Don't treat the old and unhealthy, say doctors

I also found myself wondering if this is what the US has to look forward to. Would we reach a point where some people would not "qualify" for health care?

There has been serious consideration of withholding medical care from the elderly in the U.S.

We haven't jumped on that wagon yet, but the subject comes up at most discussions about lowering the cost of health care.

Health care paid for by your neighbors should improve your health. It definitely should not encourage or tolerate an unhealthy lifestyle.

Dr. Know, this seems reasonable on the surface but as I think about it, questions come to mind like:

Who defines an unhealthy lifestyle? Is someone who doesn't exercise living an unhealthy lifestyle for instance? Is someone who overeats high fat foods but isn't obese living an unhealthy lifestyle since it may contribute to heart disease? Is someone who works in high risk jobs living an unhealthy lifestyle? What about kids who participate in athletics, aren't they subject to more injuries than kids who don't.

It seems to me that this is a slippery slope type problem and is one of the many complex issues involved in socialized health care. Perhaps the biggest problem is from the article quote above:

with most saying the health service cannot afford to provide free care to everyone.

I just struggle with the concept that socialized medicine is the right answer at all.

EPH289 you speak wisely! Your questions are and should be addressed when discussing withholding health care. The resulting eventuality should be that we decide that any human being alive deserves health care. The reason being that we really don't know what their fate is, an obese smoker just may outlive the yoga instructor due to bad genes or a car accident. If we start judging people by their hereditary makeup we are reverting back to a really bad era of America's culture. Prejudism should not be tolerated in any arena. We should be working against it and this article reeks of it!

Slippery slope indeed.

Would you also refuse medical assistance to gays with AIDS?

After all, if you act responsibly (so we are told), you don't get AIDS.

This is one of the problems with nationalized health care. But, hey, if you want to start refusing medical assistance to those who you don't THINK are living healthy lives, go for it.

Or, once we are able to accurately forecast genetic disposition to disease, should we just stop treating them? After all, did their parents act "responsibly" in having kids when they knew they could pass on genetically transmitted ill health?

Gads, the list goes on and on and on.

Invariably, when the government gets involved in the provision of allegedly "free" services, this sort of argument abounds.

I also found myself wondering if this is what the US has to look forward to. Would we reach a point where some people would not "qualify" for health care?

We have been there for some time. Try to get cutting edge care without insurance and/or a fat bank account sometime.

Well, Scott I am not sure you can say "national health care" and "cutting edge care" in the same sentence, unless the sentence was contrasting the two.

Well, Scott I am not sure you can say "national health care" and "cutting edge care" in the same sentence, unless the sentence was contrasting the two.

I feel we can certainly use it together in many respects here with the NHS. They have some amazing treatment depending on what you have. Luckily, being treated on the NHS does not necessarily mean worse. It just means less flexibility and longer waiting.

Try to get cutting edge care without insurance and/or a fat bank account sometime.

Tell me about it. We are trying our best to stay very healthy in our house, 'cause we don't have either of the above. :-)

we already have univercial health care for the elites only.
why we give congress who makes 5 times the median income free and the best health care ever makes no sense to me..
maybe one of you anti univercial health care folks cna explain why it is ok for these guys making 200k a year and being flow to enlgland for a day of golf by lobbyiest are getting health care on my dime.

Ms. Cyprah:

Is not "less flexibility and longer waiting" in fact, "worse?"

Joules:

maybe one of you anti univercial health care folks cna explain why it is ok for these guys making 200k a year and being flow to enlgland for a day of golf by lobbyiest are getting health care on my dime.

Do you have to be anti universal health care to despise what our "elected" representatives are doing? Have you ever looked at their retirement package? LOL.

Funny how the politicians never discuss the perquisites they get.

And people think that a politician will spend three million dollars to get elected and NOT expect a huge rate of return on their investment?

What is P.J. Barnum said?

Is not "less flexibility and longer waiting" in fact, "worse?"

Yes, it is in one sense, but not if we are really talking about the treatment being 'cutting edge'. The wait might spoil it, but that does not stop the overall quality, I think.

With the new RFID tags the authorities will know every time you enter a liquor store, tobacco shop or health club. The things you buy at the grocery store will be on a registry.

With the new universal electronic records (it is in Congress), they will know everything about your body.

That's way too Orwellian (no offense George) for me. I will become an expatriate I will denounce this country, and move to one that is truly free. Australia ... or New Zealand, perhaps.

Scott:

Truly a slippery slope, especially given the knowledge we have of genetic dispositions now.

Should parents who have known genetic dispositions (or their family does) even be allowed to have children who will, eventually, bog down the system?

I totally agree. It's about preventative medicine. I see the point, however, with not treating people who have in a sense "put themselves" in their position of needing a lot of extra health care. I don't think it's feasible to take away their right to medicine.

