Lying To Doctors

July 27, 2003 10:56 AM

When Is It OK To Lie To Your Doctor?Legislation to deny first class medical assistance to those who persist with an unhealthy lifestyle is now being seriously discussed in the UK. Can lie detectors be far behind? Will smokers, heavy drinkers and couch potatoes now have to add the art of lying through their teeth - as if their lives depended on it, which they may soon do, to their solitary, sedentary and increasingly melancholy skills? More importantly, will doctors be able to help them, if the information they get from their patients is all wrong?
posted by MiguelCardoso (46 comments total)

If all the negative energy levelled at smokers was collected up and focused on corporate criminals and social injustice we might actually get somewhere.

As for smokers taking up healthcare dollars, what happens if they weren't smokers/ well, they'l ldie of something else, slightly later perhaps, and may very well spend time in the hospital for that.

Do societies just plain need to hate a certain group so much that they'll create one if that's what it comes to?

/a rather bewildered non-smoker.
posted by Space Coyote at 11:03 AM on July 27, 2003

When Is It OK To Lie To Your Doctor?

i'm not sure, but i know when you hear the snap of that rubber glove, it's already too late.
posted by quonsar at 11:37 AM on July 27, 2003

cf. GATTACA
posted by jplummer at 11:41 AM on July 27, 2003

...smokers, heavy drinkers and couch potatoes...
...solitary, sedentary and increasingly melancholy...

Just a thought but, barring insurmountable medical problems that prevent physical activity, a sensible lifestyle of exercise and moderation is a sensible solution.

A person on a regular fitness routine who is a moderate smoker/drinker should not be discriminated against, especially if s/he has proof of fitness (such as healthy blood-pressure and a low heart-rate.)

I know it's rough getting off that couch, but it's well worth it in the end. Exercise increases endorphins as well, alleviating even the silly "melancholy" bit mentioned above.
posted by Shane at 11:47 AM on July 27, 2003

Legislation to deny first class medical assistance to those who persist with an unhealthy lifestyle is now being seriously discussed in the UK.

This story doesn't matter then, 'first class medical assistance' doesn't exist in the UK anyway. Of course, if you want to continue being left on a bed in a windy hospital corridor while you die with the rest of the lumpenproletariat, it seems you will still be in luck.
posted by wackybrit at 11:54 AM on July 27, 2003

If we are talking strictly health dollars, doesn't someone that lives until their 90s cost more than someone that drops dead of a massive coronary in their 50s? Those extra 40 years of checkups and medicine have to add up somewhere... (j/k)
posted by stifford at 12:01 PM on July 27, 2003

I hate people who diagnose problems as treatable with "exercise." Who are absolutely, positively certain that if everybody would just run some more laps then they would all be fit and fine. That exercise *can* be done by everyone and everyone will profit by it. And that people are sub-human unless they are "physically fit".
And "hate" is the right word, for they have tormented me and who knows how many others with their religion.
The US military pitches soldiers out who are highly skilled, even brilliant, because they don't look good in a uniform, or can't run two miles in good time, or are "insubordinate" for not losing weight on a half-stick of celery a day.
AND IT'S ALL JUST A DAMN FAD.

I see "trim" Americans as either psychologically disturbed enough to masochistically abuse themselves, or with livers so inefficient that they don't digest most of their food, or with hormonal disfunctions. I do NOT see them as inherently healthy. Or necessarily smart, or hard working, or creative, or attractive, or caring.

And, for all you smoke haters out there: statistics say that 1 out of 4 smokers will develop cardiopulmonary problems related to smoking. 3 IN 4 WILL NOT! So, if we discover what makes that 1 in 4 susceptible, and are able to cure it, will it be okay for everybody to smoke, with reasonable public politeness?

If not, JUST BECAUSE WHAT SOMEONE ELSE IS DOING IS PISSING YOU OFF, it is not THEY who have a problem.
posted by kablam at 12:07 PM on July 27, 2003

You could argue that the amount of tax paid by heavy smokers and drinkers means they should get better treatment under the NHS, not worse.
posted by squealy at 12:10 PM on July 27, 2003

I'd say limiting treatment to those who wilfully cause themselves harm is reasonable.

I ridiculously persist in smoking twenty Benson & Hedges a day after five nasty collapsed lungs and a (presumably costly) procedure to prevent them collapsing again. If they do collapse again, I'll be wasting NHS resources thanks to my own stupidity. As such, I don't quite deserve the same treatment as someone in the same position who has stopped smoking.

