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Should lifestyle determine medical entitlement?

Health Care Life style choices 2005

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#21 Shalamar

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Posted 11 December 2005 - 10:38 AM

I want to thank every one for taking a step back and calming down.

Sparks, I do have to say that I do know people who are over weight- and not just a little -because they chose to be - without ADD, sleep disorders etc to perchance be a factor. They willfully over eat, eat unhealthy foods, don't exercise ..,

So while there may be many who do have medical factors beyond their control, there ARE those that chose to be. And to say that there are not is wrong.

That aside- I agree that it is a slippery slope of the worst sort - remember the movie Gattaca ( did I spell it right?) -
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#22 emsparks

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Posted 11 December 2005 - 11:07 AM

Shalamar, on Dec 11 2005, 11:38 AM, said:

I want to thank every one for taking a step back and calming down.

Sparks, I do have to say that I do know people who are over weight- and not just a little -because they chose to be - without ADD, sleep disorders etc to perchance be a factor. They willfully over eat, eat unhealthy foods, don't exercise ..,
Ö

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I ask this with out ranker, in the spirit of intelligent discourse. Just how do you know this?

If your going to say, I know this because is what I observe, be very careful over what you understand about cravings. If your going to say this is what I am told, be equally careful about the prolonged effect of constant abuse due to the weight problem.

As to calming down, I am trying to calm down but my very mortality is weighing very heavily on my hands, and you need to know that this is in fact a life or death issue to the obese. To reiterate like it or not, sleep issues are a major problem almost universally to the obese, and not often talked about.

Edited by emsparks, 11 December 2005 - 11:08 AM.

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#23 Chakotay

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Posted 11 December 2005 - 11:12 AM

May I just say that I'm very grateful for the input to this discussion from those to whom this is a very touchy and personal subject. It's informing all of us about the dangers of generalizing medicine and it is much appreciated.
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#24 Rhea

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Posted 11 December 2005 - 11:25 AM

Chakotay, on Dec 10 2005, 08:50 AM, said:

A bit of a debate has started on whether the National Health Service should continue to support and help patients whose lifestyle means that treatment isn't going to be as effective as would otherwise be.

This means smokers with respiratory or heart problems who don't give up.
Obese people with joint and heart issues who don't lose weight.
It could also apply to
Needle sharers who get hepatitis.
Promiscuous people who get sexually transmitted diseases.
The list could go on.

Is this the right thing to do? The NHS is famously 'free at the point of delivery for all'.

<{POST_SNAPBACK}>


That's slippery slope ethically that I would hate to see any country start down.

The whole point of medicine is to heal the sick - not heal the sick who live great lifestyles.

That said, I think organs for transplantation should go to the patients who can best benefit from them - not celebrities, not the wealthiest, but those most in need and who qualify. And that doesn't mean an alcoholic like Larry  Hagman who patently got someone else's liver, when he would not normally have qualified. There's no point in putting a perfectly good organ into someone whose lifestyle or severity of illness means that they won't stay alive long enough for it to do any good. It irks me that celebrities are given organs when normally they wouldn't even qualify for a transplant, because that means that somebody had to die so they could live. The guidelines should be the guidelines.

Edited by Rhea, 11 December 2005 - 11:58 AM.

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#25 FlatlandDan

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Posted 11 December 2005 - 12:20 PM

Does anyone know what percentage of the cost of a pack of cigarettes goes to the NHS?  I know it's a bit of a joke amongst smokers that they're paying for the program.

Like others have said, it's a slippery slope.  I think that people should, wherever possible, try to make lifestyle choices that keep them in good condition.  If they don't then they risk that medicine won't be able to do anything for them.
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#26 Schmokie_Dragon

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Posted 11 December 2005 - 01:13 PM

If there was the case that it was truly ONLY a medical problem, then there would be cases of it in every country. Now, taking my country as an example, there is a rising percentage of obease people. Are we, in the age of modern medicine, becoming more ill? or are we, in a nation of fast food, desk jobs and "I want it all" attitudes becomes more indulgent?

I cannot prove that there ARE some people who are obese from idleness. But I can gather evidence and present a convincing case. And I can say that I, while not yet obese, have a weight problem. And I KNOW that this is ENTIRELY my fault. I have little time, I dont exercise as much as I should and I crave carbs. It is difficult for me to eat well, as I am depressed and seek out food for comfort and happiness. I also dont like vegetables and fruit, while lovely, leaves me feeling like I didnt eat anything.

