Uk bans Operations For Fat Smokers

originally posted by: ketsuko
a reply to: OtherSideOfTheCoin

And this is why a system like the UK's is one I hope we never have.

I tend to agree with your that people who make bad health decisions should have to pay for them, but they should have to pay for them and not have it decided that because they made bad decisions, they will now have no access to care at all because it's more cost effective to the collective.

I know of someone whose son has some severe difficulties because of some things that were missed prenatally and the lack of preparation by the team at his birth exacerbated his condition. A year or so ago, they were told that he needed a pacemaker if he was going to have any chance of surviving into his teen years, but because of some other complications, they were also told that it was unlikely they would find someone who would take the chance of operating.

The NHS would likely have decided to simply deny that surgery because of the risk of death on the table and lack of long-term outcome even if successful.

Instead, the parents were free to find a surgeon who would take the chance. They knew the risks but they also know they will lose their son and decided that chance to have the extra years with him and the chance that medical science could come up with a solution was worth the risks.

They are fortunate they do not live in the UK I think.

These people are not being refused care?

They are being told that if they want non life threatening ailments treated then they need to make the choice to make themselves fit and healthy enough for the op by loosing exessive weight and not smoking.

Where you get the notion that the evil NHS would refuse to treat sick kids whereas the good ol US system of paying a health insurance company if you can afford it is baffling.

a reply to: ketsuko

People who make poor "lifestyle" decisions being refused care is just the nose of the camel in the tent.

Now that personal DNA can be tested, why shouldn't people with unlucky DNA also be refused health care? What is the value of giving surgery to people whose death by cardiac failure is predictable. or just a higher risk than average.

Age, of course is the biggest predicter of disease. Is there a value to providing treatment to those over the age of 65? There productive years are over anyway.

I see all the people in this thread condemning smokers and those who are overwieght.

In reality, you are condemning yourself.

So the big question here is. Is it time to stop paying into socialized medicine and leave people to pay for their own healthcare?

Why are we paying for healthcare for the healthy? Its saves money but isn't it just a bit unfair?

a reply to: TiredofControlFreaks

Smokers and overweight people have to meet certain criteria in the US as well. They need to be healthy enough for surgery.

Now are they pushing that line down to "thinner" fat people to save some cabbage? I can't answer that question.

BMI has been played with over the years. A very healthy muscular man is obese. Problems abound.

a reply to: nonspecific

I get the notion because the NHS did not make this decision based on caring for those people. They did it because they know very few people are going to be sympathetic to the plights of smokers or the obese, so it is easier to use this as a means of saving money which is really why they are making this choice and *NOT* because they are doing it in their best interests.

I compared it to the person I know and her family's situation because of poor prognosis of her son in both general life expectancy and the treatment she was told he needed. If the NHS was looking to save money (and it is, be honest), then what reason would they have to care about the situation, only the bottom line, and the bottom line is that the kid will most likely never see 20, never be a productive citizen paying taxes, and had very a high chance of not surviving the procedure to allow him to live past his 7th birthday.

Easy to say no to that. Yes?

originally posted by: ketsuko
a reply to: nonspecific

I get the notion because the NHS did not make this decision based on caring for those people. They did it because they know very few people are going to be sympathetic to the plights of smokers or the obese, so it is easier to use this as a means of saving money which is really why they are making this choice and *NOT* because they are doing it in their best interests.

I compared it to the person I know and her family's situation because of poor prognosis of her son in both general life expectancy and the treatment she was told he needed. If the NHS was looking to save money (and it is, be honest), then what reason would they have to care about the situation, only the bottom line, and the bottom line is that the kid will most likely never see 20, never be a productive citizen paying taxes, and had very a high chance of not surviving the procedure to allow him to live past his 7th birthday.

Easy to say no to that. Yes?

And what are they looking to save money for would you say? this is a national health service so unlike the US system cutbacks and savings do not increase the profits and dividends for the shareholders do they?

As the population pays into the system the service has a responsibility so if you think they can start pulling the kind of tricks that corperations do then just wait until the watchdogs and tabloid press and social media get hold of that kind of plan and see what happens.

