Obese patients and smokers banned from routine surgery in 'most severe ever' rationing in the NHS

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ucfengr said:
Explain to me again how single payer is the most compassionate way to distribute health care…

telegraph.co.uk/news/2016/09/02/obese-patients-and-smokers-banned-from-all-routine-operations-by/
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It will be here soon as well. Right now, the government pays healthcare providers a premium to gather health practices of patients and to “admonish” poor habits. After enough admonitions are given without positive result, the patient is labeled “noncompliant”. As healthcare, already a scarce resource, becomes even more scarce, that “noncompliant” label will be used to deny treatment. In some clinics, it already is.

And it won’t be limited to obese and smokers, either. There are a lot of things providers will “admonish” a person for.
 
Don’t they already refuse non-lifesaving surgery from people if they’re seriously overweight, just because it’s far too dangerous to operate on them until they lose weight? Don’t they turn smokers away for the same reason sometimes - because if you smoke, it takes longer for you to recover from surgery, therefore they tell you to stop smoking for a few weeks before the operation? I’m a bit confused here - seems this isn’t as simple as “rationing” surgeries, but might actually be a case of “let’s not do surgery on people if it can wait until they make changes to their lifestyle and therefore the surgery is less risky for them”.
 
Ridgerunner said:
It will be here soon as well. Right now, the government pays healthcare providers a premium to gather health practices of patients and to “admonish” poor habits. After enough admonitions are given without positive result, the patient is labeled “noncompliant”. As healthcare, already a scarce resource, becomes even more scarce, that “noncompliant” label will be used to deny treatment. In some clinics, it already is.

And it won’t be limited to obese and smokers, either. There are a lot of things providers will “admonish” a person for.
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But expressing concern about someone’s weight is ‘fat-shaming’ and we need to support body acceptance.

Legalization of the smoking of marijuana is pushed, even portrayed as a medical treatment (without the usual FDA required studies on efficacy compared to current standards of care, dosages, and interactions with other drugs).
 
Costs must always be contained in Healthcare.

No I don’t like this method since unduly targets the lower class from what might be basic essential care.
 
sugarmouse said:
Don’t they already refuse non-lifesaving surgery from people if they’re seriously overweight, just because it’s far too dangerous to operate on them until they lose weight? Don’t they turn smokers away for the same reason sometimes - because if you smoke, it takes longer for you to recover from surgery, therefore they tell you to stop smoking for a few weeks before the operation? I’m a bit confused here - seems this isn’t as simple as “rationing” surgeries, but might actually be a case of “let’s not do surgery on people if it can wait until they make changes to their lifestyle and therefore the surgery is less risky for them”.
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On the one hand, there’s some merit to this argument. Obesity is a serious risk factor for many surgeries. Even when I had a non-elective and completely necessary surgery, I was warned repeatedly that my weight and pre-existing health problem would make recovery much more difficult (and the doctors were right).

But on the other hand, we’re talking here about hip and knee surgeries. These aren’t life-saving, but it’s awful hard to lose weight and stop being obese if you can’t exercise due to knee or hip pain, KWIM? Sort of a catch-22 for those patients. Not to mention the serious pain that accompanies the injuries or conditions that lead to a need for surgery.

I’m OK with healthcare providers deciding that a particular patient needs to wait for surgery due to XYZ. They do this all the time in the USA with obese patients seeking bariatric surgery, for what it’s worth – they require that the patient lose a certain percentage of weight prior to surgery to prove he or she is capable of lifestyle change. But I’m not OK with blanket decisions saying if you’re above a certain BMI, you can’t have surgery.
 
sugarmouse said:
Don’t they already refuse non-lifesaving surgery from people if they’re seriously overweight, just because it’s far too dangerous to operate on them until they lose weight? Don’t they turn smokers away for the same reason sometimes - because if you smoke, it takes longer for you to recover from surgery, therefore they tell you to stop smoking for a few weeks before the operation? I’m a bit confused here - seems this isn’t as simple as “rationing” surgeries, but might actually be a case of “let’s not do surgery on people if it can wait until they make changes to their lifestyle and therefore the surgery is less risky for them”.
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If individual doctors do not want to operate for whatever reason, I am okay with them saying no, but this needs to be decided by the patient and the doctor on an individual basis, not by a government accountant deciding for the entire country.

