NHS Approaches Medical Discrimination
There is word out of the UK that obese people and smokers may be denied "priority" care in the UK under potential new NHS standards. The idea, of course, is to induce people into more healthy lifestyles, which in turn, will collectively ease the cost of health care.
This is rationing and it is purely political. And because it is overtly and explicitly political, you can bet that people with unhealthy life styles that are not disdained by the media and ruling classes--such as promiscuous people who may get HIV or another STD--won't be similarly punished for by denial of "priority" care (nor should they).
This gets to the heart of the unjustness of these kinds of schemes. Such political correctness can lead to people dying for want of medically appropriate treatment and it has absolutely no place in medicine or health care policy.
posted by Wesley J. Smith @ 9:25 AM
5 Comments
5 Comments:
This happens with so-called "wellness programs" in private insurance. Because I refuse to partake in my company's program, I will be charged $40 a month extra, which is deducted from my paycheck.
This is outright discrimination, and it is just as bad in private insurance--and perhaps worse--than public insurance.
Yes, but let's clarify.
Your private insurance is making a BET that offering wellness programs (an extra cost!) will cost them less eventually, and offer incentives or disincentives accordingly.
That's what they do, take BETS with the statistics of our lives to make money and stay in business.
Government on the other hand - as a justice issue of the 4 "sacred" laws of medical bioethics (beneficience, nonmaleficience, justice, autonomy) in offering PRIORITY to TREATMENT to certain classes of individuals is truly being discriminatory, and as Wesley states there are other "risky" people that they don't penalize, perhaps for political reasons.
Robert, I don't entirely deny the distinction you are making, but I think the line is becoming blurred. I'm not sure why this is happening, but it seems to me that insurance companies, esp. HMO's, are jumping on PC bandwagons whose priorities are largely set by following the lead of government.
I'm quite sure this is true in the medical profession as a whole, and it would not be surprising if it worked its way into insurance practices by way of the doctors themselves.
There's a book out now called (I think) _Unprotected_ written by a doctor working at a university student health center. He (or she) publishes anonymously for fear of professional reprisals, and the theme of the book is the refusal in university health centers to tell young people, esp. young women, that promiscuity is not good for their health. (Well, duh!) The author, I gather, points out that the girls can be nagged about not sun-tanning, not eating high-fat foods, and all sorts of other lifestyle issues, but no one can even suggest to them that they are risking depression and other mental and physical problems by sleeping around.
If those kind of twisted priorities can obtain among the doctors, why should it surprise us if the insurance companies are following suit?
The older I get the more I'm forced to abandon my assumption that private corporations will act rationally, even in terms of their own self-interest.
And imagine how much worse it will get if they are able to excluse some from "priority" are based on genetics.
This highlights yet another reason to value medical privacy.
In the world of commerce, retailers use price discrimination to charge rich people more than poor people. Thus rich people prefer the anonymity of paying cash, while poor people lug around a purseful of loyalty cards.
In the world of medicine, the incentives to price discriminate are also there but are subtler. If you drink or smoke or are even slightly overweight, the fewer people who learn this the better. Having derogatory data about you available online is not sensible.
This is one of the reasons we're running a campaign in England to get people to exercise their right to opt out of the national health database (see www.TheBigOptOut.org). It's not just people like HIV positive rape victims who can suffer harmful stigmatisation - even being a stone overweight can damn you nowadays. It doesn't matter if you swim a mile three times a week and can run up ten flights of stairs carrying a rucksack. One negative fact can be all it takes to impair your access to services.
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