When does their right to a risky life-style impose too much on their right for health care paid for by those maintaining a healthier lifestyle?

Communism fails because people get tired of working harder that others, yet get the same pay. As a worker proved his ability his quota went up yet his pay did not. Increasing the taxes to pay for the health care of others using more will eventually wear on people.

Scott:

Oh, I think George is still alive and kicking as evidenced by these proposals.

Can it really be worse than the current health care system in U.S.?

Of course it can, infinitely worse. The fact is that all systems have benefits and detriments, including our system.

People just aren't looking at the benefits of our system, to date.

I am reading these comments and see some great misunderstandings

1. there may be medical reasons why one is morbidly obese, etc.

There are some very erroneous comments - some people's bodies produce more steroids, hormones, etc reducing their need for exercise, etc. to remain 'healthy' (for example, a skinny friend of mine can eat an entire extra large pizza and not gain an ounce of weight) The only standard is that there is no standard

2. If smoking is a problem, outlaw it. (let me say that my understanding is that tobacco itself is not the problem; American cigarettes are covered with chemicals from sprouting - fertilizers,pesticides, etc. - and again when 'processed' into cigarettes - flavor enhancers, aromatizers, etc. - and its the chemicals that are the problem. The same is true when the government gives us tests of marijuana - it's not naturally grown

if heavy drinking is a then outlaw it; etc. The deal here is that with health care we are dealing with the effects rather than the causes; health care is not where you make these decisions, you make them at the cause.

but denying health care to the elderly??????? they did something wrong by failing to die earlier, by not being rich, what???

Next you are going to deny health care to any couple who has more than 2 children (at public expense - all those pre-natal visits, delivery room, etc. Shameless!)

3. (and here's the biggie) ECONOMICS 101 --

any economic system is an allocation system and the issues that arise are ones of scarcity - not enough resources for everyone to have everything. The allocation issues are that (a) the government ought NOT be judging people or (b) those who have garnered more than their share whether legitimately or not, want to protect that by reducing contributions, reducing health care to those who 'have not'. This is kind of a winners vs losers argument.

We have this scarcity allocation issue in our present system - consider transplants (kidney, liver, etc.) There is a shortage of transplantable organs so the doctors decide who 'deserves' the transplants by who would benefit most - if you are already in bad health for whatever reason you don't qualify.

There is a cheat - given money you can go outside the system; or find your own donor - and its these cheats that allow those who have more than their share of the resources to continue having more than their share. These cheats are what some people consider 'the benefits of our system' and they ONLY apply to those who can afford them.

I am personally for universal health care because I believe that everyone deserves health care - not just the cheaters. Ths is a personal moral decision; but from a political point of view I don't believe that health should be apportioned by how much you inherited or stole from others, etc.; health should be a right.

health should be a right.

How can "health" be a right? Maybe Health Care, but not health. Even if you go with "health care," how can that be a "right?"

It seems to me lots of folks want lots of things (plug in your favorite) to be a right.

But doesn't the creation, out of whole cloth, of so many "rights" diminish the ability to protect true "rights?"

in America we started with life, liberty, and the pursuit of happiness.

I posit that health (health care. not having poisons in the food and water and air, etc.) is a part of 'life', that lack of health equals death

health means more than just health care.

I like it! So, when I get sick, who do I sue for violating my civil rights?

1. there may be medical reasons why one is morbidly obese, etc.

There are some very erroneous comments - some people's bodies produce more steroids, hormones, etc reducing their need for exercise, etc. to remain 'healthy' (for example, a skinny friend of mine can eat an entire extra large pizza and not gain an ounce of weight) The only standard is that there is no standard

There may be, but there usually is not. Hence the success of gastric bypass surgery. Eating less food, makes fat people lose weight.

Your skinny friend may be able to eat whatever he wants and never gain weight, but that does not mean he is deathly; it only means that he is presumably a normal weight, his blood pressure and cholesterol could be elevated.

In US society, if you want to be and remain healthy, you need to put effort into it. You need to exercise, and you need to follow a diet that does not consist of convenience and packaged foods. Many people are not willing to make that effort.

Griff:

I like it! So, when I get sick, who do I sue for violating my civil rights?

Exactly.

There are many, many people in this Country who want to make everything a "right"

Unfortunately, there are feckless politicians who pander to such crap.

There is certainly *some* merit to the ideas being tossed around, but I think it needs a lot of work.

When you're working with finite resources (which they clearly are, there's only so many doctors/hospitals/etc), you have to optimize. In the case of something like socialized medicine, it *does* make sense to focus on helping those who can most make use of that help.

Granted, how to actually pull this off is a huge question, and the details incredibly important, but as a concept, helping those who stand to benefit the most (and perhaps also who stand to help others the most) is not a terrible idea.

Granted, how to actually pull this off is a huge question, and the details incredibly important, but as a concept, helping those who stand to benefit the most (and perhaps also who stand to help others the most) is not a terrible idea.

