Posted on 02/24/2017 2:34:09 AM PST by markomalley
An irate man contacted me recently to complain he’d been turned down for back surgery because he’s a smoker.
“It’s just not right,” said the Charlotte man, who suffers from chronic hip and leg pain. “I need this surgery. It’s to the point where I can’t walk around the block with my dogs.”
He acknowledged smoking is a “bad habit,” but after 35 years, he’s not sure he can quit. And he doesn’t think he should have to.
(snip)
Spector said it’s part of a national trend for doctors to run down a checklist of behaviors in preparation for elective surgery. Before spinal fusion, Spector said he might tell a patient: “Listen, I want you to stop smoking, but if you can’t stop smoking, at least cut it in half. A two-pack-a-day smoker is going to have a higher risk (of complications) than a two-cigarette-a-day smoker.”
(snip)
At OrthoCarolina, Spector said doctors agree that all patients who register for the bundled payment plan must go through “surgical optimization” so they’re as healthy as possible before surgery. At some point, insurance companies may even begin to refuse to pay for elective surgeries on smokers.
(Excerpt) Read more at macon.com ...
The main surgical prob w/smoking is that it negatively impacts circulation which is why, in general, it’ll take a smoker longer to heal than a non smoker. If you’ve ever seen those carbon monoxide warning on packs, that’s what causes it. CO tends to pit the inside of arteries and veins. This operates in addition to the obvious lung probs.
Per arguments I’ve seen here: lawsuits can thus be closed by demonstration the smoker had continued to smoke. There are simple blood tests for this.
Per tax dollars, if you haven’t noticed, tobacco is abusively taxed. Smokers not living as long as others also draw fewer tax dollars due to an absence of social security payments. If you’re going to use a tax dollar argument, you could only argue smokers should be treated at no charge since they’ve paid so much all along. In fact, thanks to wellness plans, smokers will pay more for insurance. If insurance is not going to cover it, then smokers should actually pay less.
All surgery has risk. I think most smokers underestimate the threat of complication in their case. Nevertheless, as with all surgery, you only do it if the risk outweighs the benefits.
As a smoker myself with addiction level a 10 on a 1 to 10 scale, I can tell you I consider myself surgery-averse. It’d have to be pretty debilitating for me to even consider it.
And what about treating homosexuals with AIDS? Their behavior caused them to contract the disease. Will they refuse to treat them?
I did read it but made a mistake... 1000 pardons... please refer to my last post to Markomalley...
By smelling him and looking in his mouth.
It's not rocket science.
Should medical insurance be a mandatory redistribution of wealth? Should healthy people have to pay for the weak?
People have to decide if they want to be poor socialists and live a trace longer at the expense of others, or preserve the right to life, liberty, and the pursuit of happiness, and pay for you own damn doctor.
Medicare (promise to pay without limit using other people’s money) + EMTALA have, in effect, dictated nationalization.
It’s just taken a while.
The tobacco gets the blame for the lung and mouth cancer but it is the agriculture chemicals used in growing and processing the tobacco that is the problem. Of course Monsanto will deny that and they have the money to push the blame on the tobacco itself. My grandfather would plant a few plants of dark and burley tobacco off by itself and not use any chemicals on it. He used these plants to tie his own twists he used for chewing. He said if that stuff will kill backer worms he would not put it in his mouth. He chewed everyday and died at the age of 91, no cancer.
Oh, please.
Every penny CMS pays out for a patient is somebody else's money, taken from them under threat through taxation.
It is right and necessary that taxpayers have some say in how their money is spent.
alchoholics with bad livers
My long ago ex room mate outlived the artificial hip. They will not operate to provide a replacement because of a bad liver that might cause problems that will result in a law suit. He is waiting on his condition to get better...... but it won’t.
His world has been reduced to his recliner.
I mean, do what you want, but when someone else is paying for it, especially the taxpayers, listen to what they say.
Tobacco doesn’t kill everyone who smokes it, just a significant percentage. So a smoker living to a long age doesn’t prove anything.
While the chemicals in tobacco have been isolated and shown to do the damage, I am sure that other chemicals added in production don’t help either.
Thank you for that painful testimony. I fought for the “right” to smoke for 40 years until I got old and it caught up with me. For all those hard heads that won’t quit for themselves, consider quitting for your loved ones. They will suffer more than you.
LOL. In the ER. For emergent medical conditions. Doesn’t include elective surgery.
A urine drug screen.
“related to their self-abuse”
People own themselves. There is no pursuit of happiness without freedom to choose.
This by necessity involves the freedom to choose wisely or choose poorly.
This isn’t the collective that forces serfs into involuntary servitude and conformity to what the government believes is best.
Life is imperfect, but free.
Best.
ummmmmmm... ive holstered my clint eastwood 44s some time ago but ya just got me to un-snap em again... with all the lifestyles out there, why are you now ganging up on the smoker?? are you sure there’s not some personal feeling shinning thru here?
Allow me to share a True story with you...
One day I’m walking down a city street with my wife on my arm, and smoking a cig... we approached a crossing. As we wait for the light to change, a heavy set woman and her obedient husband approach. and she immediately commented... “oh that cigarette stinks...” I looked at my wife and she knew lol what was coming... I took a long drag and blew it out and then looked that lady in the eye and said... “So does your ass but do you hear me bitchin about it??” Her husband busted out laughing!
Point being I grew up in a society that glamorized smoking... I use to walk into a living room as a child and there would be a smog layer above my head. Every movie star and tv program smoked. and now we’re the root of all evil in the world.
There are a few more important things to worry about that a few pennies out of your “Tax Dollars” going to “potential” risks after surgery.
To address your two points more directly:
1) Financially, smokers are paying more through excise taxes and more expensive insurance, on an individual basis, and draw fewer tax dollars by having shorter lifespans, on a population basis.
2) I would say the fundamental problem is the confusion of population vs individual. As a population, you can certainly say smokers have higher surgical risk. However, at the doctors office, it is the individual who is under consideration, not the population at large. Simply being a smoker is not sufficient because, believe it or not, not all smokers are in the same physical condition. The individual can be tested.
Per contracts, if smokers are going to be excluded from certain coverage then there is no reason to charge them more for the coverage they do get. They should be charged less.
Also per contracts, a fundamental problem is requiring people to have insurance. In a free market, insurance companies could discriminate on coverage and policy holders and the individual can decide whether or not to buy it.
For non smokers contracting with those same insurance companies, they could decide whether or not it is worth it for them to have a policy from a company that handles smokers a certain way.
Many of these people don't work and rely on the state for food stamps, etc.
And a doctor who says “I won’t operate on a Black person, an Oriental person.....” Not to say the Hippocratic oath, which is probably ignored in modern medical schools.
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