“Drop the Health Bill”

[vtsnowedin]

Modern medicines outcomes need not mean a longer time of frailty and decline. What it gives us is more healthy years with the same amount of decline on the end or perhaps a much briefer sudden decline at the end. People that used to die at sixty were sick at fifty and perhaps too busy or too poor to do anything about it. Today we look askance at anyone who dies before sixty five and wonder what went wrong with smoking the first suspect. Before 1960 or so half of us died before age 65 hence it being the median age of death. This is all well and good. The problem has become that the medical establishment has become very good at performing very expensive services for us in our period of decline to the point that many people have more charged to their accounts in their last six weeks of life then they ever made in all of their working years. Look at that again. I am not saying that they exceed all the health insurance payments they ever paid, I am saying the bill can exceed the sum total of every paycheck they ever earned. When one person in a hundred in an insurance pool does this it is OK but when it becomes the mean or average the system breaks down. We must find a way to maximise our healthy years without letting the system blow all our assets on a lost cause when the time comes. This will entail telling people they are done or soon to be done and only palliative care is available to them. This will be decry-ed as rationing which it is but it must be done if the country is to survive.

[RenewableCandy]

You raise a good point but, faced with the scenario of wiping out my life's savings for an extra 6 weeks of pain, I would elect to be put out of my misery so my family get to keep a roof over their heads. Sadly our culture considers that immoral, defeatist and illegal. This has got to change.

The health bill isn't going to change our fundamental attitude to old age/infirmity. It's just going to make healthcare a LOT more inefficient, sabotaging as it does so the morale and enthusiasm of the people who work in it.

[featherstick]

I've observed a distinct trend in the media recently - a variety of commentators stressing that they'd opt for a dignified death without treatment but with lots of pain control over long-drawn-out, uncertain, painful and exhausting (and expensive) treatment. It may be that opting for treatment of your pancreatic cancer soon becomes as socially unacceptable as drunk driving. There certainly seems to be a drive in that direction.

The NHS is also getting to grips with providing far more care in the community, emphasising healthy living and self care, and de-hospitalising a lot more treatments. Generally, people are staying healthier for longer now, with the same 18 months - 3 years of decline at the end, but arriving far later. This is a good thing, especially combined with raising pensionable age.

And with greater likelihood that the NHS "reforms" will be abandoned, we should be set to have a health system fit for the rest of the 21st century.

[emordnilap]

I've observed a distinct trend in the media recently - a variety of commentators stressing that they'd opt for a dignified death without treatment but with lots of pain control over long-drawn-out, uncertain, painful and exhausting (and expensive) treatment. It may be that opting for treatment of your pancreatic cancer soon becomes as socially unacceptable as drunk driving. There certainly seems to be a drive in that direction.

You've quoted fairly good examples of patient choice but beware. In the states - whose health system many on this side of the Atlantic would like to copy - significant numbers believe that getting appendicitis or a stroke is also a choice.

[vtsnowedin]

I've observed a distinct trend in the media recently - a variety of commentators stressing that they'd opt for a dignified death without treatment but with lots of pain control over long-drawn-out, uncertain, painful and exhausting (and expensive) treatment. It may be that opting for treatment of your pancreatic cancer soon becomes as socially unacceptable as drunk driving. There certainly seems to be a drive in that direction.

You've quoted fairly good examples of patient choice but beware. In the states - whose health system many on this side of the Atlantic would like to copy - significant numbers believe that getting appendicitis or a stroke is also a choice.

Rubbiish

[emordnilap]

I've observed a distinct trend in the media recently - a variety of commentators stressing that they'd opt for a dignified death without treatment but with lots of pain control over long-drawn-out, uncertain, painful and exhausting (and expensive) treatment. It may be that opting for treatment of your pancreatic cancer soon becomes as socially unacceptable as drunk driving. There certainly seems to be a drive in that direction.

You've quoted fairly good examples of patient choice but beware. In the states - whose health system many on this side of the Atlantic would like to copy - significant numbers believe that getting appendicitis or a stroke is also a choice.

Rubbiish

What is? That people over here want to emulate a crappy system? Or the huge support in your country for letting people die 'through their own choice'?

http://www.youtube.com/watch?v=F56cfSyWOkI

[vtsnowedin]

[quote="emordnilap]
You've quoted fairly good examples of patient choice but beware. In the states - whose health system many on this side of the Atlantic would like to copy - significant numbers believe that getting appendicitis or a stroke is also a choice.[/quote]
Rubbiish[/quote]

What is? That people over here want to emulate a crappy system? Or the huge support in your country for letting people die 'through their own choice'?
It is "Rubbish" to think that "Significant" numbers of Americans think getting appendicitis or a stroke is a choice.
Also America is a free country and many realise that everyone of us is in fact going to die. The freedom comes in when you get to choose the where and how of your dieing.
They stuck libertarian Ron Paul on that question as the majority of Americans do not have the stomach to let a young person that has chosen poorly die from his poor choice ,but if your going to cover all losers in a game of chance there is no chance being taken at all, therefore no pot to split among the winners.