That is a scary statement when considered carefully.

On the other hand, if someone genuinely wants to change their unhealthy habits, however acquired, why shouldn't we help them if we can?

Why should taxpayers fund programs to help smokers drop unhealthy habits they acquired on their own accord ?

Yeah, and why should we help people who get illness through their jobs? They have a choice to quit that job. That's why we shouldn't help people who helped in the 9/11 cleanup. They made a bad decision, so they don't deserve healthcare. And let's not help crack-babies either! Their Mom's could have made better choices. Oh! And let's not help anyone with cancer, because they should have been more careful. In fact, let's only take care of people who are perfectly healthy!

As long as the government taxes cigarettes, I don't see why smokers shouldn't get healthcare. We're paying more taxes than non-smokers. Maybe non-smokers shouldn't receive any benefits at all from cigarette tax money. Oh, that wouldn't be fair would it?

Now THIS is a great point.

As long as the government taxes cigarettes, I don't see why smokers shouldn't get healthcare. We're paying more taxes than non-smokers

Funny how a government can say that something will kill/disable, etc you, but they will be glad to tax the hell out of it.

Which raises the question, why the hell won't they do the same for drugs! Seems to me the government (as usual) is as hypocritical as it can possibly be. Due, of course, to monetary/political pressure.

This is a very dangerous slope to go down. I am 60 years old this year. Who, and what, defines 'old'? 60? 70? 80? Should I be denied treatment just because I have reached a certain age and is assumed by my betters to be 'useless' to society, using up its resources, hence no care?

Yeah, and why should we help people who get illness through their jobs? They have a choice to quit that job. That's why we shouldn't help people who helped in the 9/11 cleanup. They made a bad decision, so they don't deserve healthcare. And let's not help crack-babies either! Their Mom's could have made better choices

Well said, Mars313. The minute we deny care to anyone, we begin to judge them without knowing their journey. Worse still, most of those people earmarked for no treatment would have paid their national insurance earlier in their life to ensure their treatment. I hope we never go down that road because the consequences and resentment could be phenomenal and become completely counter productive.

Ms. Cyprah:

Good point, especially given the age which humans are expected to live is constantly increasing.

A pure nanny state is never very good at making distinctions.

should the smoking companies provide get-off-their-product for free? after all, it was their ads that got us started.

Actually in Canada cigarette packs have quite a large portion dedicated to helping people quit. Not that I ever really read it. Same goes for the huge warning labels.

http://www.cigarettes-collection.com/public/images/pictures/playerslightcanada.jpg

JoTigerlily;

On the other hand, if someone genuinely wants to change their unhealthy habits, however acquired, why shouldn't we help them if we can?

I don't know anyone opposed to socialized medicine who would oppose people helping each other. What we oppose is the guy in black standing behind us forcing us to choose between helping someone HE decided needed the help or going to prison. Choosing compassion is wonderful. The problem lies in removing the 'choice' from the equation.

wmolaw

We should stop giving treament to the elderly as you said

Good point, especially given the age which humans are expected to live is constantly increasing.

This only leads to overpopulation which would make be a strain on the system.
It would be best just to treat the working age, I mean if your retired you don't need to healthy to go to work - why do you need health care when your near deaths door (just delaying the inevitable).

The quicker the old ones leave their mortal coil the easier it will be to sustain our resources for the new generations, I mean how many elderly people do you see leading an active life such as skateboarding etc, they are slow, useless selfish beings trying to stay alive, they have had they day let me have mine and when the time comes I'll pass the world to the next generation.

The elderly are only legalised junkies. Man I don't want to be popping pills, where my life is disrupted and dictated by trips to the surgery or hospital

Maybe we could set an age at which people go on the carousel to be recycled...

Right, if they are going to die anyway, why shouldn't their deaths benefit the "greater good?"

You are a doctor. You have to chose between a young person, bright enthusiastic and deeply loved by her parents and an old drunk to get a liver. Who do you choose. And why?

Very good question and the choice seems pretty easy, Gwenny. But that new liver could encourage the older person to change his life around. So both are worthy, to me.

A tremendous amount of resources are consumed extending death rather than preserving life.

Who, however, has a right to deny medical assistance to someone who wants it despite what may be (to me) a poor quality of life?

You are a doctor. You have to chose between a young person, bright enthusiastic and deeply loved by her parents and an old drunk to get a liver. Who do you choose. And why?

That is why I have never signed an organ donor card and oppose all efforts to make organ donation the default. I do not mind if anyone has any of my organs after I am dead, but I would rather keep them until that time. I don't want a doctor making a decision to let me die because someone else could use my organs.

We invoke God's will--although if we really cared about God's will we would let those He has marked for death go with love and respect.

Didn't God also give us the ability to change that? That is akin to saying "if God meant us to fly, he would have given us wings."

