Unethical theatrics
Sandy said:
You want the government to control you? Are you serious??? I thought liberals hated fascism/any kind of control??
Have your paranoid fantasies ever encountered the
social contract? In theory, a proper government is obliged to the best interests of its people. Controlling every aspect of citizens' lives is not in anybody's best interests. A government held to its obligations under a proper social contract will not control every aspect of people's lives.
Now, perhaps you can answer a question for us, Sandy:
To what is a private corporation obliged?
Additionally, I wanted to address the exaggerations of your topic post:
Doctors are calling for NHS treatment to be withheld from patients who are old or who lead unhealthy lives. Smokers, drinkers, 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.
While those two sentences are lifted directly from the article you linked to, all you've done is demonstrate the efficacy of sensationalism as a marketing device. Looking further into the article, we find the following:
The findings of a survey conducted by Doctor magazine sparked a fierce row last night, with the British Medical Association and campaign groups describing the recommendations from family and hospital doctors as "out rageous" and "disgraceful".
About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.
Managers defend the policies because of the higher risk of complications on the operating table for unfit patients. But critics believe that patients are being denied care simply to save money.
(
Donnelly)
Some of the proposed restrictions also include fertility treatment and "'social' abortions". As to obesity, the British government is already prepared to offer people cash if they lose weight. Statistics apparently project that by mid-century, over half of the population will be dangerously overweight. In the 1990s, many Americans argued, in the wake of the EPA report on secondhand smoke that society shouldn't have to pay for the damage done by smokers. Lung cancer and other treatments were driving up healthcare costs for non-smokers. Alcohol consumers, some noted, were driving up health and auto insurance costs for teetotalers. The patchwork hue and cry for personal accountability made for good electoral politics; that it never explored the costs of accommodating the conservative Christian outlook (increase in unwanted pregnancies, which affects costs and outcomes in education, healthcare, and crime) is tragically hypocritical, but also a digression best left for another debate.
It would seem your sense of panic is misguided.
The British are finding that their National Health is insufficient to provide the full range of envisioned services. The choices seem obvious. The first is to pour more money into the NHS, and, since it is a state bureaucracy, there is most likely some sort of administrative restructuring that could save some money for the patients without actually endangering them. The second option is to start trimming services, and that is already underway. The BBC reported last year that,
Rationing of NHS treatments is becoming more widespread, a survey of GPs and hospital doctors suggests.
Doctor magazine asked readers about rationing. Of 653 answering questions on consequences, 107 - 16% - said patients had died early as a result.
More than half - 349 - said patients had suffered as a result. This compared with one in five in a similar survey conducted nine years ago.
The government said decisions had to be made on which treatments to provide.
(
BBC News)
Rationing has long been a subject of debate
vis a vis the National Health. The issue has become more acute in recent years. Doctors have reported not being allowed to prescribe anti-smoking drugs and anti-obesity treatments. That is,
preventative care is being rationed, as well as fertility treatment, abortion services, and "a host of minor operations".
The BBC also notes that budget limitations compel local trusts to cut back on treatments in order to keep up with new recommendations by the NIHCE advisory body. Dr. Michael Dixon, of the NHS Alliance—an organization representing those local trusts—said that, "Rationing is the great unspoken reality". And as to who won't speak of it, he noted, "The only people who refuse to mention the 'r-word' are the media and the politicians, who continue to want to promise everything for everyone in order to win elections".
Richard Vautrey, of the British Medical Association's General Practitioners committee seemed to agree. "Trusts are already being forced into this but the political parties are not talking about it," he said.
And while the debate goes on, we should consider the context of the survey, as best we can from the information we have before us. In the first place, PM Gordon Brown apparently intends to enumerate patients responsibilities as well as their rights but nobody is sure quite what this means. And of the survey result, while 60% of the responding doctors said that the NHS could not provide full healthcare to all of its patients, and that some individuals should pay for some services, only one in three said that the elderly should not be given free treatment if that treatment was unlikely to do them good in the long run. Half said that smokers should be denied a free heart bypass, while one in four said that the obese should not be given free hip replacement surgery. Meanwhile, BMA chair Tony Calland said it would be outrageous to set an age limit on care. One in five opposed public financing of "social abortions" and fertility treatment.
