Obese? Get to the back of the line, thanks…
An Ipswich MP has suggested that obese people who are unwilling to change their lifestyle should have to wait longer for medical treatment.
From the article at Queensland Times:
Jo-Ann Miller, Labor MP for Bundamba, said people who were living on a “Macca’s” diet were placing an intolerable strain on Queensland Health.
Ms Miller has called on her own government to do more to educate Queenslanders about how to eat healthily and manage their own weight.
But she believes patients whose health problems have been caused by being overweight or by smoking – but refuse to change their habits – should be pushed to the bottom of the queue for medical treatment.
“If things keep going how they are, there won’t be a choice but to get tough,” Mrs Miller said.
“Every person in this country must realise that their health is their responsibility and that in future years we just might be facing a situation where a rationing of health services may become a reality,” Mrs Miller said.”
An interesting call, and one that I believe is not completely without merit. The figures speak for themselves – obesity and obesity related problems account for a huge percentage of hospital presentations, equating to billions of dollars in costs to the taxpayer.
Heart disease treatments, such as drugs, angioplasty, cardiac bypass procedures, valve replacement and cardiac transplant are very expensive.
An angioplasty for a patient who has had a heart attack costs more than $7000, a coronary bypass would cost about $23,000 while there would be many other costs involved with each case, such as the ambulance, intensive care, and rehabilitation.
Mr Lucas said it was reasonable communities would have to make a decision about how much they are willing to spend on health care before it gets to the point where state and federal budgets were spent on nothing but health.
“It is clear that the health of Queenslanders and the health system is under threat from chronic disease,” he said.
The Queensland Chief Health Officer’s 2008 report said ten obesity related diseases were included in the 15 diseases which drove the 56 per cent increase in health care expenditure in Australia between 1987 and 2000.
The net cost of loss of wellbeing due to obesity in Australia is valued at $50 billion with about $10 billion in Queensland.
So do we focus more time & money on primary health care, addressing obesity early on in a bid to reduce the figures before they cause further bulging strains on our health system?
Certainly, this sounds like a great idea, however the situation is a little more complex than it may first appear.
On the face of it I would say yes – reducing obesity = reducing ridiculous amounts of money spent on obesity related problems. But how do you determine whether or not someone is trying to address their obesity? How do you differentiate those milking the system & those genuinely struggling? What if you’re an obese child? Smoker vs non-smoker? How do you convince someone that they can take action to reduce the risks of extremely serious side effects and complications, if only they can make some serious changes to their diet, exercise & lifestyle regimes?
Should we encourage a cut-throat approach, making assessments on weight alone? ie: “You’re fat, therefore get to the back of the line & sort that out, then we’ll help you out.”
Obesity related problems are many and varied, and there can be no denying that they cause major strains on hospitals and the health care system as well as the individual. According to Stanford Hospital, just some of the health related issues related to obesity include:
- high blood pressure – Additional fat tissue in the body leads to an increase in the workload of the heart because it must pump more blood through additional blood vessels.
- diabetes – Obesity is the major cause of type 2 diabetes. Even moderate obesity dramatically increases the risk of diabetes.
- heart disease – Atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese. Coronary artery disease is also more prevalent because fatty deposits build up in arteries that supply the heart.
- joint problems, including osteoarthritis – Obesity can affect the knees and hips because of the stress placed on the joints by extra weight.
- sleep apnea and respiratory problems – Respiratory problems associated with obesity occur when added weight of the chest wall squeezes the lungs and causes restricted breathing.
- cancer - In women, being overweight contributes to an increased risk for a variety of cancers including breast, colon, gallbladder, and uterus. Men who are overweight have a higher risk of colon and prostate cancers.
- metabolic syndrome – The National Cholesterol Education Program has identified metabolic syndrome as a complex risk factor for cardiovascular disease.
- psychosocial effects - Overweight and obese persons are often blamed for their condition and may be considered to be lazy or weak-willed. It is not uncommon for overweight or obese conditions to result in persons having lower incomes or having fewer or no romantic relationships.
What do you suggest should be done about this serious problem?
Great website. Just started my own with a perspective on human natures and I really enjoyed finding yours. I will be following. Have a good weekend.
