Brit doctors: don't treat people who make bad choices or get old
This'll muss up yer hair.
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/27/nhs127.xml
Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.
Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.
About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.
Some of our fellow Brit dwellars fit into these categories. My friends, I would do
anything to get you care if you are denied it. Even if it is a financial burden, I will send you the money for a plane ticket so you can fly to Philadelphia; I will pick you up at the airport; and I will take you to the nearest hospital.
Do you know what the financial condition of your hospital is? It serves you well to find out.
Among the survey of 870 family and hospital doctors, almost 60 per cent said the NHS could not provide full healthcare to everyone and that some individuals should pay for services.
One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.
Ninety-four per cent said that an alcoholic who refused to stop drinking should not be allowed a liver transplant, while one in five said taxpayers should not pay for "social abortions" and fertility treatment.
To be fair, they can get treatment, they just have to pay for it themselves.
It would be closer to go to Sweden...
Where life is beautiful all the time
And I'll be happy to see
Those nice, young men
In their clean, white coats
And they're coming to take me away, Ha-haaa!
We touched on this sort of issue a few months back, in a thread about an overpopulated island. Finite resources, demand exceeding supply, hard decisions.
It isn't a case of doctors saying, we've got plenty of resources but you aren't worthy. Rather, doctors (and medical administrators really) are saying, our limited resources would be better used on this person with a better likelihood of a long and productive life afterwards, than on this other person who has a much less chance of that.
It's a very hard decision, but it is one we have to face, unless we want to greatly increase spending on health. Taxes, anyone?
It's a very hard decision, but it is one we have to face, unless we want to greatly increase spending on health.
There is also the option of improving the efficiency and effectiveness of the system. More money does not by definition mean better.
What's the problem?
I don't believe -for example- alcoholics who refuse to give up drinking should be given a liver transplant at all if there are others in more need of the liver, even if they pay for the treatment themselves.
But they're not being refused treatment altogether -just treatment on the NHS. How would you feel about your taxes being increased so every alky in the gutter can receive a liver transplant on medicare?
The elderly are more tricky, but there are many procedures which can result in more pain and suffering that would be caused by not having them. If people refuse to take the advice of their doctor about when to stop treatment, they should do it on their own dollar.
It's no different from your insurance company dictating which procedures it will pay for, which doctors you can see.....
Where does that system go when it gets to the point of saying " You don't contribute enough to society, so no treatment for you."?
It's no different from your insurance company dictating which procedures it will pay for, which doctors you can see.....
No different? Can we make that a bumper sticker?
[SIZE=4][COLOR=Red]Universal health care: [COLOR=Blue]no different[/COLOR] from current insurance coverage[/COLOR][/SIZE]
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.
To be fair, they can get treatment, they just have to pay for it themselves.
But, didn't they pay for it once already with their taxes?
But, didn't they pay for it once already with their taxes?
Well sure, that's what they were told. But still, it's probably cheaper for UT to just send them the money to get treated in Britain rather than flying them here first.
No different? Can we make that a bumper sticker?
[SIZE=4][COLOR=Red]Universal health care: [COLOR=Blue]no different[/COLOR] from current insurance coverage[/COLOR][/SIZE]
Sure you can. It's not what i said, but if it makes you feel good, go right ahead.
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.
Oh please. Are you trying to tell me that everyone with health insurance can get the latest most expensive fertility treatment from the provider of their choice? Even 80yo great-grannies?
You've just reminded me why I've never bothered to join in these "discussions". The American health insurance blinkers and obsession with the evil socialism rife in Europe make it pointless and impossible. You'd be bereft without Nationalised Healthcare to fear and mock. Natiionalised healthcare will never work here because no-one will ever give it a chance. So let's just forget it and carry on.
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.
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.
Ok, not "flatly denied" but I imagine this situation is similar to what happens in Britain; a 92-year-old with emphysema is given medication to manage it, rather than a lung transplant, but they are not "flatly denied" treatment.
But, didn't they pay for it once already with their taxes?
Well sure, that's what they were told.
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.....
Ah fuck it. I'm done. Y'all have the healthcare you deserve. It sucks, in my opinion, but then most of you haven't experienced anything else so you don't know what your missing, and I'm lucky enough to be able to afford reasonable insurance. Sucks to be poor here, though, I would imagine. Ignorance truly is bliss sometimes.
Sucks to be poor here, though, I would imagine.
yeah....don't be poor. poor is bad, m'kay?
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.
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.
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.
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.
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.
__________________
Edit: btw, nice putting this in "Current Events" so you didn't have to choose between "Health" and "Politics"
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.
See post
#10
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.
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.
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". :eek:
Naturally, I made other arrangements. Ignorant twits.
Stormie
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.
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.
Ah, but the person you talk to is that organization. The person on the phone, is Dell, is VISA, is the IRS.
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.
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.
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.
By 'eat correctly' you mean, knife in left hand and fork in right hand, elbows off the table, etc.?
That seems harsh.
By 'eat correctly' you mean, knife in left hand and fork in right hand, elbows off the table, etc.?
That seems harsh.
Are you left handed?
By 'eat correctly' you mean, knife in left hand and fork in right hand, elbows off the table, etc.?
That seems harsh.
Are you left handed?