Near the heart of the debate seems to be that 94% of the (870) respondents said that an alcoholic who refused to stop drinking should not be allowed a liver transplant:
Paul Mason, a GP in Portland, Dorset, said there were good clinical reasons for denying surgery to some patients. "The issue is: how much responsibility do people take for their health?" he said.
"If an alcoholic is going to drink themselves to death then that is really sad, but if he gets the liver transplant that is denied to someone else who could have got the chance of life then that is a tragedy." He said the case of George Best, who drank himself to death in 2005, three years after a liver transplant, had damaged the argument that drinkers deserved a second chance.
However, Roger Williams, who carried out the 2002 transplant on the former footballer, said doctors could never be sure if an alcoholic would return to drinking, although most would expect a detailed psychological assessment of patients, who would be required to abstain for six months before surgery.
Prof Williams said: "Less than five per cent of alcoholics who have a transplant return to serious drinking. George was one of them. It is actually a pretty successful rate. I think the judgment these doctors are making is nothing to do with the clinical reasons for limiting such operations and purely a moral decision."
(
Donnelly)
It's an ongoing discussion for the British. And you seem to be frightened by the idea that some British doctors share certain ideas with American conservatives and centrists. So what
is the difference between a government bureaucracy that places a financial value on human life and a corporate structure that does the same? In the end, the difference is that a government can be held to the social contract, but only if the people care enough to enforce those obligations. The
Daily Telegraph, which is considered a
conservative broadsheet, also ran a related editorial:
Those judgments have been condemned as "outrageous" and "disgraceful", and so, in many ways, they are - but the unpleasant reality is that they are only a reflection of the inevitability of rationing within the NHS. The Government repeatedly promises us that "the NHS provides treatment on the basis of need, free at the point of delivery". That promise generates the expectation that we will receive free treatment for whatever condition we develop. The expectation is frequently disappointed, however, and for one simple reason: the promise on which it is based is fraudulent.
Treatment is never free, but has always to be paid for from taxpayers' money; taxpayers' money is always severely limited, so doctors and health authorities have constantly to make judgments on what conditions they can afford to treat. The Government encourages people in work to believe that, because they have paid national insurance throughout their lives, they have in effect paid for whatever treatment they turn out to require. That is false, as the Government knows perfectly well: the NHS is not funded on the basis of personal insurance contributions; those contributions form only a tiny portion of the total budget. Ministers decide on the amount of taxpayers' money that will go into the NHS every year. The cost of the medical treatment that ill or injured people could benefit from always and inevitably exceeds the budget the Government allocates. Rationing is therefore unavoidable ....
.... The way health care is funded in Britain ensures that a wider range of treatments are rationed here than in countries such as Germany or France, where personal insurance genuinely does make a significant contribution to the overall budget. There is more money available in those systems, so while the problems of rationing exist in them, they are considerably less acute than they are within the NHS.
Changing the way the NHS is funded is not, however, on the political agenda. For the moment, the issue is actually not whether there will be difficult rationing decisions, but rather whether those decisions are made on the basis of clear principles, and are subject to public scrutiny - rather than being made in secret, and under the pretence that what is happening is not really rationing.
Too often, at the moment, rationing decisions are opaque, unaccountable, and unacknowledged. Doctors and managers can deprive or bestow treatment without explaining the reasons for their decision. The Government should consider instituting a body, similar to NICE, which would advise on issues such as whether chronic alcoholics should be given liver transplants, or whether heavy smokers are entitled to heart by-pass operations, or whether old people should have the best life-prolonging treatment available for whatever conditions they have. That way, no-one would be deprived of treatment simply because doctors disagreed with the way they have chosen to live: such a rationing "principle" would surely never survive public scrutiny.