Again, all I can do is apologise if I have caused offense. However, it must be accepted that no one here can speak for everyone. I am not claiming that all obese people are lazy and it is there fault. I simply suggest that in a possible case where it IS their fault, THEORETICALY speaking they should have deal with the problems they have brought upon themselves. However, this policy would be infinitely difficult, as Delvo pointed out, and the lines would be very blurred.

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But then, that would also include sports as a dangerous thing that tends to cause medical problems, wouldn't it?... at least "extreme sports"... but then do you make a list of which sports are bad and which are good, even though even the good ones still have risk?... and then doesn't such a limiting of options just cause more people to not excercize if the kind of excercize they'd like to do gets blacklisted?...

As for dangerous sports - these have distinct advantages. They promote the desire the explore and seek advanture. They help keep you fit and often require a good fitness level in the first place. There is no long term health issue. They are unlikely to get a condition that has deteriorating effects. It is more likely to be broken bones etc. These sports and activites help keep our natural instsincts alive, keep the adrenalin going, the brain alert and honed. The only real disadvantages are the likelihood of damage or death.
For drug abusers, smokers, alchoholics etc, they have brought the problem upon themselves. They knew the risks. Their "problems" have NO genuine health or lifestyle benifits when weighed against the damage they do.

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Then what would be required to make such a system work is a way to separate those who are the cause of their own problems from those who aren't. And if the problem in question is being fat, that policy's troublesome and unfair in more ways than one...

But as I have said before, this is not something that is easy to apply to real life. Please dont assume I am suggesting that this should ACTUALY be applied. I simply debate the theory.

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the best way to go about it seems to just make the rules be specific about "drug users" and "injuries received in commission of a crime", not something as big and nebulous as "people who contribute to their own medical problems".

Yes, I agree. That is at least a good start. I feel very strongly that injuries received in commission of a crime should not be treated other than to a VERY limited extent.
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#27 Chakotay

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Posted 11 December 2005 - 01:19 PM

Duty on cigarettes - 22% of the retail price + 9.68 pence per cigarette - a total of £2.93 for a packet of 20 cigarettes at an average retail price of £4.25 per pack which means that the duty is 69% of the price.



http://www.who.int/t.../en/atlas35.pdf for a global view and the UK isn't in the top 5
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#28 Schmokie_Dragon

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Posted 11 December 2005 - 02:25 PM

Ironic that smokers help pay for the NHS
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#29 Talkie Toaster

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Posted 11 December 2005 - 02:58 PM

Schmokie_Dragon, on Dec 11 2005, 07:25 PM, said:

Ironic that smokers help pay for the NHS

<{POST_SNAPBACK}>


Not especially, given how many illnesses the NHS has to treat that are smoking related
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#30 Schmokie_Dragon

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Posted 11 December 2005 - 03:03 PM

I guess smokers are kinda paying for their own treatment. But still. if they didnt smoke, they woundnt have to be treated.
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#31 Natolii

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Posted 11 December 2005 - 03:17 PM

And what about those of us that suffer from the 2nd hand smoke?

I've been told that it is discrimination to ban smoking.
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#32 Schmokie_Dragon

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Posted 11 December 2005 - 03:39 PM

You are being damaged by someone elses freedom. I hate smoking. If I had my way it would be illegal, or at least restricted to use ONLY around other smokers.
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#33 Lin731

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Posted 11 December 2005 - 03:53 PM

Welcome to the slippery slope I mentioned at the top of the thread

THIS is precisely why we should NEVER go down this path...The reasons behind any number of physical diseases and ailments is far more complex than the often simplistic definition we give to them. From smoking to weight, to heart disease, high blood pressure etc...No two people are alike, no two people have the same life experiences, physical make up, genetic history etc...Who decides who's worthy of treatment? What conditions are worthy and what ones aren't and ultimately what are we advocating as a country? Are we advocating cutting off medical care for the sick we deem "unworthy of treatment"? Are we willing to watch them die for lack of that medical care? We already leave millions in this country without a safety net because they have no insurance (our way of deeming the poor unworthy?) now we want to extend that to the disease-of-the-moment. Right now it's fat folks and smokers, what's next? Who in this discussion can honestly say their livestyles are so squeaky clean that they have the right to condemn others? So you're not fat, you don't drink or smoke? You can still drop dead of a heart attack tomorrow because you load up on salt, don't exercise, eat too much fatty foods (you CAN be thin and unhealthy too).
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#34 Talkie Toaster

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Posted 11 December 2005 - 04:30 PM

Schmokie_Dragon, on Dec 11 2005, 08:03 PM, said:

I guess smokers are kinda paying for their own treatment. But still. if they didnt smoke, they woundnt have to be treated.