You are a doctor. You have to chose between a young person, bright enthusiastic and deeply loved by her parents and an old drunk to get a liver. Who do you choose. And why?

You are a school administrator, you have to choose between providing funds to bright, enthusiastic and deeply loved children, or to an orphan who is only of ordinary to less than ordinary intelligence, which do you give the funds to?

There are decisions which need to be made in regards to preemies, the elderly, and others. But is the government the entity who should make such a decision? Is the doctor? Seems to me it should be the parents.

Is life a gift? If so, do you think the children born who have horrific health problems, problems they will have all their lives would prefer to have not been born?

Life is a gift. Sometimes it's not the gift we would have chosen, but it is still a gift. Why would you wish a soulless doctor to make a decision as to whether it should be taken away from you? Or worse, a beauracrat?

UNOS regulations here in the States would prevent the old drunkard from getting the liver transplant. His or her alcoholism is a sign that another organ would most likely be wasted on him/her. An alcoholic would be deemed a poor candidate. It's not about morality so much as probability.There is a method to the madness.

Is life a gift?

Not. At best it just is. ::shrug:: At worst it is an inescapable burden.

You are a school administrator, you have to choose between providing funds to bright, enthusiastic and deeply loved children, or to an orphan who is only of ordinary to less than ordinary intelligence, which do you give the funds to?

Your assignment is to go and figure out why this is a logical fallacy that has absolutely no place in this discussion.

If so, do you think the children born who have horrific health problems, problems they will have all their lives would prefer to have not been born?

You've missed, I suppose, where I've said that at around age five I told my mother that I wished I had never been born. My opinion has not changed in the intervening 45 years.

Seems to me it should be the parents.

I think that Life's decision should be respected. Life decided that that particular collection of cells was unfit. Parents are seldom emotionally in the place to make that decision, they can't access what choosing to force life on a mistake will mean long term. So a few ounces of human genetic matter is subjected to medical horrors and pain so that it can marginally said to be alive and the parents are subjected to years of sorrow and misery, when it could have been over quickly.

Life is a gift. Sometimes it's not the gift we would have chosen, but it is still a gift.

Life just is. It's not a gift. It's a random selection of DNA that created you and you are no better or worse than any other collection of DNA.

And fear not lest Existence closing your
Account, and mine, should know the like no more;
The Eternal Saki from that Bowl has pour'd
Millions of Bubbles like us, and will pour.

Why would you wish a soulless doctor to make a decision as to whether it should be taken away from you? Or worse, a beauracrat?

Soulless doctor, indeed. What a vile and ignorant thing to say! There are doctors in it for the money. But the vast majority of them care deeply for people. You want power over your life, take it. Any intelligent person needs to have decided that and be clear about what they want so that their future isn't in the hand of a doctor, or even worse, their grieving loved ones. Hence, I have signed, notarized orders that there be no heroic efforts to save me and that my body be thoroughly harvested to give hope to as many as possible and that the balance of refuse is cremated and used to grow dandelions.

You are a doctor. You have to chose between a young person, bright enthusiastic and deeply loved by her parents and an old drunk to get a liver. Who do you choose. And why?

I would rather chose the child as he/she is just starting on the journey of life and will contribute to society in his/her working life.

Very good question and the choice seems pretty easy, Gwenny. But that new liver could encourage the older person to change his life around. So both are worthy, to me.

As for the old drunk he/she had his whole life to turn it around but didn't so what makes you think it will with what little time he/she has. Remember George Best? he had a liver transplant though hi drinking and started agin to damage his new one. That liver could have gone to a little girl/boy who would have taken care of it..what a bloody waste. How would you feel if you knew someone had abused you volunteered organ

the problem is there are not enough of a resource to go around (donor organs) so there has to be an agreed upon process to figure out who gets them. whether or not we want to, someone has to define this process and thus determine who lives and who dies.

and during the creation of this process value judgements were made. like it's much harder to get on the transplant list if you are a drug abuser or mentally ill. certainly anything is possible like in your example the old drunk could end up saving someone that might have huge positive influence on the world. but the only way to be semi-objective (limited to our current science) is to deal with the probability that any given person will have a positive impact.

it would be hard to make those decisions but if the idea is to "do the most good", then a utilitarian philosophy like this seems to makes sense.

None the less, these questions come up daily in organ donation (and I suspect in many other aspects of healthcare), and someone has to answer them.

EPH, good example and point.

Let me ask a related and, to me, an easier question.

Should all people, once dead, be available for organ harvest?

Don't mean to hijack a thread, but seems to me this is an important question.

Should all people, once dead, be available for organ harvest?

Only once all discarded stem cells are available for research.

Lets say one guy smoked for seven years and another guy smoked for six years. Both need the transplant. Who gets it?

Lets say one fatty loses 50 pounds and another 55 pounds. Who should qualify for the care?

