably, the NHS should have covered it, since it was for health reasons. We were told she wasn't ill enough, At that point, there had already been one scare when we had been told she wouldn't survive the night. She survived about another 8 or 9 months.)

so yeah, I am increasingly unsurprised at the Coalition's unpopularity right now- they seem to be entertaining utterly stupid suggestions. ( one that has thankfully been dropped AFAIK was for employees to be able to accept one-off payments in exchange for giving up employment rights- such as against unfair dismissal. Yeah, as if they wouldn't become expected to get a job. (juts like virtually everywhere expects you to opt-out from the Working Time Directive)