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What Single-Payer Looks Like: Smokers and Obese Banned from Surgery at British Govt Hospital Thanks to Budget

What Single-Payer Looks Like: Smokers and Obese Banned from Surgery at British Govt Hospital Thanks to Budget

“I think we are going to see more and more decisions like this”

Just last week, Bernie Sanders rolled out his Medicare for All bill. Sanders and the bill’s advocates railed against the current healthcare system as ineffectual, forgetting (or hoping the public has forgotten) that it’s the product of Democrat ideas and votes.

In Sanders’ fantasy world, single-payer system is the only cure for what ails the American healthcare system. Most of his Democratic Senate colleagues agree. They were wrong about Obamacare and what it would fix and they’re wrong single-payer.

The reality of single-payer’s implementation is incongruent with what it promises to deliver.

Look no further than Britain, who employs a single-payer system, to see what lies ahead if the U.S. chooses to wander down a similar path. There, rationed care is not fear mongering; it’s an unfortunate challenge for the system’s consumers.

Most recently, British government run hospitals have banned hip and knee surgery for smokers and the obese citing budget cuts.

Avik Roy writes at Forbes:

If you’ve been concerned about the fate of veterans’ health care in the U.S., look to its cousin across the pond. A subsidiary of the government-run British National Health Service has decided to bar obese patients and smokers from undgergoing hip and knee operations. “I think we are going to see more and more decisions like this,” said Chris Hopson, the head of NHS Providers told The Telegraph. “It’s the only way providers are going to be able to balance their books.”

The British NHS and the U.S. VA are cousins

The British National Health Service and the U.S. Veterans Health Administration are two of the last remaining socialized health care systems in the world. That is to say, both systems have not only single-payer, government-run health insurance—the government also owns the hospitals and employs the doctors.

When government has that dominant of a role, it has no choice but to prioritize how to spend the money. In May, NHS England disclosed that its health care providers—hospitals, clinics, doctors and the like—had spent £2.45 billion ($3.26 billion) more than they had been allocated.

In North Yorkshire, England, hospital leaders have decided to cut back by denying hip and knee surgeries to smokers who refuse to quit, and those with Body Mass Indices above 30. (If you’re 5’10”, a BMI of 30 is 209 pounds; if you’re 5’5”, it’s 180 pounds.)

“Major surgery poses much higher risks for severely overweight patients who smoke,” said an NHS England spokesman. “So local [providers] are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their hip or knee operation.” The change “saves the NHS and taxpayers millions of pounds.”

No amount of blaming the wealthy or Republicans will alter the math — socialized medicine is simply not sustainable. Roy continues:

Left-wing advocates of the NHS-VA approach argue that rationing isn’t a big deal because in a free-market health care system, health care is “rationed” based on an individual’s ability to pay for it. But that’s balderdash.

In the rest of the economy, when a product or service is too expensive, businesses have the incentive to figure out how to deliver it less expensively. Think how much high-definition TVs cost when they first came out—tens of thousands of dollars—compared to today, when Amazon sells dozens of models for under $100. That economic incentive—to deliver better services with higher quality and lower costs—only exists in the private sector.

The more we can put patients back in control of their own health care dollars, the better. Let’s start with the VA.

Follow Kemberlee on Twitter @kemberleekaye


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notamemberofanyorganizedpolicital | September 18, 2017 at 1:37 pm

RE: “What Single-Payer Looks Like: Smokers and Obese Banned from Surgery at British Govt Hospital Thanks to Budget”

The UK “un-health” un-caring system(?) is Soooo BAD that it is a frequent and recurring subject of ridicule in the Britcom TV programs.

One Foot in the Grave – S01E04 – Ill Retire to Bedlam

Smokers and the obese should pay for their own smoking and obesity related problems. In Britain they can still get knee/hip done on their own dime.
Sure Obama care is a disaster, this is in advertently making a case for it.

    mrboxty in reply to beagleEar. | September 18, 2017 at 2:46 pm

    They already are paying about $7000 in taxes per person for a shoddy, second rate product. You’re asking them to pay twice for the same turd.

    It is sick to think if you have some unapproved lifestyle no less being overwieght which the dirty little secret is mostly genetics, just take a look at identical twins, you would deny medical care altogther.

    We will see what you think when you know someone that doesnt’really eat a lot but is overweight or a smoker who has failed many times to quit gets denied medical care.

    Just remember folks if you don’t eat and drink exactly what the government says you have to you don’t get any of the medical care others are entitled to. Great ad for socialized medicine and socialism.

    LibraryGryffon in reply to beagleEar. | September 18, 2017 at 9:11 pm

    I have a hypermobility joint disease (genetic) and have already had two arthroscopic surgeries on my left knee for torn cartilage. We’ve tried injections, including the gel. At this point, I’m living on NSAIDs, can only take stairs one at a time, and occasionally have it buckle for no reason at all; last time that happened I injured my right foot so badly when I fell that I was in a walking boot for six months. I’d have healed faster and been able to put weight on my good leg without pain faster if I’d broken it.

    The only option left is a knee replacement, but since I’m under 60, I’m “too young” and it might wear out before I do. Of course my current quality of life is noticeably affected including the ability to exercise. Since I can’t exercise or walk much, guess what? I’ve put on weight! Many people are in my boat; the knee/hip damage came first.

