Sunday Soapbox: Finding a Scapegoat

>> Sunday, September 13, 2009


*Steps on the soapbox*

One of the side conversations I note during any discussion on health care is the villification of fat people. *Sigh*

Alcoholics, smokers, people with stupid (and/or) dangerous sexual habits, people with poor eating habits (which may not be reflected in appearance), exercise habits (which may not be reflected in appearance), people exposed to unhealthy environments, and people who are dangerously thin (and yes, that is possible) - none of them are called out as the scapegoats for the healthcare crisis.

It's the fat people.

True, obesity is prevalent and prevalent to a degree not seen in the past. And it can be a factor in a number of diseases - but to talk about the amount of money spent on obesity is misleading since much of it is spent - millions, even billions - on people trying not to be fat. But to listen/read the blogs and news now, ONLY fat people get heart disease or diabetes or any other major cause of death or disease.

It might be noted that people lump those who are obese, morbidly obese and being overweight in the same pot, even though the repercussions and issues are not the same. In fact, I'm not sure we have clinical evidence that being overweight alone threatens your health.

You want to know what I think (and you ought to or you shouldn't be reading this), one reason obesity is being singled out as THE factor, the cause of ALL of the growth in healthcare costs, is because people can judge someone by appearance. Just a glance and one can smugly judge, calmly blame all the struggles and pain of healthcare issues on an individual. And, since everyone assumes it's a lifestyle choice, they are comfortable in thinking fat people get what's coming to them or are bringing the rest of the country down.

I don't get that. I'd never take it upon myself to judge a smoker, what kind of person they must be to take up the habit or continue it. How would I know how that happened or why they haven't overcome it? Or a drinker? Or a prostitute? I've never walked in their shoes. How do I know what I might have done if faced with the same choices? As long as they don't endanger others with their behaviors, such as drinking and driving or continuing with unprotected sex even if HIV positive, it's not any of my business what they do to themselves. As for health issues, there are plenty of people who suffer the consequences of life-threatening diseases without doing anything "wrong" and many who do nothing right and yet remain healthy.

Yet, few hesitate to judge a fat person. One glance and one assumes they know the eating habits, exercise habits, reasons they're fat, everything they need to know about someone. Just a little effort and it could all be undone. Is it true in some cases? You bet. Just like some people kick the cigarette easily.

For many others, overcoming obesity can involve years of constant diligence, tiny meals, exercise and sacrifice - even life-altering surgery.

But people would rather judge. Now, most will admit that there are some people fat through circumstance beyond their control - but those same will be quick to admit that that doesn't apply to the vast majority of obese individuals. All well and good, even if undoing it is almost universally challenging.

Can you tell which one's which by looking?

And that, boys and girls, is the problem with prejudice. Prejudice is all about deciding what a person is by their appearance, whether it's having dark skin, wearing a burka, or being fat, instead of who they are. I'm far from convinced that the obsession with weight is a healthier thing than the obesity problem - I could be wrong, but I don't think I am. Most of the fat people I know are quite aware of the problem and have already taken steps, even repeatedly, to try to eradicate it. Telling us we're losers hardly fixes anything. And treating people based on what they are rather than who they are, hating them (as fat people still are even in our otherwise politically correct world) though they hurt no one else, well... that's a step that historically has always lead to bad things.

In the end, in my opinion, judging someone by their appearance alone says a great deal more about what kind of person the one judging is than it says the person being judged. And healthcare's issues are bigger (if you'll forgive the expression) than weight control.

Just sayin'.

*Steps off soapbox*

I've decided to limit my rants to once a week and Sunday is often a good day for this sort of thing, so I'm making it a new feature. I expect I'll be getting a lot of flack on these topics. That's OK. If you've really considered something, disagreeing is fine. But I think, far too often, people react in a kneejerk way, insensitive to the effect on others.

29 comments:

  • Jeff King
     

    I agree with all you have said.

  • Project Savior
     

    I'll comment on your rant with a rant of my own:
    The saddest part of the villifacation of fat people is the people who use it as an excuse to deny them help.
    People 100+ lbs overweight simply can't lose it without help from a Nutritionist, or doing a lot of research and becoming an amateur Nutritionist themselves.
    Since most people in this country don't have access to basic healthcare, like Nutritionists, they turn to quack diets that don't work.

