9 ms·

What are we going to do now, ban smokers from the health system because they take up more cancer beds? Ban obese people because they didn't stop eating? Ban peo

What are we going to do now, ban smokers from the health system because they take up more cancer beds? Ban obese people because they didn't stop eating? Ban people who don't exercise because it's easy to do, and provably lowers chance of disease? Don't respond to car accidents due to speeding since it was preventable? As soon as you start excluding people from the health system because of lifestyle choices, you are deciding who should live and die.

nielsbot 5y ago
Who says we won’t care for these people? This says their choice not to get vaccinated is costing billions. Re: Cigarettes and seatbelts are bad analogies. Society (via the government) has made moves to reduce smoking and encourage seat belt wearing. Looks like the same is now happening for vaccinations with Biden’s new mandates. Finally, the US healthcare system already decides who should live or die… either intentionally or structurally.
bdibs 5y ago
Triage exists for a reason, and it seems reasonable to apply that here. If you want to accept the risks of your “lifestyle choice”, you should be the one who faces the consequences by being lower in priority for healthcare. If I exercise and eat right, when I need an ICU bed I should be given priority over someone who accepted the risk of eating fast food three times a day, surely?
- nradov 5y ago
  Regardless of the moral issue, due to EMTALA hospitals are legally required to care for unstable patients regardless of whether they made unhealthy choices. Changing that would require an Act of Congress.
  - toomuchtodo 5y ago
    You can dump covid patients with low odds of a positive outcome off support equipment (vents and ECMOs) when healthier patients come in for treatment and equipment supply is constrained. This is already occurring (crisis standard of care). Get vaccinated.
    - Andys 5y ago
      This could be a way that systemic pro-vax bias reinforces the statistical outcomes.
      - deleted 5y ago
        [deleted]
    - Fjolsvith 5y ago
      Especially in Israel, where their coronavirus spread reaches new heights [1], despite 78% of their population being innoculated! [2] 1. https://www.timesofisrael.com/health-ministry-chief-says-coronavirus-spread-reaching-record-heights https://www.timesofisrael.com/health-ministry-chief-says-cor... 2. https://www.haaretz.com/israel-news/israel-vaccine-data-how-many-have-already-been-inoculated-for-covid-1.9626604 https://www.haaretz.com/israel-news/israel-vaccine-data-how-... They have to do something because the vaccine just isn't stemming the tide!
      - keyboardCowBoy 5y ago
        They are also giving boosters out. Someone please explain why Israel is struggling with COVID-19?
        treeman79 5y ago
        Because the vaccine helps a lot; but doesn’t solve Covid. Even at 100% vaccination rate there would still be issues, less issues, but far from Zero.
      - loktarogar 5y ago
        I'm guessing that's eligible population as the numbers mentioned in the article line up more with around 66% of the total population, which isn't enough to stem the tide.
- xboxnolifes 5y ago
  Triage isn't about making a moral decision. It's a decision of balancing patient medical needs vs resource availability.
toomuchtodo 5y ago
I assume insurers could choose to not cover the treatment costs for a condition if you decided not to get vaccinated. Exposing someone to the full cost of an avoidable expense is a solid method of disincentivizing reckless behavior during a pandemic (smoking and obesity are not comparable). If you can prove vaccination status, of course, costs should still be covered for hospitalization, as you made the very little effort to derisk.
- nradov 5y ago
  Your assumption is wrong. Any medical insurance plan regulated under the Affordable Care Act (Obamacare) is not legally allowed to deny coverage or raise premiums based on vaccination status. According to the CDC, obesity is a significant risk factor for COVID-19. https://www.healthcare.gov/how-plans-set-your-premiums/ https://www.healthcare.gov/how-plans-set-your-premiums/ https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm
  - toomuchtodo 5y ago
    Wow, that’s disappointing, but not surprising for American healthcare (don’t cover everyone, but no personal responsibility expectations from those who are covered). We’ll just have to let the fire burn through the forest I suppose and eat the costs from these people until travel and employment vaccination mandates kick in.
    - felistoria 5y ago
      Obesity costs the US healthcare system 147 billion per year. We need Health Passports right now if cost is an issue. 5.7 over 3 months is nothing compared to the cost of obesity.
  - topkai22 5y ago
    It does, however, apparently allow for employers to charge employees more for insurance under a “wellness” scheme. This is how Delta is charging unvaccinated employees $200/month. Edit- I am also familiar with wellness incentives/charges around smoking, obesity, and exercise.
Factorium 5y ago
Actually, smokers and obese actually save Governments money on healthcare and pension costs, because they die earlier: https://taxfoundation.org/new-study-shows-smokers-and-obese-actually-save-government-health-care-costs/ https://taxfoundation.org/new-study-shows-smokers-and-obese-... "According to the research, a person of normal weight costs on average £210,000 over their lifetime, a smoker just £165,000 and an obese person £187,000."
- justwanttolearn 5y ago
  "Because they tend to live longer" so ok let's not vaccinate because the unvaccinated will die off faster and cost the healthcare way less
relax88 5y ago
If there was a safe and effective vaccine against lung cancer and obesity do you think your argument would be as strong?
- nradov 5y ago
  There is a safe and effective vaccine against cervical cancer. Hospitals still care for unvaccinated cervical cancer patients. https://www.cancer.gov/news-events/cancer-currents-blog/2020/hpv-vaccine-prevents-cervical-cancer-sweden-study https://www.cancer.gov/news-events/cancer-currents-blog/2020...
  - toomuchtodo 5y ago
    The HPV vaccine is given to boys and girls for free in Australia, and they’re on their way to eradicating cervical and other cancers associated with HPV. Vaccines are compulsory to receive child care and family tax benefits. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30183-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...
  - bananapub 5y ago
    you mean the vaccine that isn't universally available for free to all americans? why would you bother making such a silly comparison?
    - nradov 5y ago
      The HPV vaccine is available for free to all Americans with medical insurance regulated under the Affordable Care Act (Obamacare). That's the vast majority. https://www.healthcare.gov/preventive-care-adults/ https://www.healthcare.gov/preventive-care-adults/ We do still unfortunately have about 8% uninsured but local health departments occasionally offer free vaccination clinics for them.
- nanis 5y ago
  Y'know, Obamacare mandated coverage of alcoholism and drug addiction in all plans: That is, no one can opt out of paying for other people's problems even when they are caused by a completely optional activity. I am all for a reforming health care markets and getting third party payers out of the system. Until then ...
varelse 5y ago
So that's a job best left to private insurance companies excluding coverage?
vkou 5y ago
If smoking were contagious with an R-factor of 3-6, overflowing hospitals and ICUs, and could be cured by two shots a year, it might not be a bad idea. A better example, actually, is someone refusing free treatment for lung cancer at stage 1, because they believe that cancer isn't real and Big Onco is trying to kill them, and then barging into the hospital, and demanding treatment when they hit stage 3. I'd have very little sympathy for that person.
syrrim 5y ago
We tax cigarettes. My understanding is the tax is restricted in the budget to only go towards paying for healthcare for smokers. So the smokers can stay, at least.
raxxorrax 5y ago
Very few unhealthy people will ever cost as much as a Methusalem getting pensions and health care. So should we introduce forced euthanasia?