This is exactly why there is such resistance to a NHS like system in the US. They spent themselves into a hole and now accountants are making medical decisions for the entire population. It is a terrible idea.
 
I guess this is the proverbial “pain pill” and the death board, that everyone was concerned about, manifesting itself. I didn’t think they would be that fast about it. This is what happens when the government takes control.

My insurance company [not through the exchanges] has been trying to contact me through “health coaches,” for the past three years. They want to ask a bunch of nosy questions in return for giving me spending credits I don’t even use, as I don’t have an HRA.

This is just so they can turn around and make “suggestions” on how I should do something. I can get suggestions from my Doctor if I want them.
 
This was so much in my heart today as I watched an old farmer struggling to get into his car. I was in mine, parked next to him by a shop. He had no idea I was there. He was clearly in utter agony.

He is on a waiting list for hip surgery and is not a slim man. One hospital has refused to treat him so he is on the waiting list at another.Not a 100 per cent sure why but he stands no chance of losing weight when he is all but immobile .Meanwhile he is in great pain and losing his mobility,

Waiting lists here for surgery for "public patients " are appalling. They are their own "selection ’ methods
 
Bill_Martin said:
If individual doctors do not want to operate for whatever reason, I am okay with them saying no, but this needs to be decided by the patient and the doctor on an individual basis, not by a government accountant deciding for the entire country.

This is exactly why there is such resistance to a NHS like system in the US. They spent themselves into a hole and now accountants are making medical decisions for the entire population. It is a terrible idea.
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These decisions can have a solid medical basis, but in socialized medicine the doctor becomes a government employee. It is bad enough that doctors are paid by insurance companies rather than the patient. That is more than enough interference in the doctor patient relationship.

Mandatory health insurance which was attempted in the ACA eliminates a real source of competition where a competent and prudent consumer could bargain directly with a health care provider and use the savings from not having to pay for insurance to cover the bill. The choice to use only a major medical policy that provides all that many people need was taken out of the market. ACA is bad news both financially and medically.
 
Rosebud77 said:
This was so much in my heart today as I watched an old farmer struggling to get into his car. I was in mine, parked next to him by a shop. He had no idea I was there. He was clearly in utter agony.

He is on a waiting list for hip surgery and is not a slim man. One hospital has refused to treat him so he is on the waiting list at another.Not a 100 per cent sure why but he stands no chance of losing weight when he is all but immobile .Meanwhile he is in great pain and losing his mobility,

Waiting lists here for surgery for "public patients " are appalling. They are their own "selection ’ methods
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The compassion of government health care. :nope:
 
Ridgerunner said:
It will be here soon as well. Right now, the government pays healthcare providers a premium to gather health practices of patients and to “admonish” poor habits. After enough admonitions are given without positive result, the patient is labeled “noncompliant”. As healthcare, already a scarce resource, becomes even more scarce, that “noncompliant” label will be used to deny treatment. In some clinics, it already is.

And it won’t be limited to obese and smokers, either. There are a lot of things providers will “admonish” a person for.
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How long will it be before citizens here in the US who exercise their second amendment rights are denied health care, or their children are?

Jon
 
Its nice to see people aren’t doing their usual mantra of, “Well, they chose to live that way, they shouldn’t get help unless they change their ways.”

My response to any (Christian) person that would say that is, “Doesn’t Jesus give us every chance for forgiveness? Even after his Passion, and countless persecutions through time, he still forgives us.”
 
A few years ago President George H. W. Bush was quoted as saying “Government run health care will be as efficient as the Post Office and as compassionate as the IRS.”
 
I saw this in the news last night. it isn’t on government rationing. It’s a self rationing idea or maybe better said a common medical practice that likely will cost a good amount but provide little benefit to most patients.

On the obese patients and smokers not receiving quick treatment, to some degree it has me confused. Health officials need to keep costs in mind. Choosing this area though doesn’t see to add up to me. There isn’t all that many effective ways to loose weight long term. Diets and exercise can help with weight loss, but frequently are reported to be short term fixes. I remember reading an article were around 95% of people put the weight back on after loosing it following a diet. Ironically smoking seems to be one of the better ways to help keep weight off.

The article I saw concerned dental exams. I thought it made sense.

