Originally Posted by
Mark Rippetoe
It's very good.
"if we take as a guiding principal that people must submit, even against their will, to health interventions they would not willingly choose in order to serve the common good and keep hospital availability high by not using up scarce resources so that others might have them at need, what other policies can we justify?
well, quite a few it would seem.
how about demanding that all obese people submit immediately to forced programs of exercise, dietary restriction, and even surgical intervention such as lap bands if they fail to lose enough weight to drop their risk to a societally determined acceptable level? 30-50% of health spending in the US can, one way or another, be traced back to obesity. imagine how much we could save and how much would be left for the rest of us if we took a “zero corpulence” policy to heart.
shall we declare ourselves out of patience with this epidemic of BMI and demand not just an accounting but action on what their refusal has cost us all? if not, why not?
after all, exercise and good diet have almost entirely positive side effects. what have they got to lose apart from 30 pounds and 3 comorbidities? shouldn’t the labor and health agencies force them to do what is right for themselves and all of us? the help against even covid would be profound. or is this simply a choice we have no right to force on people just because it might benefit us?
provoked yet? let’s get more provocative.
young male members of certain minority groups account for a vast share of gunshot wounds (and gunshot wound infliction) in this country. gun control has zero effect on this and seems to actually make it worse. (look at the top cities/neighborhoods for shooting deaths)
but we could almost certainly stop this with medical interventions using testosterone blockers or mood stabilizers like xanax or klonopin. do these groups owe it to us to take these drugs they do not want in order to stop clogging ER’s and surgical suites with needless wounds and inflicting such harm on others in society? we might make neighborhoods far safer and more livable as a knock on effect! or do we think maybe this is a grotesque violation of human rights and a form of presumptive punishment over what someone MIGHT or is merely statistically likely to do?
shall we deny medical care to people with diabetes who fail to take sufficient care of themselves to keep their A1C’s within safe ranges? if they will not put in the time to care for themselves, why should medicare and medicaid spend something on the order of 15-20% of their total outlays to manage the ill effects of the microvascular damage and other problems arising from poor glycemic management? if these people will not follow federal guidelines for care, why should federal funds be spent to pay for the costs of “their refusal” on all of us? or is maybe vilifying people for a medical condition and extorting them into compliance by dire threats and vicious moral opprobrium just plain evil?
i could go on and on here, but i suspect by now you get the point."