Overweight and Need Hip or Knee Surgery? Denied!

Recent decisions by the National Health Service in the United Kingdom could be a harbinger of things to come in the United States.

The NHS recently decided that obese patients and smokers would no longer have access to hip and knee operations. Why? Because the service can’t afford it.

Patients who are obese or who smoke cannot get routine surgeries.

The NHS had a record £2.45 billion deficit last year — that’s $3.27 billion in the red. When that news was released in May, Chris Hopson, the chief executive of NHS Providers, said it would likely mean poorer quality of care.

“The combination of increasing demand and the longest and deepest financial squeeze in NHS history is maxing out the health service,” he said in a release. “We have to rapidly regain control of NHS finances, otherwise we risk lengthening waiting times for patients, limiting their access to services, and other reductions in the quality of patient care.”

It didn’t take long for the NHS to limit access to services. Hospital administrators in North Yorkshire, England, decided to deny hip and knee surgeries to patients who refuse to quit smoking or refuse to lose weight. Currently 64 percent of adults in Great Britain are classified as overweight or obese.

“At this rate we may see service reductions becoming the norm rather than the exception,” said one medical expert.

The statement from the NHS Vale of York Clinical Commissioning Group explained, “The local system is under severe pressure. Hospitals are being warned they will not be paid for surgery if they carry out operations on obese patients who are not exempt from the policy.”

“This work will help to ensure we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it,” the statement also said.

It’s still unclear what qualifies as an exemption. Right now, the policy is that patients who are obese or who smoke are barred from routine surgeries — meaning non-life-saving procedures. But a car accident that results in damage to a hip or knee may not qualify as life-threatening. Normal wear-and-tear on ligaments and joints doesn’t qualify. Nor have administrators said whether they will take into consideration the possible causes of abnormal weight gain, such as a thyroid disorder or pregnancy.

Under this new policy, obese patients are barred from surgery for a year. They can appeal for faster surgery if they lose 10 percent of their body weight during that time. However, since exercise has proven an effective weight loss strategy — it might be difficult for patients with a bum knee or hip to keep the pounds off.

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Smokers, for their part, are barred from surgery for six months. They can get on a waiting list a little sooner if they can prove they have quit smoking for at least eight consecutive weeks.

Clare Marx, president of the Royal College of Surgeons, said in a media release that this policy is too severe for her taste.

“At this rate we may see brutal service reductions becoming the norm, rather than just being exceptions.”