Is Health Insurance Dedicated to Promoting Health?

True Discernment links to a Daily Telegraph debate about British medical care:

Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.

Have your say: Should lifestyle play a role in deciding who gets NHS treatment?
Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.

Fertility treatment and "social" abortions are also on the list of procedures that many doctors say should not be funded by the state.

The findings of a survey conducted by Doctor magazine sparked a fierce row last night, with the British Medical Association and campaign groups describing the recommendations from family and hospital doctors as "out­rageous" and "disgraceful".

About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.

Managers defend the policies because of the higher risk of complications on the operating table for unfit patients. But critics believe that patients are being denied care simply to save money.

And lest you claim that this is a socialized medicine issue, John Edwards would be the first to remind you that denial of health care occurs in our privatized system also. Edwards' (suspended) campaign blog links to this story (which, if I recall correctly, Edwards mentioned after the Iowa primary):

An insurance company that initially refused to pay for a liver transplant for a 17-year-old Northridge girl who died in a hospital should face criminal charges and pay civil damages....

Cigna HealthCare "literally, maliciously killed" Nataline Sarkisyan, attorney Mark Geragos told reporters in downtown Los Angeles....

Geragos said Cigna twice took Sarkisyan off the liver transplant list and purposely waited until she was near death to approve the transplant because the company didn't want to pay for her after-care....

In a statement issued yesterday after it had approved the transplant, the company said the procedure "was outside the scope of the plan's coverage." "... and despite the lack of medical evidence regarding the effectiveness of such treatment, Cigna HealthCare has decided to make an exception in this rare and unusual case, and we will provide coverage should she proceed with the requested liver transplant. Our thoughts and prayers are with Nataline and her family at this time."

Actually, this raises a scary thought in me. Could Mark Geragos run for President? But I digress.

Perhaps Christians and others who believe in "quality of life" issues will be moved to state that doctors should abide by the Hippocratic Oath, instead of denying claims for the old and infirm. But before you start preaching the Hippocratic Oath from the pulpit, you may want to read it. Christians, feminists, abortion advocates, and anti-child abuse advocates in particular may have severe problems with it.

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

So we're supposed to swear to Satan, to ensure the continuance of male-centric domination, to refrain from abortions, and to keep all secrets, including those from dying child molesters. Watch out what you swear about, or to whom you're swearing.

Needless to say, Louis Lasagna updated the Hippocratic Oath in 1964. We're not swearing to the Greek gods any more, and some other changes were made also.

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

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