  • Stephanie B
     

    I agree that's a significant concern, Project Savior. I think that that only acerbates another part of it. In order to overcome something like this, one must feel like one is worth it, must have self-confidence and a sense of self-worth. The villification and contempt undermine those efforts whether one has healthcare support or not.

  • Shakespeare
     

    Agreed. And what is so horrifying about all of this is that while the U.S. is criticizing fat people, its habits and consumerism are pushing people towards obesity. Can one go into any restaurant without having more food than one asks for pushed at one? (Would you like to Super-size that?).

    Food addiction is very much like smoking or alcoholism. Only it's even more emotional because people are judged more for showing signs of it (outwardly) than any other kind of addict. It's also the only addiction where one cannot "kick the habit" completely without dying.

    Gotta eat. And that means that even if one is able to lose the weight, the struggle will never be over. It's a very tough road, very tough road.

  • Stephanie B
     

    Good point.

    One of the things that frustrates me is the emphasis on appearance rather than health. People, who might have slightly larger hips or heavy thighs are pressured to lose weight, be skinny, be "beautiful", not only decimating their self-esteem, but often putting them (unnecessarily) into the diet/despair cycle that might even lead them to the obesity they might never otherwise have reached.

    Much of the money spent on "healthcare" is spent on surgeries to remove tiny amounts of fat, unsightly (no to mention facelifts or laser skin treatments or breast enlargements, etc aud nauseum). This preoccupation with appearance adds to financial burdens, stress, and perpetuates those very stereotypes.

    There is a standard out there that one size fits all. I beg to differ. As long as the skin's surface (and/or lumpiness) is considered the measure of a person's worth, we are missing out.

    In my opinion.

  • The Mother
     

    I will grant you the entire post worth of points.

    I do want to make a few of my own, though:

    Obesity is largely an American disease. While one does find the hefty Italian matriarch on occasion, it's largely the American lifestyle that is conducive to massive overweight-ness (you did mention that, I just wanted to clarify).

    Obesity is, though, one of THE major causes of hypertension, heart disease, diabetes, stroke, amputations, several kinds of cancer...

    Yes, there are lots of other bad habits that cause disease, too. I sort of feel the same way about all of them, and that is:

    If the public is going to pay for health care, there has to be SOME control over the amount of spending that is done on VICES.

    (In the British system, an overweight smoker gets ONE treatment for his heart attack. If he doesn't lose the weight and stop smoking, the next one is on HIM--I'm not sure that's such a bad idea.)

    The "Fat is Beautiful" movement was a terrible thing. It's waning now, but there is still a huge lack of acceptance of responsibility out there. Docs see it daily--you tell a person to lose weight or they will DIE. You send them to the nutritionists and the bariatric surgeons and the exercise physiologists, and six months later they are sitting in your office with a blood pressure of 160/100, chest pain, and a bucket of fried chicken, swearing that they TRIED, they really did, but it's just not their fault.

    Yes, I know losing weight is hard. I struggle with it myself. But I accept responsibility for it, and I keep on plugging.

    And I'm willing to admit that it's not the public's responsibility to pay for me to stay fat and enjoy the consequences.

    This all really boils down to the one thing no one says, but that is inherent in the idea of a public health care system--THERE WILL BE, BY NECESSITY, A RATIONING OF CARE.

    Everyone is just trying to carve out their niche, so they aren't the ones getting rationed. It's much easier to point fingers than to admit the truth.

  • Stephanie B
     

    It is largely an American disease made more so (I believe) by two traits particularly: we drive absolutely everywhere (including to the gym) whereas folks in almost every other industrialized nation uses walking/biking/public transport and our sacrificing direct experience for vicarious/virtual involvement and convenience.

    The second is incidious. We don't play golf on the field but do so on our game consoles. We don't go out and play football with our buddies; we get together and watch the game, eating chips and drinking beer. We sacrifice savoring a well-cooked and potentially healthy meal for one we can pick up on the way home.

    By all means, tax "vices." Tax booze and cigarettes and sugared drinks and fast food. I wasn't against it (and many other addicts weren't either - it was the manufacturers that hate that).