nielsbot 5y ago

Who says we won’t care for these people? This says their choice not to get vaccinated is costing billions. Re: Cigarettes and seatbelts are bad analogies. Society (via the government) has made moves to reduce smoking and encourage seat belt wearing. Looks like the same is now happening for vaccinations with Biden’s new mandates. Finally, the US healthcare system already decides who should live or die… either intentionally or structurally.

bdibs 5y ago

Triage exists for a reason, and it seems reasonable to apply that here. If you want to accept the risks of your “lifestyle choice”, you should be the one who faces the consequences by being lower in priority for healthcare. If I exercise and eat right, when I need an ICU bed I should be given priority over someone who accepted the risk of eating fast food three times a day, surely?

nradov 5y ago
Regardless of the moral issue, due to EMTALA hospitals are legally required to care for unstable patients regardless of whether they made unhealthy choices. Changing that would require an Act of Congress.
- toomuchtodo 5y ago
  You can dump covid patients with low odds of a positive outcome off support equipment (vents and ECMOs) when healthier patients come in for treatment and equipment supply is constrained. This is already occurring (crisis standard of care). Get vaccinated.
  - Andys 5y ago
    This could be a way that systemic pro-vax bias reinforces the statistical outcomes.
    - deleted 5y ago
      [deleted]
  - Fjolsvith 5y ago
    Especially in Israel, where their coronavirus spread reaches new heights [1], despite 78% of their population being innoculated! [2] 1. https://www.timesofisrael.com/health-ministry-chief-says-coronavirus-spread-reaching-record-heights https://www.timesofisrael.com/health-ministry-chief-says-cor... 2. https://www.haaretz.com/israel-news/israel-vaccine-data-how-many-have-already-been-inoculated-for-covid-1.9626604 https://www.haaretz.com/israel-news/israel-vaccine-data-how-... They have to do something because the vaccine just isn't stemming the tide!
    - keyboardCowBoy 5y ago
      They are also giving boosters out. Someone please explain why Israel is struggling with COVID-19?
      - treeman79 5y ago
        Because the vaccine helps a lot; but doesn’t solve Covid. Even at 100% vaccination rate there would still be issues, less issues, but far from Zero.
    - loktarogar 5y ago
      I'm guessing that's eligible population as the numbers mentioned in the article line up more with around 66% of the total population, which isn't enough to stem the tide.
xboxnolifes 5y ago
Triage isn't about making a moral decision. It's a decision of balancing patient medical needs vs resource availability.