Of course, the problems come when you try to judge who is to be denied treatment and who is to be 'rewarded' with the right to healthcare. Still, better to negotiate that grey area when apportioning resources than adopt the private model, where class is the key factor in deciding the quality of treatment.

As for George Best, the old 'Where did it all go wrong?' anecdote still applies. He is, literally, a waster.

On preview, in the direction of sqeally: The taxes on cigarettes and alcohol are punitive, intended to force people away from fags and booze, but also compensatory, in that without that revenue the non-smoking/drinking taxpayer would be subsidising the treatment of their deliberately unhealthy peers... er, that's casting aside the fact that such taxes are effectively a levy on the poor, who are more likely to be drinking/smoking/drugging their way into hospital for obvious reasons, but you know what I mean...
posted by jack_mo at 12:31 PM on July 27, 2003

Oop, could I have misspelt squealy more?
posted by jack_mo at 12:35 PM on July 27, 2003

Disagreeing with me and spelling my name wrong jack_mo? It's lucky for you I'm a lover not a fighter. ;-)
posted by squealy at 12:42 PM on July 27, 2003

It would save much more money to deny health care to the sick. Any set of statistics will show that they consume by far the lion's share of your health-care dollar (or pound, as it were). Here in the US, our free-market capitalist health care system has already realized and incorporated this fact, and our highly efficient medical system is founded on the principle that the well should pay through the nose for the health care they will promptly be denied when they become ill.

Here in the US, we've already realized that health care is all about saving money (or making money, if you're in the insurance business). It sounds like the UK is finally coming around to that fact as well.
posted by rusty at 12:43 PM on July 27, 2003

kablam: don't hate me because I'm beautiful.
posted by Ptrin at 12:44 PM on July 27, 2003

heh. kablam is fat.
posted by quonsar at 12:45 PM on July 27, 2003

All the medical doctors I've known socially were heavy drinkers and smokers. All the ones I've known as a patient have come across as puritans. I wish doctors would stop trying to come across as infallible to their patients and would just admit that, having been to medical school, they are the biggest party animals in society.
posted by jamespake at 12:56 PM on July 27, 2003

It sounds like the UK is finally coming around to that fact as well.

Yep, looks like it. And under a Labour government. Which makes you sick. Ironytastic.

...they are the biggest party animals in society

Well, fair dos. I'd be off me face all the time if I spent my days mucking about in someone's guts.
posted by jack_mo at 12:59 PM on July 27, 2003

Holy Fire
posted by Snyder at 1:03 PM on July 27, 2003

Kablam, you sound like you need to relax, you could be suffering from hypertension. You should run a couple of laps, it'll make you feel better.
posted by monju_bosatsu at 1:05 PM on July 27, 2003

Um rusty, when you say the US has a "highly efficient medical system" you're joking right? Like it's so well known the US spends far more per capita on health care than any other country in the world but Americans have generally unimpressive life expectancies.
posted by bobo123 at 1:23 PM on July 27, 2003

bobo, I think you've missed the sarcasm tag.
posted by monju_bosatsu at 1:45 PM on July 27, 2003

Jack_mo: wilfully cause themselves harm is reasonable
Can't we also use that to deny first-rate treatment to people who deliberately participate in dangerous activities? For example, if a chap playing rugby one fine Sunday should break his leg, isn't it his own fault for indulging in a dangerous pastime? What about Potholers? Divers? Parachutists?

Oh, yes. Let's make it compulsory for anyone who knowingly indulges in a dangerous activity to have private medical insurance. Yes, indeed, that ought to reduce the drain on the NHS :)
posted by kaemaril at 1:47 PM on July 27, 2003

Ah sarcasm, that's a relief.
posted by bobo123 at 1:52 PM on July 27, 2003

For those living in the US: do not get any medical insurance. When ill, go to emergency ward. Tell them you can not afford help. They will treat you (they are requried to) and your bill will be absorbed by those in regular wards and having insurance...same thing with car insurance. Get it for registration. Drop it. Accident? the other guy, conscientious, has paid extra to cover his butt for the uninsured guy like you.
Another tactic: pray.
posted by Postroad at 2:12 PM on July 27, 2003

Unless you enjoy paying lawyer's fees and having your credit rating destroyed, you should not take postroad's advice.
posted by monju_bosatsu at 2:15 PM on July 27, 2003

'first class medical assistance' doesn't exist in the UK anyway.

yawn. It's only a matter of time before you start slagging off your own teeth, wackybrit.
posted by riviera at 2:29 PM on July 27, 2003

People are generally stupid and busy. Would it help the economy to leave them in a foul, less productive state of "disrepair". People will always be weak and stupid, they will do things you hate and things you wish you didn't have to pay for. I don't think it's really fair to leave them in that much pain. We have the resources available in the world to end a lot of unpleasantness. We might as well use it.
posted by abez at 2:56 PM on July 27, 2003

kablam - I see "trim" Americans as either psychologically disturbed enough to masochistically abuse themselves, or with livers so inefficient that they don't digest most of their food, or with hormonal disfunctions.

