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Medicaid Plan Prods Patients Toward Health
The New York Times ^ | 12/1/06 | Erik Eckholm

Posted on 12/01/2006 8:40:32 PM PST by Eric Blair 2084

HAMLIN, W.Va. — No question, John Johnson is a doctor’s nightmare. “I guess I’ll have to sign it,” she said of the pilot agreement. Speaking from the easy chair where he spends his days in a small wooden house near this small Appalachian town, his left trouser leg folded by a safety pin where a limb was lost to diabetes, he lighted another cigarette. Mr. Johnson, 61 and a former garbage collector, takes insulin and goes to a clinic once a month for diabetes checkups. Taxpayers foot the bill through Medicaid, the federal-state health coverage program for the poor. But when doctors urged him to mind his diet, “I told them I eat what I want to eat and the hell with them.” “I’ve been smoking for 50 years — why should I stop now?” he added for good measure. “This is supposed to be a free world.” Ignoring doctors’ orders may now start exacting a new price among West Virginia’s Medicaid recipients. Under a reorganized schedule of aid, the state, hoping for savings over time, plans to reward “responsible” patients with significant extra benefits or — as critics describe it — punish those who do not join weight-loss or antismoking programs, or who miss too many appointments, by denying important services. The incentive effort, the first of its kind, received quick approval last summer from the Bush administration, which is encouraging states to experiment with “personal responsibility” as a chief principle of their Medicaid programs. Idaho and Kentucky are also planning reward programs, though more modest ones, for healthful behavior.

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: biggoverment; medical; nannystate
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I've said it 459 times. I'll say it another 439,321,009 times.

These onerous health initiatives like trans fat or smoking bans are nothing more than a Big Government sponsored behavior modification program.

It's nothing but liberal, progressive social engineering designed to hopefully reduce the need for medical care and save liberal medical entitlement programs like Medicare and Medicaid from sure bankruptcy. PERIOD.

FReepers are informed and they know. Anyone who can't see that is a retard.

1 posted on 12/01/2006 8:40:36 PM PST by Eric Blair 2084
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To: Eric Blair 2084

Well, if he has his hand out to the taxpayer to pay his medical bills, then the taxpayer has a right to ask him to eat right and stop smoking.


2 posted on 12/01/2006 9:17:55 PM PST by Panzerfaust
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To: Eric Blair 2084

Hello this guy is sponging off of the taxpayers. He's been smoking for 50 years. He's unrepentant and we're paying for it. As long as he is getting care on MY dime then he should have to sign a forest worth of papers and jump through a million hoops. Abolish Medicaid or at least ban illegals & people engaging in high-risk lifestyles from mooching off of it.


3 posted on 12/01/2006 9:24:48 PM PST by Extremely Extreme Extremist (Why can't Republicans stand up to Democrats like they do to terrorists?)
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To: Eric Blair 2084

I agree. Seems you are talking to the nannies on these topics. You know those do-gooders that complain they are paying the tab. The same tab they are sucking from for babysitting or some other tax break the government trouth offers. Last time I looked eating and smoking were legal and we were free to make choices. Course, mountain climbing, sailing, and all the other recreational activities that rescue is expected to be available for these same folks is something they deserve (at the taxpayer's expense).

WE all feed at the same trouth--just different menus.


4 posted on 12/01/2006 9:31:31 PM PST by Snoopers-868th
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To: Panzerfaust
Well, if he has his hand out to the taxpayer to pay his medical bills, then the taxpayer has a right to ask him to eat right and stop smoking.

Right after they ask all the HIV/AIDS patients whose medical bills are likely way more than this guys to quit engaging in high risk behavior?

5 posted on 12/01/2006 9:41:30 PM PST by sockmonkey (Die, Possums, Die)
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To: sockmonkey

Yup, I'd say the same thing to the losers who can't keep their johnsons in their pants


6 posted on 12/01/2006 9:50:04 PM PST by Panzerfaust
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To: Eric Blair 2084

“I told them I eat what I want to eat and the hell with them.”