“Going to the dentist every six months is unnecessary, says UK’s top dentist”

telegraph.co.uk/news/2016/09/07/going-to-the-dentist-every-six-months-is-unnecessary-says-uks-to/

snippet from the article:

Patients must challenge dentists who insist they return for a check-up every six months, the country’s most senior dentist has urged - amid warnings that dental treatment is becoming a “rich man’s hobby”.

Dr Sara Hurley compared dentists to mechanics and said patients should not “blindly adhere” to instructions to come back frequently.

Current guidelines say that time between check-ups should depend on the state of a patient’s teeth, with intervals of up to two years for those in good oral health.

But the chief dental officer for England said too many dentists are failing to stick to this and seeing patients more regularly.

Private check-ups can cost up to £120, while NHS visits are £19.70.

“It’s down to patients to say ‘why do I need to come back in six months?’” she said, suggesting patients should be less trusting if they were told to keep coming back.

“If you go to have your car MOT, and he says, come back in six months, do you blindly adhere to that advice?” she asked.

Last year an investigation found that Britain’s five highest earning dentists have average earnings of almost £700,000 a year each.

Around half of adults visit a dentist every six months, with almost 40 per cent paying for a private dentist.

Speaking at the NHS Expo conference in Manchester, Dr Hurley was challenged about the costs of dental visits and the money being made by dentists…
 
sugarmouse said:
Don’t they already refuse non-lifesaving surgery from people if they’re seriously overweight, just because it’s far too dangerous to operate on them until they lose weight? Don’t they turn smokers away for the same reason sometimes - because if you smoke, it takes longer for you to recover from surgery, therefore they tell you to stop smoking for a few weeks before the operation? I’m a bit confused here - seems this isn’t as simple as “rationing” surgeries, but might actually be a case of “let’s not do surgery on people if it can wait until they make changes to their lifestyle and therefore the surgery is less risky for them”.
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Many doctors won’t operate on the super morbidly obese because there is a good chance they will die while under anesthesia. It’s not the surgery that is dangerous.

And this rationing of government health care is not for the super morbidly obese, but is for anyone even labelled “obese”, which is MUCH lower level. They will cut off anyone with a BMI over 30. To give you an idea what a 30 is, for a 6 ft tall man, who weighs 215lbs, he is at a BMI of 30.

For a 6ft tall man, 215 is overweight, but not very much, especially if he is muscular.
 
zz912 said:
Many doctors won’t operate on the super morbidly obese because there is a good chance they will die while under anesthesia. It’s not the surgery that is dangerous.

And this rationing of government health care is not for the super morbidly obese, but is for anyone even labelled “obese”, which is MUCH lower level. They will cut off anyone with a BMI over 30. To give you an idea what a 30 is, for a 6 ft tall man, who weighs 215lbs, he is at a BMI of 30.

For a 6ft tall man, 215 is overweight, but not very much, especially if he is muscular.
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This is what I do not like about BMI. It does not discriminate between fat and muscle.

I know a former Air Force colonel who had about 6% body fat. Just looking at him, you would know that he is extremely fit. Yet according to BMI, he is overweight.
 
Sarcelle said:
This is what I do not like about BMI. It does not discriminate between fat and muscle.

I know a former Air Force colonel who had about 6% body fat. Just looking at him, you would know that he is extremely fit. Yet according to BMI, he is overweight.
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BMI is especially inaccurate for tall people. Every one of the superbly conditioned athletes in the NFL is overweight if you only use BMI. It sounds to me like this was proposed by jealous little accountants rather than medical professionals.
 
I think it’s apples and oranges to compare the £120 with the ‘out of pocket’ £19.70 for NHS service. How much do the accountants supplement the £19.70 with additional government funding.

I agree the Govt should educate people on recommended frequency of dental visits. I also don’t change my oil on the short cycle recommended by the oil change guy.

That said, I expect the high salary dentists owned large practices, and were making their money as small business owners more than doing dental work.
 
Trader said:
BMI is especially inaccurate for tall people. Every one of the superbly conditioned athletes in the NFL is overweight if you only use BMI. It sounds to me like this was proposed by jealous little accountants rather than medical professionals.
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The scale is incredibly unfair to people too big to be stuffed in lockers or lifted off the ground by the elastic of their undies.
 
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