|Prevention, not pills, a big part of the cure||Oct. 15, 2003|
|Provided by: Sun Media|
|How long should we be our brother's keeper? A report in the British newspaper, The Guardian, claims that being a Samaritan is coming to an end in England. Smokers and overweight people will soon be asked to sign contracts with their doctors. They will have to agree to a program to quit smoking and lose weight under a radical medical plan drawn up by the Labour government.
Health secretary Alan Milburn says it's an attempt to remind people of their personal responsibilities. The document will not deny medical care to those who refuse to sign the agreement, but the government wants to make it clear that smokers and overweight people must play a role in caring for themselves by stopping smoking, losing weight, eating a more nutritious diet and exercising.
The real message? Resources are finite, and if misused, the shortage denies treatment to others.
One can't blame smokers and obese people for feeling discriminated against. After all, what about those who have too many martinis and need medical care? Or reckless drivers who require months of treatment after accidents? The list of self-inflicted ailments is extensive.
However, the British Labour party believes that since smoking and obesity are such major killers they make a good start.
I recall the hue and cry when a Canadian heart surgeon used the same tack. He refused to do bypass surgery unless his patients stopped smoking. His argument? Why should he subject himself to the stress of this operation if the patient didn't give a tinker's damn about his or her own health.
I've often had the same reaction when operating on hugely overweight patients whose obesity was not due to genetic reasons. I've wondered if charging by the pound would be incentive for them to lose weight and also lessen their chance of operative complications.
It's ironic that we place so much scare-mongering on some health issues. Not to downgrade the impact of SARS and the sorrow of families who lost loved ones, but this infection caused a minor blip compared to the millions killed prematurely by smoking.
The World Health Organization reports that worldwide there will be 10 million annual deaths from smoking by 2020. Fifty percent of these deaths will occur in middle age, robbing people of 22 years of life! Now that's an epidemic!
Consider the public condemnation of physical child abuse. This is valid, of course. At the same time though, we allow pregnant mothers to smoke -- a legalized form of child abuse. And what about pregnant women who consume excessive amounts of alcohol and cocaine and end up with brain-damaged children at a huge cost to the child and society?
Unfortunately, there's a tendency these days to blame our woes on others. Tobacco smokers crippled by emphysema and other problems demand compensation from tobacco companies. Drunken drivers blame others for serving them too many drinks. Obese patients want to sue fast-food chains.
I think the British government is right to bring "consumer responsibility" to the public attention. Why not, when so much of today's chronic disease is preventable?
The lack of self-responsibility is one reason why our health-care system is on crutches today. This along with the fact that many people run to doctors for every ache and pain. I've claimed for years that every patient who receives medical treatment should also receive an annual statement listing their cost to the health care system. It would shock most people to see the dollar amount.
Ontario alone spends $100 million, year after year, just to treat the common cold. Millions more for sore backs that would get better with simple tincture of time.
Sir William Osler was only slightly facetious when he prescribed his treatment for a cold. "Go to bed. Hang your hat on the bedpost. Start drinking scotch and stop when you see two hats!"
Pogo would also agree with the Labour party's plea for individual responsibility. As he wisely remarked so long ago, "We have identified the enemy and the enemy is us!"
|MORE COLUMNS BY|