    I disagree with your opinion on the "Fat is Beautiful" movement - but then I've never known any fat people who really thought it was.

    I'm fat. I also have low blood pressure, low cholesteral, I eat intelligently and I have no diseases. I have to take steps to reduce my weight because I'm at high risk for late onset diabetes, but I had three healthy children and am healthy now, in part because I was meticulous in making sure my gestational diabetes stayed under control through diet. I know who's responsible for my weight and the one and only person who can fix it. Me. I'm also the one who will pay more than anyone else if I fail. Me, me, me.

    I don't know a single fat person who isn't similarly aware.

    And the obsession with uberthin isn't any healthier in my opinion. My daughter's friend is nearly six feet tall and weighs maybe 150 pounds. She's on the basketball team and is in wonderful shape. Her parents told her they'd buy her a whole new warddrobe if she lost 30 pounds.

    True, teenage suicide is cheaper for the healthcare industry than late onset diabetes, but that seems pretty damned stupid to me. The measures and demands seem unreasonable and our obsession with weight (which has lasted far longer than the past couple of decades) and our villification of the obese and overweight has certainly not curbed growth.

    I resent (and will continue to resent) people thinking they know me by looking at me. Fat is ugly. That doesn't mean I am.

  • Stephanie B
     

    And, the Mother, there's a rationing of care now.

  • Stephanie B
     

    I need to add that I'm not trying to say being obese is healthy or recommended. If I told other fat people that, they'd know I was blowing smoke up their, well, you know.

    But I'm very concerned that this attitude that ALL fat is bad or dangerous is warping us. In my opinion, all or nothing concepts have pushed people to one extreme or the other, polarizing them, when neither extreme is healthy but the middle is.

    I also think that, if obesity is an issue we need to battle (and most, including the obese, agree that it is), we will not get there by with hatred and contempt. To the best of my experience, hatred and contempt have yet to solve a single social ill.

    But your point, the Mother, is well taken. The only way a fat person will ever get slim is through their own efforts, whether with surgery or diet or exercise or all of them. EVER. None of the medical interventions will work if we don't decide to make it work as well, if we don't put in effort and sacrifice. We have to be responsible for that.

    What I argue is that we don't know that. Or that making us feel like failures will do a damn thing to make our changes easier or more likely.

  • mrsbitch
     

    Stephanie B wrote, "And, the Mother, there's a rationing of care now."

    Thank you. I was about to launch into full rant mode.

    I've not been one who has had to constantly battle weight, unlike my sister. I have an optimal weight where I feel my best, physically, and I am about 15 pounds over that right now.

    At one point in my life, I was uberskinny (5'8" & 112 pounds) when I was doing a very physically demanding job, and I felt worse (weak) then than I ever have when carrying an extra 15 pounds I didn't need. Although, it was kind of nice to be able to eat like a horse to try and put on a few pounds :)

    My only suggestion to anyone would be to find that point where you feel the most energetic and healthiest, and if it's 20 pounds over what is considered glamorous, oh well.

  • Stephanie B
     

    I agree, Mrs. Bitch. You know why I think health care is the way it is here and why we're so reluctant to change?

    Right now, it's rationed (except to the very poor, veterans, Native Americans and the elderly) on the basis of wealth. And I think we've allowed it because there's still a pervasive belief out there that wealth=merit. I wonder how much good could be done in the world (and less painfully) if we'd let go of the notion that the poor are just poor because they're lazy and the wealthy are rich because they deserve it.

    But that's a whole other soapbox.

  • The Mother
     

    Of course being too skinny is bad, too. I have a relative with anorexia who will not seek help--she's ill all of the time.

    And any obsession, including one with uber-thinness, is bad.

    Our weight tables do need a little work, and do not account for muscle mass. I agree, wholeheartedly.

    But I've seen too many obese people just throw up their hands and admit defeat. Many, many do not try to lose weight, and simply expect that they will be taken care of (just as many smokers do not try to quit). When we are forced to ration care, they are the easy ones to point fingers at. THAT was my point.

    Having paid my dues in the public health system (as it currently stands), I'm not sure I totally agree that care is currently rationed entirely on wealth. I'm not implying that it's fun to go to the ER at Ben Taub, but you will be treated. BT has an MRI, and CTs, and top notch surgeons and clinics for everything under the sun. There may be waits, but I've seen waits as long as six months to see a PRIVATE neurologist.