<{POST_SNAPBACK}>


If the money the government generates from tax on tobacco exceeds the money lost, directly and indirectly, from treating smoking related illnesses I'd be suprised.
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#35 Schmokie_Dragon

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Posted 11 December 2005 - 04:39 PM

Basicly smoking sucks. No offense to any smokers out there but it isnt pleasant for us non smokers...
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#36 rponiarski

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Posted 12 December 2005 - 02:36 PM

"First do no harm". Those words are very important to remember. They are the reason most doctors get into the business. Now days the pay stinks, the hours are worse and your family life s**ks, so why bother! :crazy:

I realize that resources are finite, but I will always try to do the best for my patient, no matter what. Can't tell you the number of people I have seen who haven't paid me a dime (most of my hospital consults as I am not on their HMO panel  :angry: ). My father, who practiced for over 50 years, had patient's who owed him huge amounts of money and he never saw a cent.

I don't know where all this leaves me, but I will just keep plugging away, doing my best for as long as I can... :)
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#37 Rhea

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Posted 12 December 2005 - 03:03 PM

rponiarski, on Dec 12 2005, 11:36 AM, said:

"First do no harm". Those words are very important to remember. They are the reason most doctors get into the business. Now days the pay stinks, the hours are worse and your family life s**ks, so why bother! :crazy:

I realize that resources are finite, but I will always try to do the best for my patient, no matter what. Can't tell you the number of people I have seen who haven't paid me a dime (most of my hospital consults as I am not on their HMO panel  :angry: ). My father, who practiced for over 50 years, had patient's who owed him huge amounts of money and he never saw a cent.

I don't know where all this leaves me, but I will just keep plugging away, doing my best for as long as I can... :)

<{POST_SNAPBACK}>


I suspect that leaves you where all good doctors are - doing your job to the best of your ability regardless of circumstances.There are few people I admire more than good doctors. I've never known a good one who wouldn't treat a person regardless of their ability to pay. I suppose it's a matter of ideals, which are sometimes in short supply these days, but which I profoundly hope never goes out of fashion among doctors.
The future is better than the past. Despite the crepehangers, romanticists, and anti-intellectuals, the world steadily grows better because the human mind, applying itself to environment, makes it better. With hands...with tools...with horse sense and science and engineering.
- Robert A. Heinlein

When I don’t understand, I have an unbearable itch to know why. - RAH


Everything is theoretically impossible, until it is done. One could write a history of science in reverse by assembling the solemn pronouncements of highest authority about what could not be done and could never happen.  - RAH

#38 WildChildCait

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Posted 12 December 2005 - 04:17 PM

I pay my taxes.

Why should I be denied care?

What about sports injuries? They are self inflicted if i've ever seen any.
How about suicide attempts? That's a life style choice, should they be left out to dry?

I find htis utterly disgracefull and disgusting.
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#39 Schmokie_Dragon

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Posted 12 December 2005 - 04:21 PM

slightly off topic, but in the US, do the patients pay the doctor directly, or the hospital/health trust get paid and then they pay the doctor? Or is there health insurance etc? I dont really understand the system.
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#40 Rhea

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Posted 12 December 2005 - 06:14 PM

Schmokie_Dragon, on Dec 12 2005, 01:21 PM, said:

slightly off topic, but in the US, do the patients pay the doctor directly, or the hospital/health trust get paid and then they pay the doctor? Or is there health insurance etc? I dont really understand the system.

<{POST_SNAPBACK}>


Generally the patients pay a "co-pay" and the rest is paid directly from the insurance company to the doctor. There are variations on this theme, and types of insurance that can really leave a person with a serious illness with huge medical bills.
The future is better than the past. Despite the crepehangers, romanticists, and anti-intellectuals, the world steadily grows better because the human mind, applying itself to environment, makes it better. With hands...with tools...with horse sense and science and engineering.
- Robert A. Heinlein

When I don’t understand, I have an unbearable itch to know why. - RAH


Everything is theoretically impossible, until it is done. One could write a history of science in reverse by assembling the solemn pronouncements of highest authority about what could not be done and could never happen.  - RAH



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