toomuchtodo 5y ago

I assume insurers could choose to not cover the treatment costs for a condition if you decided not to get vaccinated. Exposing someone to the full cost of an avoidable expense is a solid method of disincentivizing reckless behavior during a pandemic (smoking and obesity are not comparable). If you can prove vaccination status, of course, costs should still be covered for hospitalization, as you made the very little effort to derisk.

nradov 5y ago
Your assumption is wrong. Any medical insurance plan regulated under the Affordable Care Act (Obamacare) is not legally allowed to deny coverage or raise premiums based on vaccination status. According to the CDC, obesity is a significant risk factor for COVID-19. https://www.healthcare.gov/how-plans-set-your-premiums/ https://www.healthcare.gov/how-plans-set-your-premiums/ https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm
- toomuchtodo 5y ago
  Wow, that’s disappointing, but not surprising for American healthcare (don’t cover everyone, but no personal responsibility expectations from those who are covered). We’ll just have to let the fire burn through the forest I suppose and eat the costs from these people until travel and employment vaccination mandates kick in.
  - felistoria 5y ago
    Obesity costs the US healthcare system 147 billion per year. We need Health Passports right now if cost is an issue. 5.7 over 3 months is nothing compared to the cost of obesity.
- topkai22 5y ago
  It does, however, apparently allow for employers to charge employees more for insurance under a “wellness” scheme. This is how Delta is charging unvaccinated employees $200/month. Edit- I am also familiar with wellness incentives/charges around smoking, obesity, and exercise.

Factorium 5y ago

Actually, smokers and obese actually save Governments money on healthcare and pension costs, because they die earlier: https://taxfoundation.org/new-study-shows-smokers-and-obese-actually-save-government-health-care-costs/ https://taxfoundation.org/new-study-shows-smokers-and-obese-... "According to the research, a person of normal weight costs on average £210,000 over their lifetime, a smoker just £165,000 and an obese person £187,000."

justwanttolearn 5y ago
"Because they tend to live longer" so ok let's not vaccinate because the unvaccinated will die off faster and cost the healthcare way less

relax88 5y ago

If there was a safe and effective vaccine against lung cancer and obesity do you think your argument would be as strong?

nradov 5y ago
There is a safe and effective vaccine against cervical cancer. Hospitals still care for unvaccinated cervical cancer patients. https://www.cancer.gov/news-events/cancer-currents-blog/2020/hpv-vaccine-prevents-cervical-cancer-sweden-study https://www.cancer.gov/news-events/cancer-currents-blog/2020...
- toomuchtodo 5y ago
  The HPV vaccine is given to boys and girls for free in Australia, and they’re on their way to eradicating cervical and other cancers associated with HPV. Vaccines are compulsory to receive child care and family tax benefits. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30183-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...
- bananapub 5y ago
  you mean the vaccine that isn't universally available for free to all americans? why would you bother making such a silly comparison?
  - nradov 5y ago
    The HPV vaccine is available for free to all Americans with medical insurance regulated under the Affordable Care Act (Obamacare). That's the vast majority. https://www.healthcare.gov/preventive-care-adults/ https://www.healthcare.gov/preventive-care-adults/ We do still unfortunately have about 8% uninsured but local health departments occasionally offer free vaccination clinics for them.
nanis 5y ago
Y'know, Obamacare mandated coverage of alcoholism and drug addiction in all plans: That is, no one can opt out of paying for other people's problems even when they are caused by a completely optional activity. I am all for a reforming health care markets and getting third party payers out of the system. Until then ...

varelse 5y ago

So that's a job best left to private insurance companies excluding coverage?

vkou 5y ago

If smoking were contagious with an R-factor of 3-6, overflowing hospitals and ICUs, and could be cured by two shots a year, it might not be a bad idea. A better example, actually, is someone refusing free treatment for lung cancer at stage 1, because they believe that cancer isn't real and Big Onco is trying to kill them, and then barging into the hospital, and demanding treatment when they hit stage 3. I'd have very little sympathy for that person.

syrrim 5y ago

We tax cigarettes. My understanding is the tax is restricted in the budget to only go towards paying for healthcare for smokers. So the smokers can stay, at least.

raxxorrax 5y ago

Very few unhealthy people will ever cost as much as a Methusalem getting pensions and health care. So should we introduce forced euthanasia?