    The public pays for the care of the indigent. We do it all the time and have since the 1920s. To simply assume that someone without insurance doesn't get care is wrong.

    The ER in any private hospital cannot turn an emergency case away based on ability to pay, nor can they move said person to a public hospital until they are stable. That can mean admissions of, potentially, months, in private health care facilities. And this privilege does get used, I promise you.

    Is it the perfect solution to the problem? NO. But I don't think there is a perfect solution to the problem.

    In every perforce public health system, the rationing of care is at a much higher level. The govt decides how many MRIs and CTs a city can have. It decides whether certain therapy is administered at all.

    If it takes a month to get an MRI after you've had a stroke, because there are only TWO in a city the size of Toronto, that's rationing of care. And that's what it's like in Canada, whether you can afford to pay or not. My Canadian relatives are always coming to Tx to have stuff done.

    The waits in ERs are longer, not shorter. And everyone gets treated in the same way.

    Maybe I'm a snob, but if I can afford to pay, I still think I have a right to do so. And if I'm paying for something, I think I should get decent service.

    Unless we are going to wholeheartedly embrace socialism (communism), and say that everyone gets equal shares of everything, some things are simply going to be better and easier for those who can afford to pay.

    It isn't about MERIT.

  • Stephanie B
     

    I hear all the time how Canadians envy our healthcare, but clearly the people who say so know different Canadians than I do - all the ones I know think we're insane to have the system we have. But it doesn't matter. You of all people know better than to use anecdotal evidence and yours means no more (or less) than mine.

    However, if asked, Canadians, Brits, Europeans, even the Japanese and medicare recipients all rate their healthcare systems better than we poor slobs who don't have a safety net. They consistently, even ALWAYS do so, and that trumps anecdotal data, yours or mine.

    I also think it's safe to say I wasn't talking about the indigent when I said we had it rationed (I think indigent=very poor I mentioned in my comment). I'm talking about regular people who make decisions on what treatment they get and how the get it depending on how it affects everything else. Can you find an example of this happening anywhere else? I mean, the anecdotes I hear about other countries happen here, too. But this doesn't happen anywhere but here and some third world nation where national average salaries are in the triple digits.

    AND, I don't agree with you. When it comes to buying furniture, buying a car, the treatment you get a day spa, you should get what you pay for. So, yeah, there are things that should be easier for those that can pay for it.

    But, when it comes to your medical treatment, I don't think so. I don't think medical care is a luxury item or that anyone's medical treatment should be dependent on one's bank account or that it's reasonable to bankrupt a family to treat a disease. And I have a hard time understanding who anyone could think that was OK.

    And, if it's not about merit, why is it OK?

    Not that any of that has to do with weight. And your reasoning is also anecdotal.

    I don't think we have to excuse people's obesity or pretend it's not their fault. I want to know why we have to treat them with hatred. I'm not asking for a handout. I'm asking for the same tolerance I give to everyone else, to be seen as a person first and a descriptor second.

  • flit
     

    I was at a Canadian emergency room (not that far from Toronto) just last week - my complaint was relatively minor - but I was in and out in under an hour and the only cost to me was the prescription - which will be reimbursed, as I have health care coverage through school - they'll pay 80% and I will only pay 20%.

    The Canadian health care system is far from perfect - they once kept me in hospital for far longer than I felt was justified because it is faster to get an angio if you're an inpatient - which in my opinion is RIDICULOUS - since keeping someone in the hospital to get tests that could be done on an out patient basis is far more expensive than to let them go home.

    But the point is that I did get the angio - and the (unnecessary and unwanted) time in hospital to boot. And there again, the only hit to our pocketbook was the cost of parking at the hospital and the food hubby brought in for me almost daily because I am very spoiled.

    When my kid needed her appendix out there was no wait and no hassle - I did have to jump through hoops to get a CT scan for her afterwards when she didn't heal as well as she should have - but again - no bills - just a small amount of aggravation.