I had no idea you harbored such resentment toward our President...

P.S.
Welcome back, Miguel.
posted by NortonDC at 4:08 PM on July 27, 2003

make it compulsory for anyone who knowingly indulges in a dangerous activity to have private medical insurance

Starting at those who recklessly inhale the air in congested cities while eating crisps. ; )

That said, potholers are so totally asking for it.
posted by jack_mo at 4:11 PM on July 27, 2003

Can't we also use that to deny first-rate treatment to people who deliberately participate in dangerous activities? For example, if a chap playing rugby one fine Sunday should break his leg, isn't it his own fault for indulging in a dangerous pastime?

There's a push to do just that in the US. Insurance companies will not have to cover injuries sustained doing known dangerous sports like skiing, climbing, horseback riding etc. Presumably repetitive stress injuries however WILL still be covered. So runners and cyclists are OK. Morons.
posted by maggie at 4:16 PM on July 27, 2003

Well, from a different tack, rusty had a point about not treating the sick. A while back, I remember some commentator stating that "70% of health care dollars are spent on people in the last four years of their lives."
Unfortunately, that statement can mean a lot of things, everything from emergent critical patients (barely alive from a gunshot wound), to some old guy living off machines for four years, and some baby so premature that nothing will save it. All very expensive and futile treatments.
But what it implies is the same thing: they're all gonna die in four years, give or take. So, how does that affect public policy, and should it? Would it save boucoup dollars if emergency doctors just stopped trying so hard; or if the government manages to persuade people that living in a bed, hooked to machines, sucks, so they should opt for being euthanized? Or, I'm sorry about your baby, but a million dollars spent wouldn't have saved it.

And governments all over the world are thinking these same things.
posted by kablam at 4:41 PM on July 27, 2003

kablam:So, if we discover what makes that 1 in 4 susceptible, and are able to cure it, will it be okay for everybody to smoke, with reasonable public politeness?

The result of working out what makes the 1 in 4 susceptible will be to stop people saying "you're killing yourself". However, I will probably still hate people smoking in restaurants just because I don't like the smoke in the air and my nose etc. Different issue, I know.
posted by suleikacasilda at 5:30 PM on July 27, 2003

Back to the point of the thread..

No matter what kind of "unhealthy lifestyle" I have, remember that I have already paid for this treatment in my taxes. Under what circumstances is is acceptable to deny me necessary treatment for which I have already paid? Is someone going to refund me my money?
posted by suleikacasilda at 5:48 PM on July 27, 2003

It implies no such thing, Kablam (not calling you out. I realize you were just stating the position, not advocating it), because medicine is, like all sciences, improving every year with new discoveries and treatments. The most money is always spent on the few who are close to death, but by treating them we learn, and in later years people with those same ailments can be treated effectively. There will always be new ailments, and healthcare money will always go largely to those people on the edges of our ability to help. But the result is, over time, longer lifespans, healthier lives, and better medicine. That 70% of healthcare dollars is well spent.

So what it implies is that people currently in treatment for things at the edge of our abilities will likely die, and expensively, but their children, and all the generations that follow, may well be spared.
posted by Nothing at 6:31 PM on July 27, 2003

People, this is why communism doesn't work.

Unless everyone is the same shade of grey socialist services will always either be pulled towards the elite, or to the downtrodden.

Fix it. Make those who abuse pay. In fact, make everyone pay for what they use.

Myself, I'm a fatass (working on that), and I've only used a hospital four times in my life -- and two of those times were before I could speak full sentences.
posted by shepd at 6:48 PM on July 27, 2003

Why is it people always fall back on libertarianism to defend their own bad habits?
posted by monju_bosatsu at 7:58 PM on July 27, 2003

Why is it people always fall back on libertarianism to defend their own bad habits?

I don't smoke and I'm not fat, but I think both should be permitted, and that those who indulge should be able to get health care.

