Obese? Get to the back of the line, thanks…

credit: Kyle May

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?