Brit doctors: don't treat people who make bad choices or get old

[lumberjim]

Originally Posted by monster

Sucks to be poor here, though, I would imagine.

yeah....don't be poor. poor is bad, m'kay?

[DanaC]

There have always been some procedures and areas of medical care which have required payment from the patient: dentistry, even on NHS incurs a charge; unnecessary treatments are not provided on the NHS. That said, I would point out that even cosmetic treatment is provided on the NHS if it can be shown to be of enough benefit to the patient and if the lack of it can be reasonably surmised to be damaging to their physical or mental well-being. For example, I had real problems with my teeth, they were crooked and the enamel was porous so I could never make them look clean no matter how conscientious I was about dental care. I was given veneers for upper and lower front teeth (all bar the molars) partly because it was medically advantageous and partly because it was affecting my self confidence. If I'd had that done at my own cost it would have been several thousand pounds. Because I was unemployed and therefore able to claim free dental care it cost me nothing. If I had been working it would have cost me about £400 on NHS. Still significantly less than private.

There are some procedures and treatments that it is not sensible to allow to certain patients. It's about resources, but it's also about good medicine. Like monster says, giving a new liver to someone who refuses to stop drinking isn't just wasteful, it's medically unsound as it's highly unlikely to work. In terms of age, there comes a point where you are trying to hold back the tide...at that point it can be reasonably argued in many cases, that the medically sound tactic is to make that patient as comfortable as possible, rather than attempting to 'cure' them.

Making them comfortable, by the way, includes things like the provision of oxygen canisters and a variety of inhalers, all of which the patient is provided free of charge after the age of 65, and prior to that at the standard prescription rate of £6.75.

The NHS has been wonderful to me. It's been wonderful to my Dad. It's been wonderful to numerous friends and family members. It ain't perfect, but the cost equation in treatment rarely comes up, and that's the way it should be at the patient's end of things.

[Flint]

Originally Posted by ZenGum

Remember how Briana was getting chemo, and needing anti-nausea medication? Insurer got all stingy and would only pay for one (IIRC) dose when she needed more.

Originally Posted by Undertoad

My friends, I would do anything to get you care if you are denied it.

Refresh my memory, Undertoad. Did you fall all over yourself to pay for the extra medicine Briana needed?

Or is your offer only good when you can make a cheap political point?
__________________

Just because a medical treatment can be offered, it doesn't always mean it should be offered. What we have in our current system are business entities, whose principal interest is the bottom line, deciding when to withhold treatment. In the examples you state here, you have doctors deciding when to withhold treatment. Oh, the horror. Doctors making healthcare decisions. Like no more livers for an alcoholic. Give me a break.

[Undertoad]

Turns out it wasn't a necessary life-threatening sort of thing.

Also I offered her a replacement medication that would have been an adequate substitute.

[Flint]

You know, that's the problem with you. It's unfair because nobody can say anything bad about you, because you're such a nice guy. Jerk.
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Edit: btw, nice putting this in "Current Events" so you didn't have to choose between "Health" and "Politics"

[Flint]

As coincidence would have it, I just recieved an invitation to this ethical seminar:

PROGRAM DESCRIPTION
As a touchstone for unpacking the ethical concept of "the reality principle" this seminar considers the December 2007 refusal of Cigna to cover under its benefit schedule a liver transplant for 17 year old, Natalie Sarkisyan, and the circumstances of her death. The content of the seminar focuses on the concept of "realism as an ethical obligation," as well as a suggested ethical framework for setting limits and the socially constructed philosophical concept that grounds "the reality principle."

Now brace yourselves, I suspect that Undertoad is about to unleash a scathing criticism of the American healthcare system, and offer his personal assistance to the poor, beleaguered citizens of the USA. After all, this is about helping people, definitely not just making cheap political points.

[Undertoad]

See post #10

Originally Posted by UT

Actually I believe that only occasionally are there cases where people are flatly denied coverage by their insurer, and when they do, it's big news. Somebody died of it recently.

That "somebody" was Natalie Sarkisyan.

[Flint]

Honestly, I just thought it was weird that I happened to recieve this particular invitation in my inbox, today.
But it does show that the problem exists, and is a subject that needs dealing with, in our present system.

[Stormieweather]

I'm at work, don't have time to write much...but here is an ancedote about our (Florida) health care system. Years ago, when I was poor and a single mother, I contacted the Health Department to make an appointment to obtain birth control. I was offered a date/time about 5 months down the road. When I protested and asked what they suggested I use in the meantime, the clerk blithely told me.."well, just have a baby! We have excellent infant services".

Naturally, I made other arrangements. Ignorant twits.

Stormie

[Undertoad]

One person is truly neglected and dies - that's a mistake, not a problem. There are 300 million people here and we will need to see more cases of it before proclaiming it a systemic problem. Meanwhile, this one case sparks ethical seminars and we all get a chance to put the magnifying glass on it.

[classicman]

Originally Posted by Stormieweather

Naturally, I made other arrangements. Ignorant twits.

Check - make that Twit - singular. I am sure that the organization as a whole doesn't agree with that one idiots opinion.

[xoxoxoBruce]

Ah, but the person you talk to is that organization. The person on the phone, is Dell, is VISA, is the IRS.

[classicman]

not to me xoB - I recognize that I have a job and represent the company that I work for, but I am not that company. If I say something stupid or make an offhand remark, it shouldn't be assumed that the entire organization agrees.

[ZenGum]

Originally Posted by Stormieweather

twits.

Was that a typo?

[TheMercenary]

Originally Posted by monster

Um, no, but thanks for playing.

NHS care is supposed to cover standard basic medical care. Procedures which are unnecessary or against medical advice do not fall within this remit. If an alky needs a liver transplant, they must stop drinking. Not just because they are undeserving and should not get a chance to trash a new one, but how in the hell does the transplant stand a chance of working of the poor organ is not only assailed by the recipients antibodies but also a slew of toxins.....

No different from the current system of insurance. Not only do transplant patients have to stop drinking, they have to stop smoking and eat correctly.