    When we Canadians have a problem there is no monetary reason at all to avoid having it dealt with while it is still TREATABLE. We don't wait for things to become a crisis - there is no need to wait for that - and there is not one iota of doubt in my mind that THAT is most likely the single most reason for the abysmal difference in overall life expectancies between the US and Canada.

    I know 2 people with diabetes in the US - both go without treatment and monitoring on a regular basis; one lost his leg because of it! It is ludicrous - and doesn't save society a damned cent! Another dear friend of mine has other serious health problems and is going without care for God knows how long because they don't have coverage right now - do you think her condition is going to get any cheaper to fix while she waits? It's already been 2 years!

    And yet another friend, a single mom, was still going into work - where her employer had provided her with a cot so that she could rest when she could - while dealing with serious cancer, chemo and radiation. She couldn't quit work because then she would have lost her health care coverage - so her children were not only orphaned - they had no mother for the last year of her life because by the time she dragged her ass home from work she had nothing left.

    And she HAD health care coverage!

    Of course there are problems with the Canadian system - many of them a result of the fact that HC is administered largely by the provinces, not the federal government - but to suggest that our problems are a reason not to fix the US system which DOES NOT WORK and results in horrendous suffering and DEATH is just nuts!

    I am so sorry for my US friends - the whole thing seems totally unconsionable to me.

  • Aron Sora
     

    Also, what about the cost of food. I'm on a vegan diet and I burned through 100 dining dollars (same as normal dollars except they are tax free on on my ID card) for lunch and breakfast. That's for one person and I get small things for those meals. My main meal is in the dining hall where I use a different currency to get in. Back to the point, I'm spending at a rate of 200 dining dollars a month to eat salads, naked fruit drinks and fruit smoothies. I talked to some of my friends and they said they have been eating worse to save on dining dollars.

    Also, in America we are rushed. During orientation I had leisurely meals laughing with people in the dining hall. Those meals would take 1 hour and 30 mins but I would eat less. Now, I ask for a takeout box, shove as much food into it from the buffet line and move to my next class where I shove as much food as possible into my month, while balancing the container on the tiny little lecture desks, before the professor comes.

    I need to change this before it because a habit, but this is what most of my class mates do during meal time.

  • Stephanie B
     

    I hear you, Aron. That's another topic I'll explore this next week. Our obsession with time and the repercussions.

  • The Mother
     

    Your link is just as anecdotal as my relatives.

    We have two arguments running here:

    1) obesity as a defining characteristic of a person. On this I doubt we actually disagree. In terms of health care, it is an obvious thing to attack, just as is smoking or alcoholism (which was and is my point).

    In terms of personhood, however, I absolutely agree with you. It says NOTHING whatsoever about the person inside. I resent labels as much as the next person. I truly wish for the day when everyone was judged by what came out of their mouths, rather than their looks, or, my personal soapbox, what book they choose to run their lives by. And yet that day is a long time coming.

    2) universal right to health care--which is a side issue to the one that started this whole thing.

    I DO NOT believe that everyone has to be treated equally on this score. It is simply impossible for our world to economically support gold standard health care for everyone, which means that, if we demand equality for everyone, everyone will get substandard care. AND YES, that's the way it's done in other countries.

    Britain has the most rundown hospital system in the western world. Substandard care is the standard of care (REFERENCE: http://www.humanevents.com/article.php?id=31173)

    Canadians routinely come to the US. And the care from the health system would generally be considered substandard in America. (REFERNCE: http://www.city-journal.org/html/17_3_canadian_healthcare.html).

    BOTH countries have two tiered systems--the wealthy use private docs (Britain) or go to the US (Canada).

    Equality is not necessarily a grand goal. Should everyone be C students? Should everyone perform at a mediocre level? Should everyone get paid the same, regardless of intellect, education or productivity?

    While it is fairly nice to think that everyone has a right to health care, it is, quite simply, unfeasible. To grant it to everyone means that everyone will have a lower standard, because resources will run out.

    So by defining an absolute "right" to health care, we are forced to restrict the liberty of the health care buying population. Hmm...that sounds like communism to me.

    Luckily, though, no one will know, since everyone will get used to the poor care. Just like everyone got used to bread lines in Russia.

    I realize that what I'm saying is unpopular. But it is the hard, bare boned truth.