** Well from the looks of it, I think it'll be too hell with him pretty soon. You can't reason with someone like that and I wouldn't have him as a patient personally. I also do not think tax money should be given to such a person either beyond the most basic of care. Let him die. He's wasting oxygen.


7 posted on 12/01/2006 9:53:30 PM PST by cyborg (No I don't miss the single life at all.)
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To: cyborg

My doctor offers a service--last time I checked he was no God. My plumber also offers a service and he has no business telling me how many times to bathe in a week. I don't expect my Dr to tell me how to live. His obligation is to provide diagnosis and health care to me for whatever my condition is regardless of my circumstances. It is not up to him to judge me nor is it up to the government. You sound like a dictator and I do not know any one who wants to be told how to live by a service. How do you treat your tubbies? Tell them they best lose weight or you will not treat them? How do you treat you homo AIDS patients? I would go to a vet before I went to a Dr. with your attitude.


8 posted on 12/01/2006 10:10:12 PM PST by Snoopers-868th
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To: Snoopers-868th

A doctor is for diagnosing and treating a patient. A patient who does not want to even follow the most basic advice is wasting the doctor's time and talent. What do you want a doctor to do for a patient who won't obey doctor's orders based upon diagnosis and keeps getting worse? Is a doctor supposed to keep treating someone who continually sabotages his/her own health? I say no. I'm not a doctor and if I was one, I wouldn't waste time with people who do not want to help themselves. You may not like my attitude but think about it. Someone who is in ill health losing limbs to diabetes and doesn't want to help themselves obviously wants to die. Why should a doctor have to keep treating someone who doesn't want to be treated?


9 posted on 12/01/2006 10:16:20 PM PST by cyborg (No I don't miss the single life at all.)
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To: cyborg
And someday all the non-smoking, calorie consience people will have a health issue,and wonder why. And you will treat them...how??
10 posted on 12/01/2006 10:23:50 PM PST by berdie
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To: berdie

I'm NOT talking about people who are sick through no fault of their own. I'm talking about people who are willfully contributing to their own demise. You can't treat someone who does not want to be treated. It's a waste of time and energy to try to help someone who does not want to be helped. I don't know what's so hard to understand about this.


11 posted on 12/01/2006 10:28:05 PM PST by cyborg (No I don't miss the single life at all.)
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To: cyborg
If I had the education and dedication...I really don't think it would matter how or why they were ill. But that's just my view of the nature of humanity.

Most people want to be helped, in spite of their vices, "do not ask for the bell tolls..it may toll for thee".
12 posted on 12/01/2006 10:40:34 PM PST by berdie
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To: cyborg
A doctor is for diagnosing and treating a patient. A patient who does not want to even follow the most basic advice is wasting the doctor's time and talent. What do you want a doctor to do for a patient who won't obey doctor's orders based upon diagnosis and keeps getting worse? Is a doctor supposed to keep treating someone who continually sabotages his/her own health? I say no. I'm not a doctor and if I was one, I wouldn't waste time with people who do not want to help themselves. You may not like my attitude but think about it. Someone who is in ill health losing limbs to diabetes and doesn't want to help themselves obviously wants to die. Why should a doctor have to keep treating someone who doesn't want to be treated?

A Dr is not required to treat anyone. This guy is 61 and I presume has a longterm standing with this Dr (although there is no way of knowing that). I did not see where Johnson was not obeying him with regard to is medical needs. Fat people all over are diabetics should they all be told to exercise or we are going to take away medical attention? The guy could have lied, he could have gone to the weight loss/smoking programs and he could have continued on his same path. No one would know the difference. The Dr. has a right to deny a person medical attention because he doesn't like the lifestyle the guy chooses however, if he accepted him as a patient and he has been a longtime patient I believe the Dr has an obligation to continue his medical needs.

All of this lifestyle vs medical stuff is part of the politically correct agenda and NEW talk. Seems to me drug addicts and alcoholics are able to draw SS. Never heard of a Dr wanting to deny them medical care because they did not mind the Dr and quit drinking or doing drugs. It depends on what the Federal definition of the day regarding the medical condition is as to how that person is treated in the Dr's office.

