Smokers in the UK could be denied surgery.

[greguganus]

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/06/04/nhealth04.xml

[rubberducky]

1. Next will be overweight people.

[barb162]

10. and maybe drinkers

[lonestarnot]

13. Tokers.

[barb162]

24. huh?

[lonestarnot]

27. huhers.

[barb162]

29. Okay.

(huh?)

[kenny blankenship]

30. A toker says what?

[barb162]

43. I give up

What?

[lonestarnot]

44. huh?

:shrug: :rofl:

[LeftishBrit]

18. Actually, very overweight people have often been encouraged to lose weight before elective surgery

And not just in the UK. The whole point is not to change people's lifestyles permanently to 'healthy' ones; it is to reduce surgical risks. Sometimes there comes a point where too much attention to reducing the risks of surgery can lead to greater risks in terms of delaying surgery. Common-sense needs to be used, and sometimes isn't. But it's not an anti-smoking measure; it's a surgical-risk-reduction measure.

[Solo_in_MD]

41. Already happend in the UK

Its one of the reasons Gov run health care makes Americans nervous

[Warpy]

2. I know smokers who didn't quit right after surgery

but who managed to quit within a year. Denying care on the basis of habits we don't like is silly. Most folks don't really want to die young and most folks will do the right thing in their own sweet time.

The few who don't generally end up getting their second bypass operation within 5 years. After the second one, that's it. There are no more.

As for susceptibility to MRSA and other less serious wound infections, that is much more common in diabetics than smokers. Should we deny diabetics life saving surgery because they have a disease that makes them prone to complications?

Don't get me wrong, I absolutely despise smoking. I am allergic to smoke, I think it's an ugly habit, and it stinks up everything it's near. I just don't think we should deny people the right to live a few years longer because they were dumb enough to start when they were immortal teenagers.

[Bake]

3. I'm sure this will bring out the Smoke Nazis here!

You know, "Great idea! Ought to do the same thing here!" That kind of stuff.

:popcorn:

Bake

[marions ghost]

4. Draconian...

What about a serious program to help smokers quit before surgery, instead of denying surgery?

I agree with strong measures to limit smoking in public places and general discouragement. My own Dad quit in 1990 because of this kind of discouragement, and it has given him years that I'm convinced he never would have had if he continued.

But this is going too far.

[muriel_volestrangler]

6. You mean like this?

The Leicester plans would involve smokers being given counselling and nicotine patches to help them stop. But the patients would have to give a blood sample to prove they had quit before being put on the waiting list and admitted for elective non-emergency surgery.

Doctors would decide whether to operate if the patient failed to give up.

[marions ghost]

32. I'm in favor

of patches and counselling before the surgery, absolutely. But then, considering the risks, the patient should decide if they want to risk it or go with the medically prudent choice to stop before surgery.

Same goes for alcoholics or other addictions. When you are dealing with addictions, you can't force compliance. Some people are just powerless against them, no matter what the odds.

If you give smokers all the info and tools to quit, and they still don't--then you should perform the surgery. Otherwise it gets into tricky areas of discrimination about who 'deserves" elective surgery or not.

I think the doctors DO have a right to ask that patients attempt to quit, as some of them will be able to do it. But if they can't then one must suspend judgment and do the procedure.

[SoCalDem]

5. Gee. I wasn't aware it was illegal in the UK

If someone uses something that is LEGAL, I don't see how they could be denied services..anymore than a person who CHOOSES to drink alcohol...or who drives too fast..or who didn't use their seatbelt or helmet..or who eats too much pizza :)

Who wants popcorn??

[LeftishBrit]

22. It's nothing to do with legal or illegal

The point is not to penalize anyone whose illness might be 'self-inflicted'; that doesn't influence the decisions at all. In fact, a smoker who needs emergency surgery for cancer or a blocked artery linked to their smoking will get the surgery promptly, as it's clearly more dangerous to wait in such cases. In the case of non-urgent operations that have nothing to do with conditions that might be caused by smoking, some surgeons may choose to delay it till the person hasn't smoked for a few weeks, to reduce surgical risks.

Just as if someone is seriously anaemic, a doctor might wish to institute treatment to increase their blood count, before scheduling an operation which might be more risky in an anaemic person.

I'm not saying this is necessarily a good policy, especially as there are some people who simply would be unable to cut out their smoking for a few weeks. But the decisions are being based on what increases or decreases the risks of the *operation*: not with doctors trying to force people to quit smoking, or blame smokers for their illnesses.

[Zavulon]

7. If we go to universal care here, that sort of crap is inevitable.

This is why I always say "help the poor, leave the rest of us alone." The last thing I want is government deciding (or even having the power to decide) who gets surgery / care and who doesn't.

[laundry_queen]

8. Yes because it's so much better

if the insurance companies deny coverage based on your habits and/or pre-existing conditions. I'd much rather have for profit corporations deciding my care instead. :sarcasm:
That said - I think denying any coverage based on habits/weight is unethical and total BS.