If anything a lot of the issues within the NHS are created by using private companies and the profiteering involved, many medicenes that have been developed using NI funding alongside private drug companies are marketed at a cost too expensive to be then provided by the very health service that we pay into to provide health care.

a reply to: nonspecific

Now you have brought up a very very important point!

Why is everyone so worried about "wasting" money on smoker's and obese people but no on is watching how much is being charged for the services.

Why does hip surgery cost 10s of thousands in the states but only about 8,000 in spain?

This entire "concern" for smokers and obese people is just a means of misdirection while insurance companies continue to increase profits.

If you want to save money, why don't we stopgiving knee surgery to people to jog? how about no health care to people who ride motorcycles? How about people who surf, get tennis elbow from playing tennis?

In general, people who choose to indulge in sports are making the choice to take the risk of getting hurt. Don't talk to me about how "exercise" is healthy. YOu can get exercise without getting hurt!

a reply to: TiredofControlFreaks

The for profit medical system may not be the most efficient way, from a consumers point of view, to provide medical care.
As we can see the US medical system is very very good at making huge profits.

a reply to: Oldtimer2

Liberals wonder why they are looked on how they are,

Not really. We know who and we know why. But we consider the source, so it doesn't bother us.

Can anyone point me to any hard data that show a significant elevation in mortality among smokers undergoing surgery? I'm not saying that there are no such data, but I'm having a hard job finding them.

a reply to: audubon

Even if you do find it, it is epidimiology and the raw data can be manipulated to show anything and everything you want. Including that smokers live longer, are healthier etc.

Funny thing about epidimiology, you just start counting something and stop when the trend is going the way you want it to.

What you want is hard science showing smokers do not do as well.d

a reply to: TiredofControlFreaks

here are some examples of hard science showing surprising results for smokers

www.ncbi.nlm.nih.gov...

Smoking Interaction with Clopidogrel; Another Smoker's Paradox?

Smoking increases the risk for cardiovascular events and mortality in patients with established cardiovascular disease, but clopidogrel treatment may be more effective in smokers. Therefore, the interaction of smoking with acute myocardial infarction deserves further study in more patients using designs that show fewer time limitations.

forget anything said from the american heart association. all of it is epidimiology and not hard science. Further, this study did not provide any data and therefore should not have mentioned anything by the AHA

originally posted by: audubon
Can anyone point me to any hard data that show a significant elevation in mortality among smokers undergoing surgery? I'm not saying that there are no such data, but I'm having a hard job finding them.

It cannot be heard to find I am sure.

I saw something in the UK that said that the revenue from smokers was greater than the cost of treating smoking related illness over here though which is food for thought.

a reply to: LondonMan

Perfectly fair, if you don´t care about your health why should the state care? However you should be given the choice of paying or not paying a certain percentage of your taxes, the part that would go to nhc and that you will not be able to use.

a reply to: paraphi

Do you believe treatment for Diabetes Type II should be discontinued? (Seriously, how cold and heartless are you?)

Some cold greedy people on this thread. Some, the same old ones. Others, unexpected.

I actually almost wept reading some of these posts. Mankind. Humankind. Not very kind to one another.

originally posted by: angeldoll
a reply to: paraphi

Do you believe treatment for Diabetes Type II should be discontinued? (Seriously, how cold and heartless are you?)

Some cold greedy people on this thread. Some, the same old ones. Others, unexpected.

I actually almost wept reading some of these posts. Mankind. Humankind. Not very kind to one another.

You need to factor in the fact that it is a non threatening operation not witholding medicene essential to staying alive and that it is not stopping the op just putting in place a condition to attempt to be healthy before undergoing it.

Also the national insurance contributions go towards more than just health and there is no way to opt out.

a reply to: LondonMan

And the alternative? What you desire?

I'm very 'on the fence' about this one - and it's happening here in the US as well.

I do understand that joint replacements don't last as long for heavy people and the 'system' (whatever it be) wants to maximize Return on Investment (and therein lies the problem - human values of quality don't apply).