Every life is of equal value.

There is no other way to look at it.

Fabulous comments here. I just went down and voted up a ton of remarks, all things I was going to say but don't need to now.

Great seed.

Should all people, once dead, be available for organ harvest?

Do you own anything? Do you own your own life and your own body?

Only if you hold the belief that ownership doesn't exist can you presume to arbitrarily determine the disposition of someone's body.

Should all people, once dead, be available for organ harvest?

My gut reaction to your good question is yes.

However, there may be good reasons for that not to be the case. I think if someone for instance has religious prohibitions against that practice, they should be honored.

I know from discussing this with my wife that she thinks they shouldn't. She didn't even want me to be an organ donor listed on my license which I am.

She is concerned that people have been known to have someone killed so that their organs which appear to be matches can be harvested.

Mars:

And that was responsive?

Seems to me that the issue is an important one. If ALL people who died automatically became subject to organ harvest, the need for such organs would be incredibly reduced, don't you think?

Just a note, it seems that researchers don't need stem cells from fetuses any longer, they have learned how to, essentially, create stem cells from adults. Gee, what a surprise, eh?

We need to be very carefull when we try to say one life has more value than another. I know I'm not qualified to do it and I don't know anyone I want to trust with that responsibility.

Absolutely, EPH289. We can never tell what the consequences of such arbitrary decisions will be so we shouldn't be too free about making them and judging others in a superficial way..

After you have made your call, somehow (God for instance) you get to see that the old drunk saves the life of your child 3 years in the future by jumping in front of speeding car and pushing your child to safety and at the same time you see that the darling little girl grows up into the next husband murderer who just happens to marry your grandson. Did he make the right call?

That is hogwash! First, there is no evidence of god. So unless you can provide incontrovertible evidence of this mythical being, don't invoke it in arguments. Second, if there is a god, it already decided that the drunk was supposed to die and humans decided to intervene. Third, the drunk wants to die or s/he would change their ways and live properly and if god REALLY cared, it would heal the drunk on its own. Fourth, because there is no god, the Earth and society are best served by giving a not failed being an opportunity to grow up.

Finally, my children are grown and my grandchildren are halfway grown so your story is not only stupid it has absolutely no application to my life.

Gwenny:

First, there is no evidence of god. So unless you can provide incontrovertible evidence of this mythical being, don't invoke it in arguments

Why is the burden on him? Many beliefs do not have "incontrovertible evidence" supporting them. Take, of AGW, evolution, that gravity is a 'weak' force, that time is another dimension, that time runs only one way, or a myriad of other beliefs.

Merely because there is not "incontrovertible" evidence does not mean something does not exist.

Our ability to discern truth is sorely limited by our ability to observe the phenomena going on in this universe and elsewhere. Until we are able to discern each and every event, in each and every universe, I am afraid we will all need to live with "beliefs."

Maybe even then?

Second, if there is a god, it already decided that the drunk was supposed to die and humans decided to intervene.

You seem to have a fundamental misunderstanding of a belief in God. If God meant a person to die, period, no human could intervene. If humans did intervene, then it was God's will (either specifically, or giving humans the ability to intervene) that the intervention occurred.

Third, the drunk wants to die or s/he would change their ways and live properly and if god REALLY cared, it would heal the drunk on its own.

People get wrapped up in events, courses of action over which they have no real control. We see this all the time. Should we merely abandon all who act in a way with which you do not agree? Seems kind of mean, eh? What about all the children/adults in Africa and elsewhere who cannot get enough food to eat, should we let them starve if we have the ability to assist them, or the person with cancer (hell, they probably caused it by smoking/eating fat/living in a particular area/etc). Further, you seem to want God to do everything. But that is not the way people who believe in God think of him. They believe he gave us the ability to choose.

Fourth, because there is no god, the Earth and society are best served by giving a not failed being an opportunity to grow up.

As opposed to a "failed" being? Such as a 2 year old in Africa? The examples are numerous. Should we start giving IQ tests to all children, and those that score under 110, abandon them to the elements? Or those who are born with reparable birth defects, let them die or abandon them?

Seems to me you wish to play God, or have some flunky government pencil pusher do it for you.

Me, I am not ready to abandon all who act in manner or who participate in activities with which I disagree.

Further, you seem to want God to do everything. But that is not the way people who believe in God think of him. They believe he gave us the ability to choose.

Excellent comment, wmolaw, because that is what our time here on earth is all about. We have already been given the tools to get on with the job in our own way. Still expecting God to bail us out at every crisis does not say much for why were given intellect and the ability to make those choices.

Ms. Cyprah:

Although I am certainly not a religious person, and actually verge on the agnostic, it has become clear to me that there is quite a movement to prevent/deny people the ability to believe in God, any God.

Believe in God, correct or incorrect, can be a very gratifying and uplifting, positive experience. I have seen it in others.