[Zavulon]

11. The government was unable to

handle flu shots with any degree of competence. The government is unable to handle proper health care for the military even though the number of people in the service is mandated by Congress and is no secret. The thought that an inefficient behemoth like our federal government can properly provide health care for over 300 million people is simply absurd, and it never ceases to amaze me how many people want to let the government try. Once its foot is in the door, it's not as if we can say "Naw, let's go back."

When the government misspends our health care taxes, and it WILL, it will scale back benefits and coverage. Guess where they'll start? Habits and pre-existing conditions. I, unlike you, would gladly trust a corporation over the government = and I can state my position without sarcasm, too.

[SoCalDem]

12. The BUSH govenment n/t

[Zavulon]

17. Bush was in the White House at the time, but

not EVERYTHING can be blamed on him. He wouldn't get personally involved in flu shots anyway - it's not like he gives a fuck about sick people to begin with.

However, your post made me think of two points immediately:

1.) Just because I would prefer a Democrat-led government doesn't mean there's a guarantee that it would handle health care for 300 million people perfectly, and

2.) There's no guarantee that Democrats would hold the government forever. I do NOT want to be dependent on the government for health care in my senior years and see a Republican take the oath of office the day after I've been told that I've got 18 months, tops.

[SOS]

15. The government does not "provide" healthcare under Medicare

They simply pay the bills at one-tenth the overhead costs of private insurers.
Ask anyone over 65 if they like Medicare.
My 81 year-old father has said many times "Thank goodness for Medicare, without it I'd be dead by now".

[Zavulon]

28. Never said it did.

What I'm saying is that under a universal system I would not trust the government to do the job properly.

[laundry_queen]

20. Your federal government

isn't able to handle much anything with any amount of competence lately.
The lovely thing about the Canadian system is that the federal gov't only sets the laws and regulations, and partially funds universal health care. The rest is up to individual provinces. No inefficient behemoth here. Much more efficient than a zillion different insurance companies and HMO's piecemeal-style health care for none.
Oh, and FYI, at the moment, I think your government and the corporations are one in the same. You're fooling yourself if you think otherwise.
But I do sympathize, I wouldn't want the Bush white house in charge of any sort of universal health care either. However, that's why you need to get a dem in there to put the system in place.

[Zavulon]

26. Unless you could guarantee that there would ALWAYS be a Dem

in place, I want no part of it. How would you like to give birth the day before a Republican takes the Oath of Office and assumes the office with a majority in the House and Senate? They could unravel anything put in place.

I used to live in Canada (born in Dollard-Des-Ormeaux), and even though what you say is correct, individual provinces seem quite adept at limiting their coverage when money runs low. As an example, last year British Columbia exempted itself from paying the expenses for autistic children. Really nice. When I have time I'll look up, from province to province, the lists of things not covered by Canada's system and - if I can find it - items that used to be covered but no longer are (it's an ever-growing list). Canada's health care system is why my parents eventually left the country. I'd much rather pay for my own insurance, because if I don't like it I can always switch. If the government gets involved, there is no going back. I personally want nothing to do with "universal care," socialized medicine or whatever else you or anyone wants to call it.

Further, there is no reason to believe that our government would let states control as much as provinces do. I read Hillary's 1993 plan cover-to-cover and was absolutely horrified - so horrified that this former Republican (who voted for Clinton in 1992) came dangerously close to voting for Dole in 1996 - just because of this issue. Up to fifteen years in prison for seeking care outside of your HMO? A plan like that does not lead me to believe that Hillary would let the individual states have a say at all.

Your assertion that government and corporations are one and the same is not unreasonable, but I repeat my point: if I don't like one corporation, I can switch to another. If government runs the show, it's permanent and I have no options.

[Retired AF Dem]

38. Go visit some VA Hospitals

socialized medicine at its best.

[kenny blankenship]

9. You're taking the bait

from the hand of a troll. From the article itself:

Smokers could be denied routine operations on the NHS unless they quit a month before surgery.

Health managers are considering the move after research showed that smokers take longer to recover from surgery and are more prone to hospital-acquired infections such as MRSA.

All that is contemplated here is requiring smokers to kick before a non-urgent surgical operation. They can go back to killing themselves after they leave the hospital.

[Zavulon]

14. I'm a smoker. If I were told today that I need surgery and had to

lay off for a month, I seriously doubt I could do it. None of my attempts to quit smoking lasted longer than 2-3 days.

Smoking is a legal activity, and if I'm forced to pay into a system and am refused service for something that isn't even illegal, sorry, I can't support that. I'm not taking any bait at all, I get the same one vote as everyone else and think this sort of thing is horseshit.

(No offense, it's just that we're not going to agree on that).

[Solon]

19. I'm a smoker too, and I think this is reasonable...

granted, this is could be exaggerated, but nicotine is a stimulant, so complications from surgery could arise from being ON nicotine in any form. From a medical point of view, to speed recovery, and minimize risk, people routinely are told to lay off food and drink before surgeries, sometimes days before, or on restricted diets before or after the surgery. Alcohol and other drugs are also forbidden, even, in some cases, prescription drugs.

