Deny smokers repeat heart ops: expert

Deny smokers repeat heart ops: expert

Rationing health spending by denying repeat open-heart surgery to smokers who refuse to quit would be fairer than picking on women in their forties having IVF, an expert says.

Michael Chapman, chairman of the IVF Directors' Group, was commenting on research which showed that producing a child through in vitro fertilisation cost around three times more, on average, for women aged 40 or older than for IVF patients as a whole.

An article published on-line in the Medical Journal of Australia (MJA) found the average cost of a live birth through non-donor assisted reproduction was $32,903 compared with $97,884 for women aged 40 or older.

But this skyrocketed to $182,794 for women aged 42 or over.

http://www.theage.com.au/news/National/Deny-smokers-repeat-heart-ops-expert/2005/12/21/1135032044076.html

medical financing (as well as HBOs).

...I fear of government is in charge of healthcare there will be more incentive to curtailing costs and taking preventative measures. In other words, criminalizing unhealthy activity or at the very least denial of treatment if you choose to ignore the government warnings.

If you thought denying someone government funding for school was ridiculous because of a drug bust, wait till sentiments like those expressed in the article are done by those in charge.

You took another break I believe.

Nice new logo. Although, I'm from Dallas, I'm a longtime (and long-suffering) Saints fan. Which means I am an Eli fan..which makes me a Giants fan.

Eli's been struggling but Tiki has been super-human.

Just in case I don't "see" you, I hope you and your family have a Merry Christmas and Happy New Year.

Always nice to talk to you.

who are spending more and more of their administrative dollars in denying care, not offering it. Nobody is worse than a corporate CEO who is trying to cut his insurance premiums down as far as he can by trying to weed out the smokers and drinkers and some of the unhealthier people who work for him.

...its legislative measures to correct unhealthy behaviors.

Granted its a pretty far out fear, but it is there nonetheless.

would be covered. It's an entirely optional procedure, not necessary for the woman's survival (and may actually threaten it) and has little chance of success. Late 30s would be a more rational cutoff date.

As for repeat coronary bypass ops for smokers, I know a lot of physicians who refuse to perform a first one on a patient who continues to smoke. There again, nicotine causes arteriospasm, which means that non replaced arteries have a high chance of occluding and killing the patient despite the best effort of the surgeon.

Obviously there would be common sense rationing, like no liver transplants for alcoholics who continue to drink and no heroics for premature infants that weigh less than half a kilogram. Plastic surgery would be something else that would be self pay, except in the case of severe deformity through birth or injury (and yes, mastectomy is in there).

The point is that the few would grumble about not having access to heroics and vanity surgeries that either don't work or aren't necessary. The rest of us would have access to common sense healthcare that would lower the maternal and infant death rates, keep us as healthy as possible, and give us access to care for all ordinary illness.

I think that's a great tradeoff.

for a person who's already had open-heart surgery but still smokes? I'm guessing it's so outrageously high that most Americans couldn't afford it, which results in de facto rationing. (I could be wrong though.)

Yet I haven't heard reports about rationing on this basis in any of the other Western democracies that have universal healthcare. And since I reside in one right now, I'm guessing I would have heard some complaining about it if it were happening.

Furthermore, private insurers and HMO's are probably more aggressive in cutting costs than governments are. They're naturally trying to maximize their profits, which is a powerful incentive government doesn't have.

than I do with single-payer systems. I guess, I'm not talking about such systems in current practice. I guess I am addressing the concentration of power that COULD occur in such a system.

but I'd argue that the potential for this would occur under any system which gives insurance coverage to everybody.

In a system where risk is pooled but keeping costs low is a top priority, the agencies managing the risk pools will do everything they can to keep a potentially expensive person out or deny them services. The advantage of a single-payer plan is that it's the one way whereby cutting costs can be a priority that's secondary to actually providing comprehensive service. (I'm not saying this unique focus of priorities will happen, just that it can happen.)


By the way...
Merry Christmas/Happy Holidays!

I'm not anti the idea of such a system, just worried about how we protect against such consequences.

If someone is denied open heart surgery, they die.
If someone is denied IVF, they'll be unhappy.