And, who the hell am I, or who the hell is Gwenny to say there is no God.

But, thanks. I will never understand this desire on the part of some to abandon all those who really need help. I don't believe, necessarily, that the government should be in the business of helping all those who cannot help themselves, but to just abandon them?

Bizarre.

I agree with that, wmolaw. We are all entitled to believe what we wish to believe, even if it is in little green men. What we are not entitled to do is to impose that view on others.

I used to believe in God as a Catholic, now I regard myself as spiritual, believing in a higher power, though not in a god, per se. No one has the right to tell others what to believe, or to denigrate those beliefs, simply because they don't share them, because no one on this earth has all the answers to our lives. The very things we take for granted in our routine activities now caused fear, panic and resistance in many people years ago who felt they were not possible.

In the 1940s, for example, when Congress was considering sending a man to the moon, many religious members of Congress said it wouldn't happen, it was flying in the face of God to do such a thing, and it would be an impossible act. Their limited knowledge, closed minds and fear of their universe prevented them seeing the impossible. Luckily those with the faith and sheer belief pressed on and encouraged others to make it a reality 26 years later.

Until we know it all, we can never deny anyone their beliefs or say categorically that they are wrong in what they subscribe to. That's not for us to call. It merely shows our arrogance and ignorance in the capacity of the Universe to surprise us.

Ms. Cyprah:

What we are not entitled to do is to impose that view on others.

Wish to hell people, especially radical muslims, would learn that lesson. Be one hell of a lot less violence in the world today.

Six months, perhaps a year ago, there was a lot on the general news as well as newsvine about a man in the UK who was refused surgery on his broken ankle because he smoked. Note that he was not a poor candidate for surgery and he could not be expected to heal and walk without the surgery. But because he smoked, the physicians and hospitals refused to treat him.

This is not rationing resources to those who can benefit from them. It is arbitrarily denying services on the basis of prejudice against a life style.

This is not rationing resources to those who can benefit from them. It is arbitrarily denying services on the basis of prejudice against a life style.

Kind of like denying marriage rights to same-sex couples?

Kind of like denying marriage rights to same-sex couples?

Only if you presume same sex marriage is a right.

Note some operations . In other words, a judgment call should be made whether the patient has a chance of good outcome from a specific treatment or it is a waste of time and resources. I would be surprised if doctors were not doing this - surgery is extremely taxing to the system and a patient in poor health would be better served by other kinds of treatment.

Eight years ago my father had his third heart attack. The surgeon gave him a 5% chance of surviving the needed surgery (replacement of a valve and a gore tex patch over part of his heart). If the surgery was not performed, my father would drown in his own fluids. Not a pretty way to go.

The "surgical board" of the hospital refused the doctor permission to operate citing the low chance of survival (didn't wish to hurt their stats). The doctor tendered his resignation, the board gave in. When I spoke to the surgeon he asked me if I would consent to having an intern do the gore tex patch, and he would do the valve replacement. I consented. I will never forget him looking at me and saying, "You know what we are doing?' I told him I did, that it was surgical euthanasia and I would never forget him for his kindness. He told me that there was less than a 5% chance of my father even regaining consciousness.

My father came back on the first paddle whack, was home three days later, and lived almost five more years, good years, years in which he got to know the grandkids he had not met and they got to know him. The Doctor cried when he came out of surgery and told me my father was fine.

And you wish for some pencil pushing, heartless politician to make that decision, or some not give a damn doctor, or even surgical board?

No thanks. Let's get rid of all the wastefull expenditures of money FIRST, then let's talk, eh?

@ Glinda: bingo! preventative care! if a yearly physical were paid for by my tax dollars without any additional out-of-pocket for me i'd go every year. but as is i have to spend over a hundred dollars out of pocket (and i have insurance!) for the different lab tests and whatnot that they do, so i'm not as likely to go each year.

A marvelous thread well seeded thank you Scott.

Ordinarily I would have a lot to say on here but fortunately most of my arguments against discrimination have been put forward very eloquently by a couple of writers. I would add however that most life philosophies have a tenet that discourages us from judgement. Mind you we do make decisions based on comparisons/choices every day but do they (the philosophies) refer to the judgements about my life being better than yours because........

I look at our Governments who take the taxes then dispense them according to the importance of each policy they have. All people could be treated (both meanings thank you) equally if the taxes were distributed for the benefit of all. That being said I suggest that there are few countries who care sufficiently about their people to allow enough funds to be allocated to the health of all without judgement of worthiness.

And you wish for some pencil pushing, heartless politician to make that decision, or some not give a damn doctor, or even surgical board?

No thanks. Let's get rid of all the wastefull expenditures of money FIRST, then let's talk, eh?

Beautifully put.

if a yearly physical were paid for by my tax dollars without any additional out-of-pocket for me i'd go every year. but as is i have to spend over a hundred dollars out of pocket (and i have insurance!) for the different lab tests and whatnot that they do, so i'm not as likely to go each year.