I’m sure we could have some very interesting stories to share between our countries differences in healthcare!
Hi Storytellerdoc – thanks for the comment, will check your site out. Have a great weekend also!
Much as it would be nice to be able to but down our health care costs, this approach simply doesn’t take into account the myriad of reasons for obesity. While many obese people simply chose not to restrict their diet, many are ignorant of how to, are subject to myths about food, cannot afford to eat healthy, or have illnesses that make it impossible for them to lose weight.
I admit that it is hard for me to feel sympahty as I bust my butt to keep my weight and cardiovascular health optimal. However, I am lucky to have a naturally medium sized body type so I can hardly say what I would look like had I been born with a tendency to be larger.
Hi Kate – some fair and valid point that you’ve raised. There’s no denying that obesity leads to massive expenditure in health care facilities across Australia. Limiting limiting services or “getting tough on the obese” however becomes a whole lot more challenging due to the myriad reasons for obesity, as you mention. Thanks for sharing your thoughts.
What to do about this problem? – The Australian federal and state governments could start by subsidising naturopaths’ consultations and medicines – as it is subsidising pharmaceutical and high-tech medicine – and thus enable a broader clientele to become educated about how to achieve their health goals. Clearly, whatever has been done over the past 30 years or so has not worked. There are healthy and empowering alternatives available: “Seeing the lighter side of overweight”: http://www.brisbanenaturalmedicine.com.au/Artemisia_Natural_Medicine/Healthy_Weight_for_Life.html
Hi Gabriela – thanks for your thoughts, definitely a complex problem, that’s for sure….
My first comment here.. Read your blog a fair bit from time to time though..more of a lurker I guess.
I couldn’t resist not commenting on this.
I tend to feel a little sympathtic to obese people. If you look at it from a monetary view point then yeah.. the system is losing money, but:
The problem with an approach like this is that the minority will suffer. there are a minority who are obese due to medical problems and not because they just didn’t take care of their diet ..
You can’t really begin to ask people why they’re obese before you put them behind the line.. it just isn’t practical. If you do it without discrimination I.e every fat person should go behind the line.. then you’d be infringing the rights of the minority.
Now.. how do we solve the problem? I’d say Doctors should single out people who are obese due to their own neglect. These people can then have some sort of “punishment”.. perhaps a decrease in health benefits or something like that.
@Sandra – Hi there, thanks for taking the time to comment!
It’s great to have some feedback on this issue – definitely a tough one. I like how you’ve come up with one idea, and that is to identify those who are contributing to the problem by self neglect, and penalise them accordingly.
One of the problems that arises out of this is identifying these people. How on earth would you begin to clarify who fits into this category, and who is exempt? I imagine it would be a very difficult process!
Regardless, thanks for your thoughts….
Well.. yeah It’d definitely be difficult to clarify.. But then That’s the Doctors job. I tend to think that after seeing a patient for a few times they’d be able to make out whether the problem is simple negligent obesity or a health problem..
If something like that does get implemented.. the few people that are in fact penalized will become examples for others. I don’t mean that in a mean way though.. but we all know the strain the cause to the system.
I’m sure if we put our minds to it.. we could come up with a more realistic soultion…
I am a single mother with 2 children. I am currently studying at uni and as such am not working so receiving centrlink pension. I am also obese. I have been struggling with my weight my whole life. The last time I managed to get to a healthy weight I fell pregnant 2 weeks later and all has come back and more. I am currently at my heaviest weight ever, but not at my biggest as far as height and weight.
It is extremely hard to break the cycle of eating and depression, it is extremely hard to find the motivation to walk out the front door and exercise when you feel like everyone is judging you. It is also even harder to fill the trolley on shopping day with healthy fresh food when the not so healthy is more affordable. I have less than $100 per week for food shopping, and with this I must buy my kids school lunches, breakfast items and enough meat and veg for 7 dinner meals. If anyone can tell me how I am supposed to fill my trolley with fresh fruit, vege, low fat everthing, fish and chicken I would like them to come shopping with me.
It is not an easy fix and playing hard ball with the health system is not right or fair not matter what the circumstances. Smokers can quit for the same price or cheaper than it cost them to smoke in the first, I know because I quit a month ago, but weight management is a whole other ball game.