In Los You "pay" To Kill Yourself

[cognos]

One of my Thai brother in laws ( in Phuket ) is a chronic binge drinker, smoker (and gambler). Most of my wife's sisters are reasonably well off, except the one married to the drinker/smoker/gambler. Periodically he starts to vomit blood, and is packed off to the hospital (normally Vachira Hospital in Phuket). LOS is ahead of the curve so to speak, because they make you pay your own hospital bills 100% if they perceive your malady is self - induced/ self - inflicted/ your own fault/ however you wish to say it. The doctors at Vachira have seen him many times about this problem he has, and they tell him to quit drinking and smoking, but to no avail. Actually that is wrong, he has quit drinking ( not smoking ) for a while now. They tell him straight up, you do the damage to yourself, you pay ALL the hospital bills PERIOD. It gets expensive for his wife, and her sister ( my wife ) sometimes chips in to help pay the hospital bills ( actually, I chip in, haha ). Do you think this "pay for your own problem" would work in the Western world? In Vancouver Canada, if you need to go to emergency, you may wait 3 or 4 hours unless you are almost dying, as wounded crackheads( for example) will come in at all hours and leave the normal citizen waiting hours to see a doctor. Whats your opinion, should the west follow the Thai example?? ..or should it be business as usual...spending untold millions on people with lung cancer from smoking and alcoholics from cirrosiss of the liver??

[IanForbes]

I've said all along for years that ALL drugs should be made available to those that want them. Let anyone stuff anything in their veins or up their nose. Then, just have a big oven available to get rid of the bodies afterwards. Darwin theory. No need to criminalize what people CHOOSE to do to their own bodies. Take away the profit and there would be no need to push drugs on the stupid people. No need for pimps to get young girls hooked on drugs to turn them into hookers. There are lots of ways to get a legal high... and many are more dangerous than drugs.

[Harcourt]

On the one hand, I agree. Let Darwin's Theory work, and stop interfereing in our species' evolution.

On the other hand, using your Canadian emergency room example, the crackhead's "self inflicted" injuries are perhaps just as valid an illness as the "normal citizens" because many addicts can not help themselves. They made a mistake years ago and now suffer the disease of addiction.....like your BiL. It's not the vomiting of blood that is the highest priority to treat but his addiction.

There may also be a very practical reason behind the Thai way. Dead people can't pay. Makes sense.

[Harcourt]

We both thought of Darwin at the same time Ian..... Indeed it's a pet theory of mine.

[Neeranam]

Did you alcoholism is a disease? Darwin's theory is also a load of nonsense.

Edited November 7, 2009 by Neeranam

[smokie36]

Let's get rid of all state benefits and return to the victorian era. I need someone to shine my shoes and sweep the chmney.

[Huey]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

[seedy]

I believe any society is judged on the way that it treats the most unfortunate of it citizens.

You can not legislate morality.

Do unto others as you would have done unto you.

[Harcourt]

Did you alcoholism is a disease? Darwin's theory is also a load of nonsense.

Alcoholism is a disease, as is heroin addiction and nicotine addiction etc. It's easy to see any addiction as a matter of choice. In fact the choice was the first puff or sip....after that, chemistry takes over.

It has been shown that most addicts share a common set of genes. These days, in Australia and USA, those that do not have the "addictive" genes are treated psychologically, those with the genes are treated both psychologically and with medicines as their addiction has been recognised as a disease of the body.

What makes you think that Darwin's is nonsense?

[cognos]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

..perhaps people addicted to drugs and alcohol should receive some treatment, but this is another topic and I'm not sure if treatment works anyway. I believe people need a "carrot", or good reason that they can self-justify in order to change their lives. I was a 2 or 3 times a week beer binge drinker and pot smoker for over 30 years, but recently quit both on the same day ( October 2 ) after my wife threatened to go back to Thailand. That was a BIG CARROT. It scared me sufficiently enough to not have ONE urge for either substance since. I wanted to quit before, but did not have sufficient REASON. Fortunately my health was not compromised to any large degree, but as they say.."better late than never" Bottom line..I guess I wasn't addicted, so my bias leans towards people DO have CHOICE in what they do, hence hospitals may have a CHOICE whether they treat the CHRONICS or not..

[cognos]

I should have said..Should the Western world follow the Thai example??..not.. The western world should follow the Thai example ASAP..my mistake there. In general..I believe in treating people how you want to be treated, as opposed to what I call the F U attitude for lack of better words..treating others as they treat you..but I am not sure if hospitals should refuse treatment for those who are intent on " doing themselves in " because they have a death wish..inadvertently or otherwise, or whether they " can't help it ". If I had to guess, I would guess that people DO have a CHOICE, so they can help it. Thats why I disagree in general with AA's first rule..that you are "powerless".. I think you do have the power over choice.

[smokie36]

Do we all sit in the treetops enjoying the fruits of the forest while those who have fallen wade through the swamp without offering an olive branch?

None of us know what troubles lead a person to begin destroying themselves. Some compassion is surely needed at all levels of society or we may as well be chimps.