Either way, there's no healthcare for them (lefties), either, say so-called "doctors" (who are really commie freedom-haters).
Are you left handed?
Sometimes.
If you switch it will be like having a stranger.
It is different from the insurance system. No British citizen is without health insurance.
Cigna really does suck. I had a pinched nerve in my neck, and they refused to pay for PT for me, so my doctor hands me a one page handout of exercises (which I did), and basically says, rehab yourself. So what if it took two years before I could raise my right arm past my shoulder?
That sucks. My ex injured his shoulder about ten years ago, leaving him temporarily partially paralysed in his right arm. He went to his GP who referred him to a physiotherapy unit which he visited twice a week for six weeks and then twice a month for three months. Throughout that time he was provided with prescription pain killers at no cost as he was unemployed at the time. The original injury involved a trip to casualty (ambulance job with air and gas to ease the pain) which also incurred no charge.
And THATS why the US needs national health care (not to mention that we have no healthcare at the moment becuase my husband just started a new job)
I'm right handed. I hold my fork in my left hand the tines curved downward, and my knife in my right hand. If I'm cutting a bite of steak, for example, I stab the steak (that sounds weird...) with the fork near the left edge of the steak, and then cut that piece free with the knife. Now, in one motion I've managed to get a bite of steak onto my fork. I don't understand why someone would switch utensils/hands between the cutting and eating motions.
That is the
European, or Continental, way of using utensils. I don't know why there are basically two styles of using utensils.
My mother always taught us to use the dominant hand to cut, the other hand to hold the fork. When the piece is cut, the knife gets put down and the fork gets switched. At no time are you to have a knife in your hand except for cutting/spreading. Also, cutting you meat all at one time is not a good thing.
This is because when she went to boarding school, this was the proper manners she was taught.
Why is this in the doctor thread??
If she had been to boarding school in Europe she would have been taught differently.
How do I use the knife and fork? I like to hold the fork in my right, dominant hand and jam the fork in the eye, to hold the person steady, then in a jabbing left-handed upward motion, slice into the stomach area and cut a jagged edge up to the sternum. Then I will switch the fork to the other hand, put the knife down, and continue jabbing about the head and neck.
Well, that's how I was taught, anyway.
You should be holding your fork in your left hand and your knife in the right, and you shouldn't have to switch hands with your knife.
We've had this discussion here before about how to use your cutlery.
Why is this in the doctor thread??
Hold the scalpel in your right hand, the forceps in your left.
Better? ;)
HA, yes, much better. Thanks Z. :)
Meanwhile, this one case sparks ethical seminars and we all get a chance to put the magnifying glass on it.
Due to over-capacity audience yesterday and by request of numerous employees and physicians, this seminar will be offered again on __________, 2008 at 12 noon. Some physicians who attended yesterday indicated that Directors and Vice Presidents would benefit significantly from hearing the presentation. Additionally, yesterday a physician extended an invitation to The Center for Healthcare Ethics to present this to the greater __________ business community. To Assure a Seat, Register Immediately.
Brit docs: £24,000 is too much for life-saving kidney medication
Patient groups said the decision, announced today by the National Institute for Health and Clinical Excellence (Nice), would condemn many sufferers of kidney cancer to an "early death".
The four prohibited medicines include Sutent, which can prolong life in kidney cancer patients by up to two years. The draft guidance also rejects Avastin, Nexavar and Torisel.
Nice said the drugs were too expensive, at about £24,000 a year per patient, for the benefits they offered and would mean the health service was less able to afford more cost-effective drugs for other illnesses.
Yeah Universal Healthcare - can I have some too???
but what about all the americans who have no access to medical care? what about them? think of the children you heartless bastards!
They're trying to do the most good with the money they have. I think it makes perfect sense. Then again, I don't have kidney cancer.
they're not denying the drugs to people who have private health insurance, are they? A rich Brit has the same options as a rich American y'all. It's just that poor and medium-level Brits sometimes also get a bite at the cherry. Just not in this case. I don't hear you whining that this isn't available to the homeless bums here.......
That's because I ban the homeless bums. :p
That's because I ban the homeless bums. :p
I heard you did things to them... is ban a new euphemism for naaaasty things?
If they don't find the bodies, who cares?
They're trying to do the most good with the money they have. I think it makes perfect sense. Then again, I don't have kidney cancer.
I have no problem with that and if it is the way we go here in the US the public will get just what they asked for. But knowing the current users of our medicaid system all to well, it will never be enough. Some will win. Some will lose. It is easy to compare health system that serve similar size populations. The problem is that none of the current universal health programs that are held up as standards of success serve populations of 31 million people.
I think you left off a zero there, Merc.
It's just that poor and medium-level Brits sometimes also get a bite at the cherry. Just not in this case. I don't hear you whining that this isn't available to the homeless bums here.......
It is available to the homeless bums here. That's Medicaid.
I think you left off a zero there, Merc.
Oops.
It is available to the homeless bums here. That's Medicaid.
right. they get the expensive cancer treatments too. well they would if they even got as far as a diagnosis.
:rolleyes:
right. they get the expensive cancer treatments too. well they would if they even got as far as a diagnosis.
:rolleyes:
In fact they certainly do receive care for cancer, including radiation and long term chemo. They do not however receive experimental treatment.