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Monday, November 28, 2005

Fat People Lose Access to Some Surgeries as Cost-Saving Measure in Britain's Government-Run Health System

The British nationalized health care system has decided to halt knee and hip replacements to overweight people in at least one part of Great Britain.

Specifically, a woman 5' 2" who weighs 168 pounds or more or a man 5' 10" who weighs 210 pounds or more would be ineligible.

Says a November 27 article in the Scotsman:
Dissolute footballer George Best was entitled to a liver transplant on the NHS in 2002, despite his transparent determination to drink himself to death. But obese people in East Suffolk are to be refused hip and knee replacements, even if they are in terrible pain, as a result of healthcare rationing.

It's not as if we are talking about people who are can't-get-out-of-bed-without-a-crane fat. The area's three primary care trusts have said there will be a blanket ban on such operations for people with a Body Mass Index of 30: that's a woman who is 5 ft 2 in and weighs 12 stone or a man who is 5 ft 10 in who weighs 15 stone.

And it's not a question of surgery being denied for clinical reasons. Although hip and knee replacements are less likely to be successful in overweight patients, Dr Brian Keeble, director of public health in Ipswich, has been clear that the motive behind the decision is primarily financial. The trusts need to get rid of a 47.9 m [British pound] deficit, and apparently believe fat people are fair game.
Later in the article, the newspaper says:
...Of course, NHS resources are finite, and, unpopular though the idea is, some degree of rationing is a fiscal necessity. For this, and to control waiting lists, it may be appropriate to look at whether a particular operation is the correct course of action for a particular individual, taking into account their age, weight and personal circumstances.

But such decisions should be made on a case-by-case basis, in the same way as liver transplants such as Best's. In those instances where obesity is impeding surgery, the excess weight should be seen as a temporary hurdle the patient can overcome with support, rather than another 10,000 [British pounds] saving to celebrate.

When making these difficult judgments, it is important for primary care trusts to remember that fat people pay taxes too. After all, it is one thing to insist everyone should be required to give a portion of their income to fund services they may not use (such as education or improved transport networks), it is quite another to demand people pay for a service they will be denied when they need it.

And if we decide the best way to cut costs is to punish people for "self-inflicted" conditions, where is the blame game going to stop? Could we see health authorities refusing to treat people who are sexually promiscuous for STDs or those who use sunbeds for skin cancer?

Perhaps those in the throes of a heart attack should be interrogated on their diet before an ambulance is dispatched and anyone who fails to do pelvic floor exercises after childbirth should surely have to thole that self-inflicted prolapse. Indeed, if fat people are refused treatment for fat-related conditions, why shouldn't sports fanatics be denied treatment for sports-related injuries?

The point is we are all fallible: we all make choices every day that impact on our health, from eating junk food to having children. And unless we are willing to sacrifice our own right to NHS treatment when the time comes, we should not be so hasty in judging other people's lifestyles, and finding them wanting.
Socialized medicine. You get what you pay for. Or, maybe, you don't.

Hat tip: Kevin, M.D.

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Posted by Amy Ridenour at 1:29 AM

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