So it would be *more fair* to provide medical care to the person who risks 'being unhappy' instead of the person who will die?

:eyes:

:crazy:

there certainly is something compelling about preventing death, i grant you that.

but to describe those denied ivf as merely "unhappy" is vastly understating the devastation.
for many people, especially those who go the ivf route, having a child is their very purpose of existence.

if you've never heard a doctor tell you "you're infertile", as mrs. unblock was told 4 years ago, you can't understand just how serious this is.


thankfully, the doctors (yes, we even got a second opinion) were wrong, and mrs. unblock is now 18 weeks pregnant!


as to the "dilemna" at hand, i think it's a false choice. there's no need to ration, there are more than enough doctors and hospitals to provide for both ivf and open heart surgery. availability is not the problem, pricing and insurance is the problem.

that's great. I am glad it worked out for y'all. :toast:

after several years of trying without medical assistance, then another year of trying with and endocrinologist using mrs. unblock's hormonal system as a chemistry set, we had given up and decided to go the donor egg route. we got 7 fertilized embryos, but when we went to implant them, we couldn't -- because she was already pregnant, on her first cycle WITHOUT medical assistance in a year!

at least by my insurer(s). It doesn't seem fair, since I could have 14 children and all expenses would be paid.

cover IVF

Exceptions: self insured companies, companies who obtain insurance from other states

Also, there was a $15K limit for IVF

plus out of pocket deductible, out of pocket co-pays, etc.

14 kids? Why would you have done that?

although only 4 ivf attempts per lifetime, i believe. there are exceptions for self-funded insurance plans or for companies smaller than, i believe, 50 employees.

one of the few things mrs. unblock actually appreciates about living in nj.
oh, and they pump the gas for you here....

but we don't have to pump gas here in oregon either. I like it!

They do ration organ transplants this way, since there is a shortage of organs, but limiting or denying someone surgery, due to lifestyle issues, is very unethical.

As a healthcare professional, I can tell you that I struggle with this EVERY day.

We do heart surgeries on convicted murderers for free. We save babies that will never be normal because we can.

We limit abortions because we shouldn't mess with God's plan, but IVF isn't an act of God as far as I can tell, is it?

We keep dead people alive. We transplant organs into smokers and addicts who may or may not stay clean.

Frankly, I think a lot of this is because Americans are into denial - denial of death, tragedy, even disease. We don't want to face the consequences of our actions, or go with what life has handed us. Period.

I say this as a mother and sister to disabled, a daughter of an alcoholic, and a faithful nurse who takes care of everyone equally....from the famous to the death row inmate.

I know it means little these days, but that's supposed to be the reason doctors must help all...no matter who, what or why. It's also called humane.

This doctor is paid to perform a service...it's not his job to play god as to who deserves surgery to live (or live a little longer with some dignity of life) or die. I'm sure there are auto mechanics that are upset they have to repair the same dent over and over again, but they're not paid to do anything but fix the thing and get the car rolling.

If this doctor wants to look at the cost problems, he should get his stethescope out of his backside and look at the games the HMOs and PPOs and other insurance entities have done to the whole system. We get "quality health" care, but they're assured big profits, first and foremost with almost zero liability.

The problem I have is that, right now, as a low-income indebted cancer survivor with depression, my life may be considered somewhat less valuable than the life of, say, a corporate executive who makes a six-figure income.

In this country, money can buy you medical miracles; the problem is it feels awful to those of us without money to know that there won't be miracles for us. We are expendable.

Tucker

i do hate smokers, i dont hate them that much, id say increase the costs to the person getting the surgery,first time is a freebee(as far as additional costs) but after ther your starting to put a tax on the hospital and you should at that point either realise what your doing to yourself, or pay the FULL costs of your surgery to refelect that it is your choice to smoke

How about denying athletes repeated surgeries for injuries incurred while pursuing their lifestyle? Or, in Australia, surfers for repeated injuries while surfing.

multiple ops, then fine but that just isn't the case.

let them die.

i can go on and on

As health care is "rationed fairly" to keep costs down.

My knee-jerk response was to want to hit this guy over the head, but after reading the full article ... anyway ... it's not worth it.