[Zavulon]

23. Smokers have been undergoing surgery for decades now.

To be DENIED by a government is simply unacceptable if smoking is legal and I'm forced to pay into the system. Not that many regular smokers can just drop the habit for a month. If I could, I'd probably have managed to quit now.

Starting smoking was the dumbest thing I ever did, but that ship has sailed now. Besides, do you think such cutbacks would be limited to smokers? Next they'd go after booze, or junk food, or whatever else they think of every time they're short on money.

I don't trust government to run this for 300 million people without blowing too much of the cash. Smoking is only one example - one of what I guess would eventually be hundreds.

[pitohui]

39. no you'd just fib about it like all the other smokers

come on, dude, this has been standard for many years to hear my smoking friends tell it, you are advised to stop smoking before the elective surgery and the smoker (addict) nods and says, sure thing, doc, but mostly doesn't stop and mostly isn't expected to -- that's what addiction means

you are getting all in a knot about the u.k. spelling out something that they have undoubtedly been doing for years without interfering w. anyone's right to get surgery, in an ideal world the smoker would comply and lay off for a month but it isn't an ideal world and everybody knows it

sheesh, chill, man, they don't put you on a polygraph to see if you quit smoking before the surgery

[gollygee]

45. This kind of thing is inevitable with private healthcare too

We already have workplaces firing people who smoke because they don't want to pay for the health care. I don't doubt if private insurance companies will stop agreeing to some procedures or coverage for smokers. At least if it's a governmental agency we have some recourse - calling our congressional reps, voting for people who don't do this kind of stupid thing.

[LeftishBrit]

16. No one is trying to deny smokers all treatment, or demanding that they quit altoget

Some health trusts, in order to save money and to meet 'targets' on patients' recovery rates, have been asking that smokers stop smoking for at least four weeks before certain types of surgery (e.g. heart bypasses) that can be more risky and have longer recovery periods in people who are currently smoking. Patricia Hewett, our (not very brilliant) Health Secretary has said that it is OK for them to do so - she has not *demanded* that everyone do so.

I am *not* very happy with health trusts that apply such policies in a blanket way; but they are not doing so in order to punish or bully smokers; they are doing so in order to improve average recovery times - which translates into financial savings, and better statistics for the various health-service league tables.

Moreover, they are not expecting smokers to quit for good: only for the few weeks before the operation. People are often required to fast for some hours before an operation - this is to make the surgery safer, and does not mean people are expected to quit eating!

[laundry_queen]

21. Good point. n/t

[Spazito]

31. Thanks for the clarification, it helps in my understanding of

the rationale behind the, imo, over-the-top headline.

[Bridget Burke]

25. For all those who didn't bother to read the linked article....

1. This only involves "elective" surgery--hip replacement, etc.

2. Patients will be given help to quit smoking.

From a study in 2002:

Smokers should abstain from the habit for at least six weeks before surgery to reduce the risk complications, a study suggests.

Tobacco smoke has a damaging effect on the heart, lungs and immune system. Smoking is a risk factor for wound infection and cardiopulmonary complications in almost any type of surgery....

They (the study) found that smokers who were given help to quit or reduce their habit were much less likely to suffer complications (18%) than those who were given no help to cut back (52%).

They were six times less likely to suffer from problems with wound healing, and on average were kept in hospital for two days less than those who were not helped.

http://news.bbc.co.uk/1/hi/health/1753016.stm

Of course, simply posting a link with a misleading headline guarantees flame bait.

[greguganus]

33. Flamebait?

Misleading headline?

The official article title was "Smokers who won't quit denied surgery"

Mine was "Smokers in the UK COULD be denied surgery"

Flamebait indeed.

:shrug:

[John Kerry VonErich]

36. Not flamebait

I think the majority here don't like it. Either/or, its still the same.

[stillcool]

42. what a difference a read makes...

thanks for providing that. I see I'm as guilty as others of accepting at face value, that which I have not investigated....I guess I'm a slow learner, and my lessons have to be extra-painful.

[seriousstan]

34. This is what you get when you have a "company" doctor. Especially if the company is the government.

[WinkyDink]

35. I wonder if they'd have refused Diana for her bulimia.

[LeftishBrit]

37. Diana probably didn't use the NHS anyway...

but doctors might have decided to postpone the surgery of *anyone* with an eating disorder, if it significantly increased their risk from the operation. E.g. if someone had severe anorexia and weighed 75 pounds, doctors might well feel that elective surgery should be postponed until they gained some weight. I don't know how much bulimia as such increases the risk of surgery.

[pitohui]

40. i think your analysis is correct

mia is more "hidden" than ana, but if they were aware of her bulimia perhaps because of an upset in potassium levels, then some treatments would have to be changed and i strongly suspect some surgeries would need to be postponed, esp. elective surgeries

what bulimia/anorexia do to the heart is no joke and it would have to be accounted for when scheduling an elective procedure, seems like it would be reckless to do otherwise