Should the NHS look at potential savings v costs by the case....

[R1Geezer]

The NHS tends to have a "rules are the rules" type attitude to costs. Do you think they should have a system for judging each case on some sort of NHS equivalent of ROI calculation? Eg take this case:
http://news.sky.com/s...Weight-Loss_Operation
The gastric bypass would pay for itself in 3 years and probably save a future fortune, but no, the rules say BMI must be 45 to consider the surgery, hence this costs a lot more in the long run. This is not an obesity discussion, ok!

[Sqad]

R1...;-)...thanks.

[kinell]

blimey karen...

a bit harsh...

sadly for you no cure for being ginger though

[AB Editor]

"In this case if they do the op the NHS is in front within 3 years regardless, even if he dies on the table."

Cracking! No downsides there then! Very good Geezer.

Sqad, does weight loss reduce the need for diabetes treatment in type 1 or 2? Is his assumption correct that losing weight will he not cost the NHS in the long run?

///Gastric Band surgery is a method of attaining weight reduction.......celebrities have used this....but our man is no celebrity, he is just Joe Ordinary///

I'm sure if he was willing & able to pay for it to be done privately, he would be able to have it done in the same way as any "sleb"

[ummmm]

Naughty kinell...!!

Tonyv...yes I am sure. He needs nursing care, not assistance.

I still think it's sickening that someone would purposely abuse their body so they get an op to do the opposite...

[AB Editor]

Oh also Sqad:

///The misconception held by the majority is that if you release more calories than you take in....then you will lose weight...........this is not always the case///

Can you expand on this a bit for us please? It is certainly how I have always understood weight-loss and how I have always controlled weight (i.e. exercise & diet).

[R1Geezer]

well that's rub ED, if you've got the dosh you can have anything you like done. These cases come up because they can't or won't pay. This guys seems a bit of a waster if you ask me, he could probably pay to go private if he really wanted too. I'm not trying to make out he's a deserving case, just serves as a good example in the OP.

[Sqad]

AB

<<<<"In this case if they do the op the NHS is in front within 3 years regardless, even if he dies on the table.<<<

Seems reasonable either way..............certainly financially beneficial.


<<<Sqad, does weight loss reduce the need for diabetes treatment in type 1 or 2? Is his assumption correct that losing weight will he not cost the NHS in the long run? <<

He has gone past the point of no return concerning the effect on his diabetes, but it might suspend the onset of complications.......diabetic neuropathy, peripheral vacscular disease and diabetic retinopathy.

My point about about celebs, was to establish that gastric band surgery was a beneficial aid to everyone......not just "celebs"

[Sqad]

AB Just seen your 2nd post.

The vast majority of people will lose weight by reducing their calorific intake, but there is a well documented group, that despite, taking in less than they use use..........still do not lose weight.....psychosomatic? hormonal?.....I am not an expert.

ummmm

<<<<I still think it's sickening that someone would purposely abuse their body so they get an op to do the opposite...<<<<

I bet he would agree with you.

[ummmm]

Well he should put his energy into losing weight...not gaining weight. But stuffing your cake hole is the easier option...

[Sqad]

ummmm

<<<<<Well he should put his energy into losing weight...not gaining weight.<<<<

He has been probably trying to do just that throughout his life.........and failed.

[woofgang]

NHS organisations do have facilities to consider cases and take individual decisions. I have been involved in advising such a panel on rehab issues and the fact is that when you look into it, my experience is that very few cases are exceptional.
I question the "pay for itself on 3 years thing". The gastric bypass would only pay for itself in 3 years if the gentleman in question loses the weight and this stabilises his diabetes and he has no residual damage. I'd also like to see the basis of calculation for that rather glib statement.
I am not fattist, being fat myself. I do think that there might be something in requiring folk who play risk sports regularly, including contact sports, to buy insurance to cover injuries resulting from those sports.

[ummmm]

Sqad - there was a programme on the other week (was talked about in CB)

An overweight woman was told that at the end of the day she was to write down everything she had eaten that day. Her list amounted to app 1000 cals.

They filmed her the whole day...what she had actually consumed was over 3000 cals.

People are deluded....

[Sqad]

ummmm...that is one explanation, but it is not the whole picture.

[ummmm]

But in most cases it is. So many overweight people say the have an under active thyroid...or slow metabolism...when the reality is they eat too much.

[starone]

This is just the opinion of a yo-yo dieter. Giving up eating can be compared to giving up smoking or drinking alcohol. You can just as well be a compulsive eater as a compulsive smoker or drinker and it is just as difficult. I know from experience that when you are dieting all you can think about is food and when is the next mealtime. It is very difficult, although I know by looking at others it can be done. All a matter of willpower as in all addictions. At the moment I am yet again attempting to lose weight.

[Sqad]

starbuck.....excellent point ;-)

[Ankou]

reading some of the other articles, he just seems like a bloke who can't be arsed to lose weight and get healthier.

perhaps he should take out a loan to pay for the operation then pay it back on all the saving made from not eating a loaf of bread a day and several bacon sandwiches.

[ummmm]

That's the impression I get as well Ankou.

[starone]

Thanks sqad. Thankfully I am not in the same category as this man as I only have a couple of stone to lose (and this time I am definitely going to do it). It does help to find something else to do, like taking part in threads on Answerbank. When I am in this room away from food it is not so bad. One thing I wonder about with regard to the amount of food he is obviously eating is how does he afford it? Where does he get his money from? Is he getting himself into debt to feed his addiction?

[Ankou]

but getting back to the op, i'm not sure roi would work. wouldn't it be atodds with the hypocratic oath? some people may be subject to life saving operations which means that they then go on to need lifelong care/specialist nursing.

given that such long term care could probably eventually outweigh the cost of the original operation, would it have been cheaper to not save the life? or are we just talking about self harm type scenarios (smoking, alcohol, obesity, physical self harming etc). in this situation you would be at the wrath of mental health issues and we would be back to square one.