    I refer you to several essays on the supposed "Right" to health care:

    http://www.objectivistcenter.org/cth--14-Is_There_Right_Health_Care.aspx

    http://online.wsj.com/article/SB10001424052970203517304574306170677645070.html

    http://www.bdt.com/pages/Peikoff.html

  • Stephanie B
     

    I appreciate the links. I'll check them out before I respond.

  • Stephanie B
     

    Anecdotal evidence, by the way, is not worthless. It is, however, a poor way of judging whether an entire system is faulty unless it is coupled with statistical evidence, especially when I have yet to hear a horror story for a different country I couldn't top here. However, it is also an indication of where a system fails, where it needs to be corrected.

    My point of bringing up the one anecdote up is that I have yet to find any source that demonstrates this problem is even possible in a system that has universal healthcare. If it is not found anywhere but here, that is significant. If we're the only country that lets people die for lack of funds, that matters. You're enough of a scientist to know that.

  • The Mother
     

    People fall through the cracks in EVERY system. There is no perfect solution. I wish there were, but there isn't.

    I did manage to find horror stories in both the Canadian and Brit systems. I just didn't bother to link them, since we were sparring over anecdotal evidence.

    And while we're on anecdotes, I do think that doctors' experiences may count for a tad more than the occasional story picked up by the media. The media, as we know, is good for a horror story any day, and never covers the perfect outcomes or the way things work 90% of the time. Because that's boring.

    It also isn't PC right now, as we bash the current system to further the national plan.

    I never meant to imply that the way we do it is perfect, or even right. I am simply pointing out that the way everyone else does it isn't perfect, either, and that a perfect solution is simply NOT POSSIBLE, given the fact that health care is and will always be a commodity, with all of a commodity's attendant market pressures and economic problems.

    And I still maintain that it is simply impossible to provide gold standard health care to everyone. Again, not pc or popular, but true.

  • Stephanie B
     

    This comment has been removed by the author.

  • Stephanie B
     

    The Mother, I'm disappointed.

    Your first source "Headquarters of the Conservative Underground" whined about British healthcare and cited such frightening statistics as "1,200 people might have died unnecessarily" over a three year period, yet the US estimates at least 83,000 unnecessarily deaths per YEAR due to medical error - and that's the low end. You can check out the source because it's cited. At five times the population (per your own article cited - which about checks out) that indicates a rate >40X higher here. So, color me unimpressed.

    As for the 20,000 people/year die in hospitals, um, so what? Know what the total that die in hospitals here is? Me either, but I bet it's more than 5X more.

    Other examples were equally meaningless. There's a medicine that isn't approved in Canada but is approved here? So what? There have been tons of procedures and medicines approved overseas that weren't approved here for years, including the abortion pill. That doesn't make their system worse (or better), just that it has different priorities. The fact that it seems the the highest priceddrugs are the ones most quickly approved here (when low cost alternatives might be readily found overseas that often have fewer side effects and similar results) sounds more like pharmaceutical greed than progress, but I'm cynical.

    Speaking of truth, WHO (which is far less politically motivated than 100% of the - I love that the sources cited in the third one include Ann Raynd's novel, The Fountainhead and a host of opinion pieces), ranks both the Canada and Great Britain above us. The OECD, another relatively objective source, provides data - (again source data is available and cited) that certainly would seem to indicate we get less for the money spent than any other industrialized nation. The only exception I've consistently seen is on cancer results, so kudos for us there. Out of courtesy, I'll refrain from pointing out how lucretive oncology is.

    You are entitled to build your opinion however you choose and with whatever you sources you choose. But I will not take opinion over statistics, over hard data and call it the truth. Unjustified hysteria without evidence, that's anti-vaccination talk to me.

    Bring me hard statistical data, and I'll reconsider my position. The dearth of data defending our healthcare system (because you aren't the first to challenge my position) is pretty telling, but I'm open if you have anything compelling.

    (By the way, I couldn't care less if the difference in countries with universal healthcare is optional additional coverage. Even with that, they still spend a fraction what we do - and they have regulations to ensure everyone is covered for the basics. I don't care how it's done, but I think everyone should be covered. Period. Someone will have to provide compelling evidence to convince me we have to trade universal care for bad care because the rest of the world seems to bely that.)