Coverage for preventive care makes a lot of sense to me. But bureaucratic universal health care is problematic at best, I think.

I read recently that a yearly check up is pretty worthless as far as disease prevention goes.

I have been a faithful annual-appointment-keeper. So much for that.

@jpark
Regarding the story of the man refused surgery in the UK last year, you are misremembering.

There were complications to the story such as the leg was broken in several places AND the man initially refused to have it treated AT ALL, i.e. he gimped around on a badly broken leg for a while then went for treatment. When he finally went to hospital, doctors were unable to get the leg to heal in 3 attempts with a plaster cast.

This is not rationing resources to those who can benefit from them. It is arbitrarily denying services on the basis of prejudice against a life style.

He actually is unable to work any more because his health is wrecked from smoking. See for yourself

This is not about a lifestyle choice - it's about the condition of his health and whether it can actual stand the rigours of surgery. There is always a risk of an unhealthy person dying under anaesthetic anyway, and in this case a fair chance he would lose the leg in the end.

General anesthesia is not necessary for leg surgery. He is more likely to lose the leg if untreated than if the leg is treated.

Refusal to surgically repair the leg was due to prejudice. There is no medical reason to deny the surgery.

@jpark

He is more likely to lose the leg if untreated than if the leg is treated.

Not according to the doctors - you know, the ones with the knowledge, experience and who have been treating him. I'm curious how you come to your own expertise as it seems like the prejudice is all on your side. His health is so bad, he cannot work and his leg did not heal like a normal, healthy person's would. He has been asked to participate in his own health care by quitting smoking which he refuses to do. Meanwhile, he gets medication for the pain but won't lose his leg. Too bad for him, but he has basically brought this on himself.

A broken ankle often needs pinning to heal. He never received that intervention. The doctors refuse to provide that necessary intervention unless he quits smoking. Why? His smoking did not cause the broken ankle and does not prevent the ankle from healing. The only thing preventing the ankle from healing is a lack of appropriate medical intervention.

You cannot have capitalism and socialism at the same time, folks

Huh? Take a look at the USA, that is exactly what we have, elements of capitalism and elements of socialism.

Huh? Take a look at the USA, that is exactly what we have, elements of capitalism and elements of socialism.

Exactly. And look how well our health care system works.

If you want the freedom to be infinitely wealthy, it's incumbent upon you to at least be able to pay your own way. If you want the government to care for your health, transportation, education, etc., you have to be willing to accept median averages and business decisions made by someone else.

Granted. I did not know that was your point.

There is no doubt but that socialism tends to bring everyone to the same level. Unfortunately, it is a lower level.

The longer people live, the more expensive all insurance costs become, which is why almost no one can be 100% insured with zero co-pay anymore.

If the average lifespan is arcing well past 70 years these days, why not extend the retirement age past 65? By the time I'm 65, the average lifespan may be pushing 90. Should I expect the government or socialized medicine to give me a free ride for the last 25 years of my life as a reward for living healthy?

I disagree. That type of coverage is still possible. The cost of health care is the problem, and that is due to lack of good regulation.

It is a national disgrace that low cost health care isn't available to all here.

I disagree. That type of coverage is still possible. The cost of health care is the problem, and that is due to lack of good regulation.

Who would pay for it?

What type of regulations would bring down the cost of health care?

Yes, that surprised me too that it's coming out of the UK. I also haven't seen Sicko, but living in the US, I already know the state of our health care... and Canada and the UK are definitely superior.

I must say there were an awful lot of insensitive, inflammatory comments on this seed. I had a real hard time keeping my mouth shut. I managed though. Thank goodness for the ignore feature. LoL!

I happen to BE one of those medically challenged people such thinking affects. I lost my kidneys when I was 21 to an autoimmune disorder (this particular one is rare, they don't know what causes it, and it sends antibodies to attack the kidneys and the lungs.) back in 2000 and have been on dialysis and waiting for a transplant ever since. If not for the tax-payers (such as Kevin and myself) in this country, I would've been dead a long time ago. I want to continue living my life. I have a 10 year old son and a family that loves me and I don't think it's fair I should die just because I can't afford health care. So a big thanks to EVERYONE who is helping to keep me alive. Don't think for one second people like myself don't appreciate it. We know very well the sacrifices people make to help us, and we are grateful beyond words.

Anyone who thinks differently would change their tune awfully quick if they found themselves in my position.

Anywho, thanks for seeding this article. It's definitely something to think hard about. =)

I am too sure about Canada. I had a friend that had esophageal narrowing. It took him 6 weeks to see his primary physician. The referral to a specialist took 3 months. A year later he had the dilation that fixed his problem. He would have been seen in 14 days in the US.

