Published Mar 12, 2002
You are reading page 3 of Obesity Costlier Than Smoking
Every condition causes healthcare costs to rise. A common cold raises healthcare costs. Jeez, tonight I found out I will pay $50 for some Claritan x2 mos (with ins.). The price for someone without insurance would be $195. That's outrageous.
I noticed the article didn't mention how scientists have recently identified a defective gene in diabetics. Soon it will be proven there is a genetic basis for the more common forms of Diabetes.
Also some people have thyroid problems that predispose them to another Endocrine disorder...that being Diabetes. Thyroid problems are usually genetic also.
Obesity is usually genetic too. You're fighting against your entire genetic makeup when you're trying to lose weight. This is not the case with smoking. We weren't born with 'smoking genes.'
I'm not here to say what is right or what is wrong, I'm just trying to point out the difference. Smoke away, eat away....I would just rather share my air with an obese person.
But that's just me.
canoehead, BSN, RN
I wonder what percentage of people are non smokers AND of a healthy weight in the USA. I would bet less than 50%.
Luckily, some of us have no flaws at all...and should get the first spot on any waiting list, 1-1 nursing and free health care.
What if we got government sponsered free health care but to qualify you had to exercise daily, maintain a healthy weight, be a non smoker, wear a seatbelt and vote in every election. Would THAT be an infringement on anyone's rights? After all, we have a responsibility to society.
In response to Nebby Nurse, You must be a young thing little thing. I have been in Medicine for 30 plus years and the number of truly obese people that I have run across that are as you describe are far and few. You also mention that they are the ones with diabetes and as I said before, if it weren't for diabetes and smoking we wouldn't all have jobs. I have more often come upon heavy patients that say, give me time. Let me do it myself. I don't want to hurt you.
Right now in this country there is a lot of prejudice going on. We are trying to legalize it. We have already made outcasts of smokers, our next target will be the obese. Don't buy into it. We can't legislate health. We can only teach it.
... "What if we got government sponsered free health care but to qualify you had to exercise daily, maintain a healthy weight, be a non smoker, wear a seatbelt and vote in every election. Would THAT be an infringement on anyone's rights? After all, we have a responsibility to society."
Canoehead, that seems how it could start, as a bennie perk incentive to maintain health. What if that doesn't pan out and the government keeps going through ever vaster sums for Medicare and Medicaid on diseases due to "lifestyle choices?"
The axe and hammer are going to fall on "bad habits" if the .gov gets any deeper into healthcare, ioho. The Bottom Line will rule. It will start as benefits and incentives and incrementally change into penalties. Also, rationing is already a big factor in Oregon Medicaid. You can see where this is heading ...
But how many people would qualify for the health care if those criteria were used? I would bet about 10%
And if people don't get health care, a certain percentage will qualify for disability, another large percentage become less productive, and we end up losing money from the taxes they would have brought in over a lifetime, plus paying for their support. If a COPDer works for 30 years paying $10000 in taxes every year ($300 000 plus interest) even if they get hospitalized every year for ten years and an average cost of $10 000 we are still making money off them as a society. It would make sense to keep providing medical to this person. And I bet the number crunchers in the government have already done the math. :)
Of course once he/she retires they are a financial liability, but denying health care to seniors is a political liability, and really distasteful to think about so still everyone needs to be covered.
I left out people who are already disabled by their illness and unable to work before they even reach retirement age. But that would include a lot of illnesses that are not self induced. We could be splitting some very fine hairs, even if we could all agree that the 400lb 20yo should not get paid health care, because there is always someone that doesn't quite fit any classification.
All in all I think we would be saving money by not even subjecting politicians and the community to the debate at all.
I hate the idea that healthy people don't cost the health care system money. Have you ever been in energency as they wheel in the weekend warriors with their sprains and broken bones and concussions? May be a little off topic, but a friend has been diagnosed with terminal cancer and he's in his early 30s and healthy. You can't predict with certainty who is going to cost money and what diseases they'll get, so why bothe trying?
We don't think government attempts to modify lifestyle behaviors are going to work, but that won't stop the government It will all come down to how much $$$ it is costing. In the last 20 years we've seen an enormous change from costly end-of-life hospital care to Hospice -- so much so that we're seeing a lot of hospice placement of pts who could benefit by more medical care, and pts put on hospice via incorrect diagnosis, etc, and many situations bordering on euthanasia. And of course Oregon is the Assisted Suicide State, and the pioneer of many elder-care cost-cutting innovations.
It just seems the bean counters are going to attempt to use these studies to form new directions / directives in health care. They will have a study to see whether rewards or punishments are more effective in controlling lifestyle behaviors ...
It will all come down to money in the end (and votes equal money).
Freezin in MI
It is probably accurate that obesity is costlier than smoking, but as nurses we can only provide education and awareness, because everyone will make their own decisions about their lifestyle. For me, at 5'7" and 107#, I have a headline on my refrigerator which states, "You can't control all of life's difficulties; you CAN control what you put into your mouth."
However, I am personally appalled at a local hospital which has morbidly obese nurses working in their coronary care unit - but the hospital has no recourse - it can't get into discrimination over weight issues.
Lots of excellent posts on this topic... And you can't say that any one of them is totally right or totally wrong.
There are so many facets to the healthcare industry, I dare not even scratch the surface... equal access to compentent care, escalating costs, legal liability, insurance and the infamous "managed care"... We really have to face the fact that our healthcare system is way screwed up!!! We all know it... See it firsthand everyday... Why do you fill out so much paperwork on your job? Some of it is to actually communicate with the other members of a healthcare team, but so much of it is CYA paper. However, I digress from the point at hand...
As far as obesity and smoking, or any other self inflicted harm, I guess it boils down to a HUGE social issue. Who is responsible for YOUR health? And if you choose to make choices that have a negative impact on your health, should you be held accountable for those choices? It's one thing if you have a physiological change in your body that cannot be changed by making a choice, but it's another if you induce that negative outcome with poor choices. With our healthcare system already so screwed up, why add to the burden?
Someone mentioned prejudice against smokers and/or obese people... I don't think it has anything to do with prejudice. It has more to do with the impact those people's choices have on the rest of society. Unfortunately our healthcare system, including the insurance industry, is set up so that the costs are spread out to all participants. Some of these costs just can't be prevented, but many of the costs can be prevented or minimized. I can choose to drive safely down life's highway, and keep the risk's low for myself and those around me... Or I can be totally reckless down life's highway, and force everyone around me to accept the consequences of my actions....
Maybe it's just me, but doesn't it seem selfish to do whatever you want, with no regard to how it impacts others?
Which brings up another self induced illness, trauma from MVA's when the driver was speeding, or GSW to gangmembers.
We could talk ourselves out of a need for about 50% of the current hospital beds, and about 90% of the ER visits IMHO.
What if after the initial medical screening if a condition was deemed nonurgent the patient was sent home without treatment or scripts. That would cut ER abuse, and force people to find primary care providers in most cases. And it seems a more politically realistic option than to pick particular health problems.
Cut down on those nasty social admits too ( I hate them ).
One more thought. If you really want to reduce the cost of health care, teach people the proper use of the ER. General Practioners would be my first objective. If you can't figure out why they have a stuffy nose, don't sent them to the ER!
And enough already with the "I am personally appalled at the morbidly obese nurses working on the coronary care unit"! At least they can work and keep up the pace!
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