[emordnilap]

[Ludwig]

"Patients to be quizzed by GPs about drinking under new alcohol strategy":

GPs could be paid extra to question patients on their drinking habits and catch related problems early under proposals in the government's controversial new alcohol strategy.

Ministers hope the payments would provide an incentive to doctors to monitor the alcohol intake of their patients, to help tackle the spiralling costs of treating disease related to the consumption of drink.

Experts have advised the government to make the move as many drinkers do not come to a doctor citing a problem because they are not aware of the risks. Even couples who share a bottle of wine over dinner most evenings unwittingly increase their chances of cancer and strokes.

http://www.guardian.co.uk/society/2012/ ... ing-habits

I've no problem with doctors asking me how much I drink if it is relevant to problems I am consulting them about.

I have a big problem with doctors asking me how much I drink for no other reason than that they are receiving a wad of cash for it.

The Guardian lets this detail slip through unchallenged. It also fails to explain who these "experts"are, or what is the source of the claim that a couple sharing a bottle of wine risk damaging their health.

[Ludwig]

I've observed a distinct trend in the media recently - a variety of commentators stressing that they'd opt for a dignified death without treatment but with lots of pain control over long-drawn-out, uncertain, painful and exhausting (and expensive) treatment. It may be that opting for treatment of your pancreatic cancer soon becomes as socially unacceptable as drunk driving. There certainly seems to be a drive in that direction.

Slow boiling...

This year "Give yourself a dignified death"; next year "The disabled: what are they good for?"

[Little John]

I've observed a distinct trend in the media recently - a variety of commentators stressing that they'd opt for a dignified death without treatment but with lots of pain control over long-drawn-out, uncertain, painful and exhausting (and expensive) treatment. It may be that opting for treatment of your pancreatic cancer soon becomes as socially unacceptable as drunk driving. There certainly seems to be a drive in that direction.

Slow boiling...

This year "Give yourself a dignified death"; next year "The disabled: what are they good for?"

Yep

[woodburner]

"Patients to be quizzed by GPs about drinking under new alcohol strategy":

GPs could be paid extra to question patients on their drinking habits and catch related problems early under proposals in the government's controversial new alcohol strategy.

Ministers hope the payments would provide an incentive to doctors to monitor the alcohol intake of their patients, to help tackle the spiralling costs of treating disease related to the consumption of drink.

I have a big problem with doctors asking me how much I drink for no other reason than that they are receiving a wad of cash for it.

There is a correlation between alcohol consumption and health problems, having sufficient data to quantify the situation is useful. Many people have the attitude of "oh, that won't hurt you" to justify continuing with their health damaging habit (smoking, drinking, eating factory processed foods, etc). The result is a cost for everybody in paying for treatment to keep them going.

If you are not drinking, or not drinking much, why the problem with the question? If you are drinking a fair bit, why should you expect the rest of the population to support your treatment of self inflicted health problems, when you're indignant even about answering a question?

You risk needing an operation, which will soon become more of a life threatening exercise thanks to the decline in effectiveness of antibiotics thanks to their abuse by both humans and the consumption by animals for meat production.

Don't you think being asked a question may offer you less risk of dying early?

[biffvernon]

I have a big problem with doctors asking me how much I drink for no other reason than that they are receiving a wad of cash for it.

Since doctors get paid for all the work they do does it follow that the 'wad of cash' they receive is the only reason they do the work? And if so, does it matter what their motivation so long as the work gets done well?

[nexus]

Since doctors get paid for all the work they do does it follow that the 'wad of cash' they receive is the only reason they do the work? And if so, does it matter what their motivation so long as the work gets done well?

I've worked for the NHS and I would say that these financial incentives do adversely affect the work.

If you're in a consultation and you know you need to steer the conversation round to x to ask a question/take info/ perform a test, then you are not fully attending to what the patient is presenting with.

A good practitioner will ask about alcohol, for instance, whenever it is relevant and a payment won't change that. However payments tend to make bad practitioners worse and even tempted to cheat the system.

If you don't think this happens think about what schools do to massage their SATS and GCSE results and what welfare to work companies sometimes get up to with their stats. Both of these occur because 'wads of cash' are on offer.

[biffvernon]

Good point.