Friday, November 25, 2005


They pay for their health insurance but getting what they paid for is a problem when the government is the insurer

A patient's group has criticised the NHS in East Suffolk for ruling that obese people will not be entitled to hip and knee replacement surgery. A spokeswoman for the Patients Association said: "People are obese for all sorts of reasons. Unless there is a clinical reason for not carrying out surgery they should be entitled to have an operation as anyone else would be."

The spokeswoman's comments come after it emerged that obese people will not be entitled to hip and knee replacement surgery on the NHS in East Suffolk under new cost-saving measures taken by the three primary care trusts in the area. The advice is based upon a person's body mass index (BMI) which calculates a person's body fat percentage using a height versus weight calculation. A person of average weight would have a BMI between 18.5 and 24.9, while an obese person would be classed as 30 or above.

Under the new guidelines, the surgery will not be performed unless: "The patient has a BMI below 30 and conservative means have failed to alleviate the patient's pain and disability. "Pain and disability should be sufficiently significant to interfere with the patient's daily life and/or ability to sleep."

Hospital consultants and GPs in East Suffolk came up with a list of 10 conditions for which there must be a threshold in order for surgery to be performed. Dr Brian Keeble, director of public health for Ipswich PCT, said: "Our work on clinical thresholds has been a key part of this process. "We started from the idea that operating on some conditions, either at an early stage or before other treatments have been tried, could actually be detrimental to the patient because of the risk of side effects from the procedure. "We cannot pretend that this work wasn't stimulated by the pressing financial problems of the NHS in East Suffolk. But I believe that these thresholds will produce some clear benefits in that both patients and their GPs will know when these procedures will be performed."



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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