The smoking I understand regarding most any surgery - it slows down healing.

And the above are 'rational' outcome decisions. Again what about the quality of life - or potential quality of life for the patient. And where is the (expensive) support to lose weight or stop smoking for these people.

Then there are the doctor's who don't want anyone to die 'on their' report card. This is another metic based decision that leaves the patient's needs out of the equation.

Now then, if you are wealthy - none of this comes into play.

It doens't matter (except for, in the US, insurance company profits) whether the system is capitalistic or socialistic in nature, it's all based on 'metrics' that are measurable - not the unmeasurable values of people.

Now - if everyone - wealthy included (pols included) received the same treatment - you might see this change. I believe health carers of all types would be in agreement.

I hope you family gets the care that is deserved by the simple fact of being alive.

I guess they shouldn't treat STDs in the UK. People engage in a behavior, by choice (except in the case of rape) that leads to contracting the disease.

Of course, if they wouldn't treat the disease, the number of cases would rise.

But hey, it costs money, right?

originally posted by: butcherguy
I guess they shouldn't treat STDs in the UK. People engage in a behavior, by choice (except in the case of rape) that leads to contracting the disease.

Of course, if they wouldn't treat the disease, the number of cases would rise.

But hey, it costs money, right?

It’s apples and oranges though

The biggest reason behind not sending these people for a operation is that their life style means their chances of complications are massive. If they stop smoking and cut a few pounds then that risk becomes less.

It’s totally different.

As you said if we refused to treat people with STDs then pretty soon we would have a very sick population.

You are talking about two entirely different healthcare issues

originally posted by: OtherSideOfTheCoin
As a critical care nurse the level of ignorance on this thread is astounding.

If you are fat and smoke your risk factor for dying on the table and post-op complications is massive in comparison to a individual who does not smoke or eat like a horse. That is a just a fact. So if you are fat and smoke its in your best interests to stop smoking and cut back on the pies and go for a walk.

I actually think what the OP is complaining about is one of the inadvertent problems with having a health care system like ours. People neglect their own health, there is this attitude of "its ok the NHS will sort that". You are responsible for your own health, if you eat a tub of ice cream every night then drink a pack of beers and have a few smokes while you stew infront of the TV then its your fault you are unhealthy not the NHS or the government.

Speaking of the government, they had nothing to do with the death of Charlie Gard and have little to do with these kind of decisions, they are clinical decisions.

The NHS will never have enough funding, not matter how much money you put it, it will always need more. So resources have to be allocated appropriately. Lets say you are needing your hip replaced and you are ultra fit, is it fair then that some fat dude gets the opp before you? not really. Its a total waist of resources for the NHS to go and spend thousands on treatments for people who just won't help themselves.

Lastly OP, you didn't tell them you smoked at a pre-opp assessment?!?!?!

Can I just tell you how utterly stupid that is, if you smoke it could drastically change your management. The anesthetic staff might decide that because you smoke they want to do a nerve block rather than a GA because you could have some degree of obstruction that could make a GA more dangerous. So you don't tell them then some poor doc is going to tube you but because you have destroyed your lungs thanks to years of smoking it doesn't work or it turns into a difficult airway problem and you find yourself in a ITU. Or you go into T2RF and need critical care because you never mentioned that you smoked so nobody was fussed about how much o2 you were getting. The list of possible complications of this is actually endless and I know you know nothing about health care (as is evident from your OP) but this is dangerous. Not only that but 9 times out of 10 we know you are lying anyway about it so now you have just told a lie to the same people who are going to be giving you some very dangerous drugs. Not smart. Kind of goes back to what I was saying about being responsible for your own health.

Your aunt can stop smoking, she can eat less.

Its not actually that difficult if you have a bit of will power to see you through it.

Ive had four nerve blockers thanks, think the green may have helped too... triggered or what lol God forbid you ever get any heart trouble, nurses like you are what give the NHS a bad name, it would be interesting to know what hospital you work at ????

a reply to: OtherSideOfTheCoin

Nah....
I am talking about money.
The cost of treating people and how it saves the system money if they can find reasons not to treat them.