And it's pretty clear that socialized medicine makes this difficult, because their costs are imposed on others as an externality under "single payer".
posted by maciej at 10:43 PM on July 27, 2003

Well theoretically, as I understand it, one's National Insurance contributions (paid in part by employee and part by employer) are meant to pay for the NHS. However, as jack_mo so ably pointed out earlier, the astronomical levels of taxation on tobacco and alcohol are at least partly designed to compensate the "extra" costs to the health service. Why if we already pay these taxes to fund the NHS should we be expected to pay for our treatment either through private insurance or through charging at source?
posted by squealy at 1:40 AM on July 28, 2003

'first class medical assistance' doesn't exist in the UK anyway. Of course, if you want to continue being left on a bed in a windy hospital corridor while you die with the rest of the lumpenproletariat, it seems you will still be in luck.

Absolute bullshit. This bears so little resemblance to my own, numerous recent experiences of the NHS that it's laughable. Perhaps if the only thing that you've had wrong with you is ingrowing toenails, then your experience might be different. On the other hand, I think the diagnosis might just be an ideologically-driven jerking of the knee.
posted by bifter at 1:50 AM on July 28, 2003

I see "trim" Americans as either psychologically disturbed enough to masochistically abuse themselves, or with livers so inefficient that they don't digest most of their food, or with hormonal disfunctions. I do NOT see them as inherently healthy. Or necessarily smart, or hard working, or creative, or attractive, or caring.

Shutup cartman.
posted by delmoi at 8:36 AM on July 28, 2003

If you want to save on healthcare costs, just have sex with people from other races. You're kids will have better genes that way. You'll still be fucked, but meh.
posted by delmoi at 8:43 AM on July 28, 2003

If you want to save on healthcare costs, just have sex with people from other races. You're kids will have better genes that way

That's not necessarily true. If I, a pasty Anglo, have kids by a subsaharan African, those kids will have lower odds of skin cancer and higher odds of sickle-cell. If I have kids by an Ashkenazi, the kids will have higher odds of Tay-Sachs. If I have kids by people from a wide variety of ethnic groups, they'll have higher odds of being lactose-intolerant.

If what you assert were true, disease would be unknown in Brazil.
posted by ROU_Xenophobe at 9:25 AM on July 28, 2003

Absolute bullshit. This bears so little resemblance to my own, numerous recent experiences of the NHS that it's laughable. Perhaps if the only thing that you've had wrong with you is ingrowing toenails, then your experience might be different.

So your 'recent experiences' totally invalidate mine? I hope you enjoy living inside the M25, townie.
posted by wackybrit at 10:34 AM on July 28, 2003

I think it's probably likely that neither of your "recent experiences" encompass the spectrum of standards of treatment within the NHS. Or is that too reasonable a point to make? FWIW, which is very little, my experience over the last five years of treatment at the hands of the NHS has been overwhelmingly positive. But then I live within three miles of Britain's largest teaching hospital.

Yokel. ;-)
posted by squealy at 12:17 PM on July 28, 2003

So your 'recent experiences' totally invalidate mine

Well now, that wasn't what you said was it? At all...

'first class medical assistance' doesn't exist in the UK anyway

I've had bad experiences in Lincolnshire pubs, doesn't mean that I think it's impossible to get a decent pint in the UK.

Fairly pointless talking to you about it, as it doesn't support "public spending is intrinsically bad" dogma, but the NHS recently saved my father's life, and my mother and father-in-law are in remission from life-threatening cancer. All three have had fast, effective, caring and efficient service from the NHS. (Oh, and all are *well* outside the M25, thanks).
posted by bifter at 5:09 AM on July 29, 2003

Bifter, the NHS service is very patchy across the country. Also, you're profile says that you live in 'London, UK' so you should understand why Wackybrit called you a 'townie'.
posted by jamespake at 12:09 PM on July 29, 2003

Sure, it's patchy - what isn't? I just don't think it's particularly constructive to run down the NHS in the way in which it usuallly is by people who - in my experience - are more concerned about regulating tax burdens than standards of service. Not only is it disingenuous and demoralising to the people that work in health-care, but in most cases it is wrong.

I know at least as many people that have had bad experiences with private dentists, as have had bad experiences with the NHS. And as I (and squealy - who lives well outside London) has said, there are many, many very positive experiences of the NHS.

As for the townie thing... huh? I've been called many worse things in my time. I was just pointing out that claiming that the service becomes miraculously awful once you leave the glittering metropolis is - like the rest of wackybrit's comments - unsubstantiated bollocks.
posted by bifter at 1:43 AM on July 30, 2003