    And by denying us replacement joints, we’re going to stay overweight.

Did anyone else know about Single Payer being on the ballet in CO? ColoradoCare; please be my guest and google how it did in a state Hillary won. PLEASE DO

Not only is it daft policy and morally bankrupt, its UNPOPULAR. I think the Dems are going to bleed a couple extra seats for this. Senators from CA and NY LOL!!!

The EU had 200 million more citizens and 2 trillion less GDP! Let’s not mimic losers

why the all the hate for smokers?

statistically, they die sooner and use less healthcare resources than “healthy” people, so i don’t see a problem.

    notamemberofanyorganizedpolicital in reply to redc1c4. | September 18, 2017 at 2:34 pm

    Plus the U.S. Federal Government openly, actively, and un-ashamedly promoted smoking for military personnel and industrial workers during WWII.

      If nicotine is SO addictive… isn’t jacking up the price of cigs the same as a street drug pusher upping price to junkies?

      Had an acquaintance show up at a British clinic with swollen inflamed elbow (as in necrotising fasciitis!!!!) diagnosed as potential malaria. Quick action by US doc friend (by phone) and he was finally hospitalized for early shock and sepsis for ONLY a week in South Hampton. For an otherwise healthy 30 year old… poor medicine could have been deadly. As Churchill said of socialism, it is equally shared misery.

    MadisonS in reply to redc1c4. | September 18, 2017 at 5:35 pm

    GLBTQ must be respected but not LSMFT.

    LibraryGryffon in reply to redc1c4. | September 18, 2017 at 10:42 pm

    And they pay a lot more in taxes. 🙂

I don’t think that many of you understand Obama care. It does not cover a thing and even your own insurance product is effected and does not cover what it used to. Patients can come see me as an outpatient, but I can not get proper test for their conditions. The insurance is only a major medical policy and does not cover much.

I was surprised to learn recently that while those who live in the UK may all pay the same, the care that they receive is not standard everywhere. The example that brought this to my attention is that recently one jurisdiction stopped providing infertility treatments, though it is paid for elsewhere.

So they’re limiting access to health care based on BMI? This is my shocked face.

BMI, however, is next-to-useless as a measure of overall health. All it is, is the current re-iteration of height-weight charts (literally, it’s weight [in kg] divided by height [in cm] squared). And the problem with height-weight charts was/is that they don’t consider muscle mass (muscle is heavy, after all), aerobic capacity, metabolic rate, cardiovascular or respiratory function, cholesterol or triglyceride levels, or – the biggest factor of all, IMO – family history.

Ergo, “experts” who rely on BMI don’t know what they’re talking about. At 5’9″, going by BMI, I’m not “underweight” until I weigh less than 125 lbs, but I’m “overweight” at 169 and “obese” at 203. If we’re really worried about “obesity”, then do the skin-conductivity test to determine body-fat percentage, and give advice based on that instead of BMI. The machine for that test is handheld and costs less than the scale in any doctor’s office.

As a thought experiment, if Prince Harry or Prince William were smokers and (God forbid) needed knee surgery, would the government-run hospitals approve or deny them? Why? What are the societal implications of your conclusion?

    Paul In Sweden in reply to Archer. | September 18, 2017 at 5:35 pm

    Had the BMI problem prior to knee surgery here in Sweden a few years ago. At 6’3″ and someone that works out with weights I am off the BMI charts and needed the surgeon to examine my fitness for surgery. The examination consisted of the surgeon shaking my hand and looking up at me in the waiting room and simply saying no, you are not obese and you will receive a call for your surgery appointment. Not for nothin’ but to get to the point of actually having surgery from the date of the accident was almost four months.

    Granny in reply to Archer. | September 19, 2017 at 1:40 am

    My cardiologist recently redecorated his offices. When I noticed the lack of BMI charts on the walls and mentioned it I was told that they are so inaccurate they don’t apply to much of anybody so they’ve abandoned the measurement and discarded the charts.

Smoking and obesity are picked on because they are stigmatized as self-inflicted contributors to other diseases. By that reasoning IV drug users, hard drug users and those that engage in dangerous promiscuous unprotected sex should also be restricted to full healthcare benefits. Where will it stop? How about including the idiots that make stupid ‘Jackass’ genre youtube videos?

    Speaking of “jackasss” claims how are injuries incurred by “choice” covered?

      Paul In Sweden in reply to Conan. | September 19, 2017 at 4:09 am

      LOL – Some of those ‘injuries incurred by “choice”’ might include those that result in dependence on mental health and welfare services from the selection and participation of certain absurd courses of study in university.

    thalesofmiletus in reply to Paul In Sweden. | September 19, 2017 at 9:54 am

    Smokers and fat people are singled out because SWPLs hate those kinds of people. That is the only reason. This is what the political distribution of goods (i.e. socialism) looks like.

BMI is mostly BS. By the requirement in the article for refusing surgery (BMI => 30), many pro athletes (NFL) would not get surgery. For example:

Denver Broncos: Running Back CJ Anderson 5-8 224lb BMI:34.1

Raiders: Marshawn Lynch 5-11 215lb BMI:30.0

Texans: JJ Watt 6-5 290lb BMI:34.4

BMI does not take into account muscle mass. It effectively discriminates against those with a stocky build.