Smokers 'to sign pledge' with doctors

The Guardian ^ | Tuesday June 3, 2003 | Nicholas Watt, political correspondent

[friendly]

Smokers and overweight people will be asked to sign contracts with their doctors to agree a programme to quit smoking and lose weight under radical plans being drawn up by the government.

In an attempt to remind people of their own responsibilities the health secretary, Alan Millburn, is examining plans for patients and doctors to agree a formal programme of treatment.

Labour sources insisted last night that the plan, outlined in a Labour party policy document as part of preparations for the next general election manifesto, did not mean patients would be denied treatment if they refused to sign.

But the Labour document makes clear that patients, particularly overweight people and smokers, will be reminded that they must have a role in caring for themselves.

Under the new contracts, overweight people would be encouraged to exercise more and to eat a more balanced diet. The document says: "Agreements could be drawn up to help people to cut down or quit smoking, to lose weight, to take more exercise or to eat a more nutritious diet."

Under Clive Bates, formerly director of anti-smoking organisation Ash, Downing Street's strategy unit has been examining consumer responsibility across every aspect of public services.

The proposals are likely to be attacked by rebel Labour MPs who are already opposed to government plans to introduce elite foundation hospitals in the NHS.

But government sources made clear last night that it had no intention of forcing people to do anything and treatment would never be denied to people. A Department of Health source said: "This is about reminding people that resources are finite. If they misuse them they are being denied to someone else."

· The health secretary said that during a single week in March the target of treating patients within four hours of arrival in A&E was hit for 92.9% of patients. But a BMA survey found 55% of departments met the target in the week before the audit, 85% during that week and 63% a week later.

[RJayneJ]

LOL Yep, I'm wearing a dozen or two. Like Tom Daschle, I'm deeply saddened about the terrible things I've done to my body with a fork. (An old Steve Martin line.)

[Prodigal Son]

Aye. I don't want to seem so much like I'm ranting at you per se- I'm just generally ranting.

The thing is, I've got lots of people in my social circle who are nurses and doctors because my wife is a doctor here. I know loads of doctors smoke, drink too much, eat improperly, don't exercise enough etc etc etc. You can walk into any hospital in the UK and see obese nurses. How is one of those doctors or nurses supposed to look anybody in the eye and tell them to quit doing the very things they're doing themselves?

It's hypocrisy.

[eno_]

Government intrusion into medicine is one of the biggest destroyers of privacy and liberty. MSAs, private indemnity insurance, and truly private patient/doctor relationships should be the rule.

The income tax is another. An NRST would fix that.

You probably find the first two agreeable, but what about the third? What has turned our "justice" system into a sham that breaks your door down based on the word of a paid snitch, who is probably an addict looking to pay for a fix? What has stuffed our prisons? What has taken law enforcement resources away from real crime, causing solution rates for even murder and rape, never mind mere property crime, to fall to shamefully low levels in many big cities?

Less government. More freedom.

[FairOpinion]

"Gotta protect the sheep so our Model of Marxist Medicine- the NHS doesn't collapse. "

That's about it.
You made the point well and I agree.

And of course they will have to take even more of your tax dollars, so they can administer these new programs of packaging healthy food, which the government will provide and running the mandatory exercise classes.

[FairOpinion]

And in related news, in some states in the US they impose tax on health club memberships. It's all about the government taking more of your money, give you back less, and control your personal life more.

The Watchers
http://www.insightmag.com/news/437048.html

Posted June 2, 2003

By Jennifer G. Hickey
Fitness Buffs May Get Tax of Their Own

The weighty issue of excess poundage is not a problem confined to the ranks of children, according to the American Public Health Association (APHA), which estimates that approximately two-thirds of American adults are overweight. Although 52 percent of District of Columbia adults are overweight or obese, Mayor Anthony Williams recently attempted to impose a tax on the dues paid by health-club members.

Like many states attempting to squeeze their budgets into tighter economic constraints, Williams' spokeswoman, Sharon Gang, says the mayor looked at everything on the table "in this time of fiscal difficulty." With Americans also looking at (and sometimes eating) everything on the table, taxing those who belong to health clubs might seem counterproductive. At the end of the process, however, this tax was eliminated from the mayor's budget proposal by the city council.

