Smokers Denied Health Care to Make Them Healthier

WASHINGTON - Nov. 1, 2017 - PRLog -- A medical care entity has decided to extend its policy against smokers and the obese by banning access to routine or non-urgent surgery until they "improve their health" by passing a breath test to prove they've quit smoking, or lost a significant amount of weight.

        This ruling means that some 150,000 smokers will have to pass a test to show that they have quit, while another 270,000 will have to lose up to 15% of their body weight, in the county of Hertfordshire, if they need a certain non-urgent surgical procedure and cannot or will not pay for it themselves.  But this is nothing new, at least with regard to smoking, says pubic interest law professor John Banzhaf, noting a recent article in The Sacramento Bee reporting that "Doctors Are Refusing to Operate on Smokers - Here's Why The Trend Will Grow."

         He notes that the "trend" has been going on for many decades with regard to smoking, that it has been approved by ethics boards, and that it occurs even in countries where government health care is guaranteed.

        For example, doctors at Wythenshawe Hospital in Manchester, England, have refused to carry out heart by-pass surgery on smokers, except in emergencies, for some fifty years.

        Doctors at Leicester, Leeds and Newcastle upon Tyne follow the same policy, says Banzhaf, who founded our nation's first antismoking organization in 1967, and was successful in seeking to require smokers, in many ways, to bear some burdens of their own decisions.

         For example, in addition to championing higher taxes on cigarettes and banning smoking in public places, he obtained legal permission for health insurance companies to charge smokers more for health insurance, as they long have for life insurance.  More recently, he helped have this principle incorporated under Obamacare, which now includes a 50% surcharge on rates for smokers.

        He notes that when reports surfaced that a surgeon in Northern Ontario was refusing to operate on smokers, Ontario's medical watchdog, the College of Physicians and Surgeons, ruled that he and other doctors within the Canadian province were within their rights.

        The Ontario Medical Association also backed his decision.

        The rationale for refusing to operate on smokers was spelled out in an article in MEDICAL WORLD TODAY in a 2007 report about the Leicester City Primary Care Trust's new policy, which it said is "expected to spread quickly throughout the country."

        Here's what that medical publication reported ten years ago:

    "Smokers will be denied surgery in order to slash health care costs and reduce recovery time and surgical complications, reports Action on Smoking and Health (ASH), a national antismoking organization which has long championed making smokers bear the consequences of their habit."

    "The new restrictions are set to begin this summer in the UK, initially under the Leicester City Primary Care Trust, but the requirements are expected to spread quickly throughout the country."

    "Under the rules, smokers are to be denied operations under the Health Service unless they give up cigarettes for at least four weeks beforehand, and doctors will require patients to take a blood test for nicotine residue to prove they have not been smoking."

    "Medical research shows that smokers take far longer, on the average, to recover from operations, and are far more likely to suffer serious medical complications. This not only greatly increases the cost of providing surgery to smokers, but also ties up beds and hospital facilities urgently needed by other patients."

    "Professor John Banzhaf, [then] Executive Director of ASH, notes that some physicians in the US have refused to perform operations on smokers, and that potential recipients may be denied life-saving organ transplants if they smoke, just like patients who abuse alcohol or use recreational drugs.

    "'Smoking not only causes many very serious and very expensive diseases, but also exacerbates many existing medical problems and complicates recovery from virtually all operations.

    "Generally, since most health insurance companies charge smokers the same rates and provide them with the same benefits, these added costs and delays in providing services to others are absorbed by the great majority of patients who are nonsmokers. This is manifestly unfair."

    "One remedy is to charge smokers more for their health insurance, a policy the federal government recently recommended and approved. Another is to deny smokers certain services, especially if their smoking is likely to impair their outcome."

        Turning smokers down for surgery is not uncommon in the U.S., notes the Sacramental Bee, in reporting on a man denied spinal fusion surgery because he was a smoker who did not quit.

        It explained that "in Charlotte, some surgeons who perform spine surgery and knee and hip replacements have begun using a 'value-based' system that means accepting a single 'bundled payment' for each patient encounter. . . .  So, operating on smokers, with potentially expensive complications, could hurt the bottom line for physicians."

        Thus, as surgeons move voluntarily or involuntarily towards a system where they have to bear at least some of the risks of complications arising from surgery, and evidence mounts that smoking greatly exacerbates such complications, this long established trend may accelerate even more, predicts Banzhaf.

        It has been estimated that smoking costs the American economy some 322 billion dollars a year - several times the total cost of Obamacare - much of which is paid by the great majority of taxpayers who are not smokers, in the form of higher taxes as well as inflated medical premiums.


http://banzhaf.net/  jbanzhaf3ATgmail.com  @profbanzhaf