  • Stephanie B
     

    That's the first I've heard that people have been denied care due to life-saving care due to cost in a universal healthcare system. Please do provide examples.

    However, to answer your assertions, two things (written while I was mulling over the above comment).

    Doctor's anecdotal evidence should be given more weight, but doctors should also not be viewed as disinterested parties. And neither patient nor doctor anecdotal evidence outweighs hard data. The anecdotal examples flit provided (and I have myself) are ones from people we personally know and, while I have a limited dog in this fight, flit has none. As a scientist, you understand, of course, that having a financial interest can color one's data, particularly anecdotal data.

    And, the notion that people some people should get "gold standard" care because they can pay for it rather than all getting at least basic care is entirely repugnant to me. Would I mind if the standard were dropped but people weren't financially bankrupt by unforeseen disease or needlessly left to die because they couldn't afford it? No. Assuming (which has yet to be demonstrated) that our care really is the "gold standard." Do we have any data?

    But the notion that people with resources are somehow deserving of better healthcare ("gold standard") than those without ("NO standard"), I have to admit, disgusts me. And, even if you came up with hard data to demonstrate that's standard will drop drastically if everyone were covered (and not a single source you provided does anything of the kind), it will not change my mind.

    I'm having a hard time, actually, trying to express how disturbed I am at the notion that a doctor is touting the notion of people being saved or not saved due to their ability to pay. You say that's realism.

    Prove it.

  • Stephanie B
     

    (My point is, by the way, you want to tie medical care, at least in part, to people's willingness to do their part in their healthcare or self-inflicted problems - alright to a point. Tell me that we might need to rethink how we handle end-of life care, I suspect you're right, though that's not PC either.

    But telling me that personal wealth's a decent criteria for rationing care - you lost me.)

  • The Mother
     

    Obviously, we must agree to disagree.

    I have no financial interest, one way or another. I don't do patient care medicine, and hubby only rarely does. Obamacare will not affect our lifestyle.

    But be careful what you wish for, as the Daugherty song says. You might just get it.

    Regardless of the media hysteria on this issue, everyone is still ignoring the fact that health care is a limited commodity. The economy cannot sustain perfect care for everyone. Nor can our resources be stretched that far.

    If realizing that makes me a terrible person, so be it. But I'm not the only one saying it. I still suggest you read the essays I mentioned. I'm signing off on this one, as we obviously cannot come to common ground.

  • Stephanie B
     

    I did read them.

    I don't think you're a terrible person, even though I don't understand your position. I don't disagree (and never have disagreed) that healthcare was a limited commodity, but we clearly disagree on the best way to distribute. I don't doubt there are many other ideas about it.

    I think you're a thoughtful and intelligent person. I'm sorry we could not come to common ground, but I appreciate leaving it there.

    I really don't think there was much more to be said.

  • Relax Max
     

    I don’t believe in villification and contempt, and I certainly don’t believe in snap judgments based on outward appearances. Those are pretty shallow things to do. On the other hand I do believe in accepting evidence. I am pretty sure how a person gets fat and I am pretty sure I know how a person loses weight. So do you. I mean physiologically speaking. Diet and exercise. But it goes so much deeper than the obvious formula of diet and exercise. There are reasons people don’t exercise enough, and there are reasons people don’t eat properly. I have developed a lot of theories on this subject over the years, but won’t bore you with them here. Suffice to say, these reasons are not simply due to laziness or lack of discipline, as so many critics seem to think.

  • Relax Max
     

    For the record, I believe if a person has money, he has the right to spend that money any way he damn well feels like it. That includes buying superb, preferential, ass-kissing medical care. My opinion.

  • Stephanie B
     

    I don't think that's the question, though, because the other side of the coin is the supposition that, if you don't have the money, you don't deserve any healthcare.

    If you're so rich you want a gold plated pancreas, more power to you. I couldn't care less (though good luck getting through airport security).

    But when the fact that some people can afford whatever superb (or not) ass-kissing medical care they choose becomes and excuse to keep people from getting the healthcare they need because they're not rich or well-insured (and sometimes when they are), when people shrug as families are devastated financially because their little girl got leukemia (which is devastating enough without the money worries), something is seriously wrong with the system.

    In my own opinion, in case you didn't know.

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