However, the International Health, Racquet and Sportsclub Association (IHRSA) warns that states may be expected to increase the tax burden on those trying to reduce their waistlines. According to IHRSA, 20 states currently impose a tax on health-club membership dues with many states categorizing health clubs as "entertainment facilities."

[ISawIt]

Well, as a smoker... I can tell you how this line of
rhetoric will get shot down, state-side...

When the doctor "informs" me of this, I will point to
the little NJ State Tax Stamp on the bottom of my
pack of cigarettes, and ask him how much he thinks it
costs for one of those little stamps.

I will then inform him that it costs 4 to 8 dollars a day
for the privilege.

I will also inform him that I pay an extra $6000 per year
for my Health Insurance premium, owing solely to the fact
that I am a smoker.

I would then ask if he enjoys being a part of the
avaricious assclown parade who bought 10 lawyers 350
million dollar yachts (plus 3.5 B for "walking-around-cash"
just for taking a nice round cut of the "tobacco
settlement"? How much of this actually goes to the
healthcare system? NONE? How much buys cigars for
slick, polite, "Noath Carolayana Lawyah" types?

It's not ME that ANYONE should be complaining to. It's
the State, and the Insurance Companies. Ask them where
all the tax and smoker's rate premiums are going.

I sure the hell can tell you where they're COMING FROM.

Me.

So when a doctor suggests I quit smoking for the public
fiscal good, I will suggest to him that I give him a quite
aggressive prostate exam with a very Specific Finger.

Twice.

[Marie]

Darn good comeback! I'm printing your post!

[ISawIt]

Feel free to. Carbon copy Peter Jennings, while
you're at it. We're not on speaking terms.

[tdadams]

How much more invasive can the government be, than to tell people that they aren't allowed to smoke or be overweight?

You're confused. It's not a blanket mandate. It's a concession to the fact that someone other than you is paying for your health care (however much I may disagree with socialized medicine). If I'm paying the tab, I'm choosing the wine.

[Just another Joe]

Puff!

Now in the UK

Coming soon to a country near YOU.

[friendly]

LOL

But why smoke? I know someone who works for Phillip Morris and he claims it costs 25 cents to manufacture a pack of cigarettes. In NY City its $8 a pack, $3 to $5 elsewhere in many places. The difference between 25 cents and the rest of the money you pay goes to evil shysters, politicians (a redundency) and the tobacco companies and your local cigarette drug dealer. Do these people deserve your after tax expenditures?

But it is your choice.

[cinFLA]

You probably find the first two agreeable,

Why do you jump to this conclusion?

[cinFLA]

I know someone who works for Phillip Morris and he claims it costs 25 cents to manufacture a pack of cigarettes.

And that $4 box of cereal is about the same ...

[eno_]

So tell me why you think government controlled medicine, and the ability to poke around inside your finances is a good thing.

[eno_]

It costs about $2 to produce a $25 bottle of quality wine. Why not drink plonk out of a plastic bladder?

It costs a few pennies to make an $8 El Rey del Mundo, why not smoke Swisher Sweets?

The steel in a BWM Z4 costs the same as the steel in a Ford.

I make games that cost NOTHING to make an additional copy of.

And this is an excuse for government intrusion into our choices... why?

[eno_]

If I'm paying the tab, I'm choosing the wine.

Gee, can we vote on how you spend your Social Security money? Where you are permitted to go on highways on which days? And, as long as you are driving on government paid highways, can we do warrantless searches in your car?

There is a lot to be said both for limiting government programs that provide the excuse for government to call the tune, AND limiting the extent to which government controls those areas of our lives where it must be present.

[cinFLA]

So tell me why you think government controlled medicine, and the ability to poke around inside your finances is a good thing.

So tell me why you make these false accusations about what I think?????????

[eno_]

Well, what do you think?

Government in, or out, of your doctor/patient relationship?

Government in, or out, of your financial matters?

Which is it?

[tdadams]

You've got no argument from me about getting the government out of the health care business, the retirement business, the education business, etc. I could go on.

But as long as my tax dollars are paying for health care, some fat smoking SOB better get off his ass, put down the cheeseburger and hit the gym.

[freeeee]

But as long as my tax dollars are paying for health care, some fat smoking SOB better get off his ass, put down the cheeseburger and hit the gym.

And if he doesn't?