It took him 6 weeks to see his primary physician. The referral to a specialist took 3 months. A year later he had the dilation that fixed his problem.

Wow! That's terrible! I had no idea the waiting time and process was sooo drawn out in Canada. It can be ridiculous here too, as the waiting times to see certain docs can have you sitting for months to see someone, but once you're in, they handle things quickly. I know I waited for about 2 months just to see my cardiologist! I'm glad your friend was able to solve his problem, but it shouldn't have taken so damned long! The old saying "the grass is always greener" came to mind on this one. Just goes to show you there are problems EVERY place, not just on our homefronts. Terrible.

Man, I go to see the GE today for exactly this condition, but to be honest, as long as I eat carefully, I can manage the condition. I'm going to have the dilation, but it hardly needs to be done within 14 days of discovery.

Anyone who thinks differently would change their tune awfully quick if they found themselves in my position.

Exactly, cynna66. As I said before, it is always easy to judge from afar when it has no connection to us. Thanks for sharing that with us and hope you live a long time to come to enjoy your family and your life! :o)

I did not say it would be done in that time. I said he would have been seen for the first time in that time instead of waiting 9 months. He was having severe problem. He could only take liquids.

But could he afford to pay the doctor that would've seen him in 14 days?

There's certainly merits to both sides, but for the poor or uninsured, waiting is certainly preferable to going bankrupt.

Being a billionaire may even allow you to, essentially, live forever through cloning.

Who knows, eh?

Yes, nobody is promoting that concept at all.

Aw, nuts. My bad.

Yeah, that's a single-payer model.

That's why I'm an Obama man. His plan makes sense.

Don't get me wrong. I'm not happy with the existing health care system but do we really want our government to run our health care system?

Like they run FEMA, FDA, Medicare drug program that isn't allowed to negotiate Rx prices, etc.

Obama's plan isn't for government run health care.

And those other programs have failed under Bush because the man is incompetent.

FEMA has been the same since its inception. Bush may have allowed it to get worse but it did not have far to go anyway.

FEMA was never designed or envisioned to take over disaster response. It was designed to assist state and local governments in disaster response.

In New Orleans, the total lack of state and local response left FEMA with the responsibility by default. FEMA did not fail. It did remarkably well considering that it was never designed to so respond.

Since Katrina/New Orleans, FEMA has become the defacto first responder. Another example of people demanding Nanny government.

I repeat, nobody is suggesting the government should run health care, only that government (i.e., our elected officials) would redefine the rules to ensure that everybody gets covered, that they have appropriate coverage, and that the insurance companies stop fighting with each other and with hospitals and with Medicare, to keep from paying claims themselves. Our current system is totally broken, overly expensive, and across the broad population, delivers relatively poor care.

I have a lot of history with disaster response. FEMA has never assisted anyone.

FEMA has never assisted anyone.

Yes. It's not even their mission.

Hmmm...and no doubt so would Dr. Harold Shipman, and a few others. I'm getting old, I smoke, seldom drink, I exercise (walk) every day, and I have paid my National Insurance Contributions every day of my working life.

I have Earned the right to have treatment should I ever need it. That group of Doctors are so wrong to deny people in my situation, treatment that they have paid for.

Nice to see the Doctor Mengele School of Medicine is alive and well.

Ouch!! greenpagan...ha ha

I have Earned the right to have treatment should I ever need it.

You tell them, girl!! It's not a charity. You've already paid for it!

Thanks, Ms. C. I will! Something else too, whilst we're on the subject of health matters. If the dreaded day ever come, when I have to spend some time in hospital, I want to spend that time in a safe, warm, comfortable, and above all, CLEAN, environment.

I do not want to go in suffering from one thing, and find myself catching MRSA of C.Diff, or some other superbug, all because the Hospital Trust has cut it's cleaning budget to the bone, and the Contract cleaners are not doing their work properly!

Good comment, Beccal, I also am a firm believer in Natural Remedies, and Supplements.

Of course they don't offer the natural way... they can't make money off the sick and dying if they do it the right way. In the health care industry it's more about the money they can make off other people's misery. Learned that the hard way. It's great you've found a better way to care for yourself than having to stuff your bloodstream full of poisons! Too bad more folks don't think to look for alternative treatments.

Not to mention most of the food in our supermarkets is full of poison. Trans fats (hydrogenated oils), high fructose corn syrup, and numerous chemicals we can't even pronounce.

A friend of my girlfriend's who has long been into detox diets, fasting, and organic food posed a good question: "Instead of having a small section marked 'organic' why not change the labels to 'food' and 'food with poison'?"

I wouldn't actually do it. It's a joke about food having poison in it ... or ... a musing, if you will.

organic food industry has so gamed the labeling criteria that it is barely distinguishable from everything else?

That's why you have to pay attention to the ingredients listed on the package and research the companies and only buy from truly organic sources. I know, I know, that takes too much thought and work for most Americans.