No Dr ever went into the realms of a person's private habits in the past and if it was discovered the Dr might suggest it would be wise to not do that but never were they denied treatment. The Dr is not responsible for this man's eating and smoking and if it causes him to die--so be it. He has been advised.

These medical tactics are just another step toward euthanasia of a different type. This type of person will discontinue going to the Dr. altogether. For you to say this guy is wasting oxygen shows your value for life.

13 posted on 12/01/2006 10:40:45 PM PST by Snoopers-868th
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To: Snoopers-868th

:sigh: Well we disagree on this man's attitude about his own care then. It's not PC to advise people adopt a healthier lifestyle. His attitude about his health is fatalistic. He doesn't care if he loses limbs. Hence, my reaction to his attitude. I am not for euthanasia at all so you are wrong about my attitude. I just don't think I could keep seeing someone who doesn't want help.


14 posted on 12/01/2006 10:47:42 PM PST by cyborg (No I don't miss the single life at all.)
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To: cyborg
Someone who is in ill health losing limbs to diabetes and doesn't want to help themselves obviously wants to die.

Forgot to address this: If I am not mistaken it is not eating or smoking that causes the loss of limbs--it is the disease and that sores do not heal and gangrene sets in. I say, let the poor guy enjoy what little he has left.

15 posted on 12/01/2006 10:48:29 PM PST by Snoopers-868th
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To: berdie

How a person got sick wouldn't matter to me either if I was a physician. I also agree that most people want to be helped but I'm shocked that someone would rather lose legs than take a doctor's advice. I probably shouldn't be though. I see it right before my eyes on a daily basis.


16 posted on 12/01/2006 10:52:21 PM PST by cyborg (No I don't miss the single life at all.)
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To: cyborg
sigh: Well we disagree on this man's attitude about his own care then. It's not PC to advise people adopt a healthier lifestyle. His attitude about his health is fatalistic. He doesn't care if he loses limbs. Hence, my reaction to his attitude. I am not for euthanasia at all so you are wrong about my attitude. I just don't think I could keep seeing someone who doesn't want help.

All this lifestyle stuff came with the obsessions with medical technology, face lifts, we are going to live forever group of folks. About the time of the learn about diversity and respect others cultures talk. About the time of politically correct speak.

I did not say you advocated euthanasia I said this type of treatment of patients will create a new type of euthanasia. People will not seek medical attention for fear of being judged on their habits. Then the medical field will deal with them at the near death stage. Wonder if they will like that or will they refuse to treat them because they did not seek medical attention earlier?

It is o.k., we can agree to disagree. That is what I think this website is all about. We learn from conversation--or at least I do.

17 posted on 12/01/2006 10:57:19 PM PST by Snoopers-868th
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To: Snoopers-868th

A lot of disease, esp. diabetes is caused by poor lifestyle choices. A lot of diabetes can be reversed and life improved by altering one's food choices. A person doesn't have to be a granola cruncher but things as simple as cutting back on white bread and sugar and drinking less soda will do wonders for a person's sugar count. Sixty isn't even old but he sounds set in his ways and is typical of the mentality of poor people who have food as their chief enjoyment in life. I suppose a lifetime of diabetes drugs is his future. I work with diabetes patients who have open sores and the whole bit. I can't imagine why someone would WANT that for themselves.


18 posted on 12/01/2006 11:00:37 PM PST by cyborg (No I don't miss the single life at all.)
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To: Snoopers-868th

I wouldn't judge a person if they came to see me on a first appointment or off and on. I just wonder if I would have the stamina to care for someone who doesn't want to help themselves over years and watch then wither away :( I can see your point though. A lot of people do live in fear of criticism and I see it in men more than women.


19 posted on 12/01/2006 11:05:50 PM PST by cyborg (No I don't miss the single life at all.)
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To: Snoopers-868th; cyborg

Very true, I learn from everyone here. That's why I keep coming back. The debates always seem to bring a new insight.


20 posted on 12/01/2006 11:12:17 PM PST by berdie
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