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Originally Posted by 2000cs
Ok, if that’s your stance, how do you feel about treatment for the following:
Smokers (cancer, emphysema, COPD, etc)
Obese (Diabetes)
Snowboarders and skateboarders (fractures)
Swimmers (near-drowning, shark bites)
Drivers (auto accidents, with and without seatbelts).
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I doubt we will se the day when anybody is going to tell a doctor (or an EMT) to step away from a patient. But we already limit who gets into the ED, and who pays for that care in many ways. Society clearly has a stake in limiting activities that cause harm to others, and will regulate accordingly (and sometimes for less altruistic reasons). Also lots of areas where society refuses to share the cost of the risk and puts it back onto the individual (but far less of this than I would like).
So:
1- we restrict smokers from doing it in public where it gives others health issues; insurance companies will (when permitted) charge you a lot more to cover the increased risk; and the only reason it is still legal is that it is supported by an industry with MAJOR lobbying power.
2- diabetes/obesity does not harm others, but there are a lot of rules prohibiting diabetics from taking jobs where the effects of their diabetes on performance could (e.g. commercial driving, pilots). And many insurance companies don't pay much for the supplies, so it is a very expensive 'tax' on obesity.
3- helmet laws (increasing across the states) are based upon the relative costs/damages of injuries vs. prevention; lots of cities ban these activities wherever they can for the same reason.
4 - ask somebody with a pool what they pay for homeowner liability (and shark bites? seriously? there's also lightning strikes while golfing to worry about if you like a long shot). Many localities won't permit swimming when no lifeguard is on duty.
5 - driving.... now there's an unregulated free for all, eh? And do you have any idea what getting cut out of your car and life-flighted to the hospital will cost? and how much of that your insurance will pay vs. shunting the cost onto whoever was found to be at fault?
Quote:
Originally Posted by 6oclockshadow
ER and ICU are designed to operate near capacity. There is a shortage of HC workers, not beds. There are no ICU's currently in the US that have to refuse patients.......
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First and final points are quite incorrect - both ED and ICU are ideally run with substantial flex capacity to accommodate unexpected events (same with fire and police). Business managers would love them to run at capacity, and are always pushing to this numerical ideal, which has participated in the ongoing crisis.
The statement that no ICU has had to refuse a patient is absurd - isn't this story about a guy who couldn't get the ECMO services he needed? This happened even before COVID, but usually they just transfer the patient to another open unit nearby. I've lost one patient to a situation where they were unable to travel, and the in-town hospitals were full (well before covid).
True that in medical terms "bed shortage" usually does not mean they don't have the furniture, but last year's vent shortage shows that it isn't JUST staffing. The ultimate effects upon the healthcare system are the underplayed crisis in this, perhaps worse than the direct effects of the infection (as noted, many weather it unscathed). I see little direct reporting about just how hard hospitals are getting hit, and from every side - financially underwater, losing staff to covid deaths, workers leaving b/c afraid of getting it, and antivax walkoffs; all while operating in the kind of legal 'gray area' that has them afraid of tons of expensive lawsuits. I think that we are very close to some form of either economic cost-sharing (making unvaxxed people pay out of pocket for those loooong ICU stays) or flat out restrictions (hospitals refusing to admit unvaxxed). Anything else and the entire system is going to collapse, and America is not going to be willing to lose its entire healthcare system. Also in the background is that a lot of healthcare is run by businessmen, and they are already searching out options to get while the getting is good; If we aren't careful we will see a slew of bankruptcy/closeouts that will leave us holding the bag while these companies fold up their tent and move over into other industries.
I'm a big supporter of freedom over your body, so I'd oppose making people get a shot. But making those who don't stay home or away from others? That seems to make a lot of sense. Those who oppose 'passports' or other official verification seem, to me, to be wanting to have it both ways - keeping their autonomy, while also having the benefits of a society (which requires compromise to work). And, of course, taking some of the elitism out of this - why aren't air travelers being forced to be vaxxed, when bus drivers, teachers, and concertgoers are? Because they are in a higher tax bracket, overall (just my cynical guess, could have something to do with how the solar radiation kills the bug once you get to 20000 ft).