(
Telegraph.co.uk)
I would suggest that it is more rational for you to set aside your holy crusade against liberalism and socialized medicine and stop demanding inhuman standards of your chosen opponents. People are
human, and expecting their institutions to be perfect is a puerile foundation for argument. The reality is that the British have decided to go with a national health program, and must, inevitably, make some decisions as to what is a right and what is a privilege. They must come to terms with the magnitude of demand and the means to accommodate it. And pretending that their solutions should be, on any arbitrarily selected date,
perfect is neither reasonable nor useful.
Those of us who read beyond the
two sentences you quoted recognize the histrionics of your reaction. Indeed, simply reading the whole of the article you linked to reveals the degree of your exaggerations. And reading beyond that one article helps put the situation, to a reasonable degree, into perspective. On the one hand, I don't envy the British the choices they will have to make in the future. To the other, I do.
After all, Sandy, think about the American alternative. Imagine a doctor, in a routine examination, finds a tumor in your breast. It's an early detection, so they move quickly and remove the tumor without having to take the breast, bombard you with radiation, or poison your blood with chemotherapy. All is good. Then one day some executives run a company into the ground, and as a result, you lose your healthcare. So you get a new job or buy new healthcare. And a couple of years down the road, your doctor discovers a new tumor; your cancer has relapsed. Depending on your policy—and this is still a widespread problem—you will be denied coverage for your treatment because your cancer counts as a pre-existing condition.
There are people in this situation today. CNN's chief medical correspondent, Dr. Sanjay Gupta, wrote last month:
There are more insurance issues raised in the study, and many of them have to do with lack of access to care. For instance, 86 percent of insured women get pap smears, compared to only 68 percent of uninsured women. And, to make matters worse, if you do develop cancer, it is often difficult to get insurance because you now have a pre-existing condition. In fact, health care proposals released by presidential candidates Rudy Giuliani, John McCain and Fred Thompson have few provisions for people to obtain insurance if they already have a medical condition. That is all the more ironic, given Mayor Giuliani's history of prostate cancer, Sen. McCain's history of melanoma and Sen. Thompson's history of lymphoma.
The insurance industry is taking steps to try to create plans for people with pre-existing conditions that are not prohibitively expensive, but for many people that relief may not come fast enough.
(
Gupta)
One reader even commented that Blue Cross/Blue Shield of Iowa, "... charged inflated premium rates based on my one symptom, "heartburn", suspecting, I'm sure, future costs for Nexium, upper endoscopies, and possible surgery for esophageal cancer".
Another wrote, "Due to strong side effects from chemo I lost my job and therefore health insurance. No Insurance company would give me insurance for 5 years, until I am considered cancer free. Finally I found a very expensive high risk pool insurance that will cover me until medicare starts. Without the help of my children I could not survive."
Note the phrase "prohibitively expensive" in Dr. Gupta's blog entry. What makes such plans for people with pre-existing conditions "prohibitively expensive" is not the condition itself, but, rather, the company's obligation to achieve a certain profit margin for the comfort and enrichment of its investors and executives. Now, let's be clear here:
black ink isn't enough. That black ink must represent a certain proportion, else investors get nervous and the company starts losing assets.
Profit is the primary obligation of our American healthcare system at present. And this, it seems, is what your unethical theatrics intend to advocate.
____________________
Notes:
Donnelly, Laura. "Don't treat the old and unhealthy, say doctors". Telegraph.co.uk. January 28, 2008. See http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/27/nhs127.xml
BBC News. "NHS rationing rife, say doctors". September 24, 2007. See http://news.bbc.co.uk/2/hi/health/7010413.stm
Editorial. "A healthier way to run the NHS". Telegraph.co.uk. January 27, 2008. See http://www.telegraph.co.uk/opinion/...GAVCBQWIV0?xml=/opinion/2008/01/27/dl2701.xml
Gupta, Sanjay, et al. "Pre-existing conditions preclude you from insurance". Paging Dr. Gupta. CNN.com. December 20, 2007. See http://www.cnn.com/HEALTH/blogs/paging.dr.gupta/2007/12/pre-existing-conditions-preclude-you.html