Easy to condemn people but its a long hard road to recovery for any addict.

[cognos]

Do we all sit in the treetops enjoying the fruits of the forest while those who have fallen wade through the swamp without offering an olive branch?

None of us know what troubles lead a person to begin destroying themselves. Some compassion is surely needed at all levels of society or we may as well be chimps.

Easy to condemn people but its a long hard road to recovery for any addict.

I agree..another error on my part..instead of..saying.." perhaps they should receive treatment"..they SHOULD receive treatment should they wish to..BUT..using AA as an example..( and the recovery rates are VERY low for those who attend AA, like 5 % or less..but don't quote me on that)..for every one that quits substances through assistance like AA..WAY more do it by THEMSELVES..which may or may not speak volumes.. i agree as a society we are only as good as we treat our most unfortunate..I better believe this..as I am a special needs teacher

[nisakiman]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

And people who eat too much, or the "wrong" kind of food (according to the "experts)?

Or people who put their lives at risk mountaineering?

Or people who choose a (high risk) career in the armed forces?

Or divers?

Or people who drive on busy highways?

It's a slippery slope, once you get on it. We can all make choices that will put our lives / health at risk. Yes, some are more obvious than others, but the principle remains the same.

"You have had a heart attack because you insisted on jogging, although you are past 50 years old. Therefore the fault is yours, you brought it upon yourself, so you must pay."

A slippery slope indeed.

[bonobo]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

And people who eat too much, or the "wrong" kind of food (according to the "experts)?

Or people who put their lives at risk mountaineering?

Or people who choose a (high risk) career in the armed forces?

Or divers?

Or people who drive on busy highways?

It's a slippery slope, once you get on it. We can all make choices that will put our lives / health at risk. Yes, some are more obvious than others, but the principle remains the same.

"You have had a heart attack because you insisted on jogging, although you are past 50 years old. Therefore the fault is yours, you brought it upon yourself, so you must pay."

A slippery slope indeed.

I understand the sentiment about letting "crackheads" pay for their own treatment.  As someone paying taxes to pay the bill, or as someone waiting in in the emergency room to be seen, I can understand the feelings one might have about that..

But I think I have to agree with nisakiman here.  Where do we draw the line?  I would not go with the example of the military as military, police, firemen, etc are in high risk jobs, but for the public good.  That line is easy to draw, in my opinion, but the questions on the hiker, diver, driver, fast food eater, and such are very valid.

[TallForeigner]

I see a lot of merit in having to pay for self-inflicted damage. I also agree that it might be a bit a slippery slope if handled badly but with an intelligent framework of rules it can work and I would strongly support it.

To a certain extent it already exists in the West. Let's take the damages that alcohol does to your liver. In the West about 60% of totally damaged livers are due to alcohol. If your liver needs replacement you are a candidate to receive a liver transplant. Now there is a huge demand for livers but only a small number of suitable donor organs available. Therefore your doctor will have to fill in a long list and evaluate your case according to well established criteria - according to these criteria you will get a certain priority. If your doctor decides that your liver damage is due to alcohol then you are automatically much lower on the list and your chances to get a new liver is next to zero. The rationale here is that people who inflicted the damage by their own actions (and that's how drinking alcohol is perceived) get a lower priority for a donor organ than people who have liver damage from a viral infection or cancer or other medical reasons. Makes perfect sense to me.

Now look at insurances. How many medical insurances in the west are starting to increase bills and/or payments if you are a smoker or obese or alcoholic or drug addict. All of them should and already many will support a treatment against addiction.

How many regular accident insurances clearly exclude payments for accidents during "dangerous activities" like for example bungee jumping and other exciting stuff? If you want to be covered during certain dangerous activities then you need to pay for an extra contract - if available. Isn't that the same principle?

Another key here is that the doctors apparently warned the guy many times before - most probably already many years ago. I am also sure if the guy would have shown real efforts to quit or would have least demonstrated that he is doing something against his intake of toxic stuff the doctors would have given him a wider grace period. At the end there is no excuse. For example a smoker with some healthy brain cells knows perfectly well that he will damage his body; there are even warnings on every package. He starts his habit by his own will and knows well that eventually he will do much harm to himself. Same or similar with alcohol and other drugs. Now why should we support a mentality where one might think: oh well, if I start or I don't stop smoking/drinking/using drugs maybe in 10 years I will end up in hospital - but why should I worry, if our society or insurance will take care of my treatment? How about: I know clearly that if I start with my habit and one day I will end up with a damage or a disability caused and/or accelerated by my habit then I myself am responsible for all or at least most of the costs to treat it - especially after I have been warned and after my doctors already raised some red flags before some damages were too bad. I don't see anything wrong with that.

Edited November 8, 2009 by TallForeigner

[PhilHarries]

Good idea I say, and while you are at it how about we stop wasting all those billions on the search for an AIDS vaccine and all the associated treatments? Those bluddy druggies and pooftahs were warned years ago but did they change their ways? Nah! Let Darwinian selection run it's course, it'll also serve to reduce the world population and thus ease the problem of global warming.

In a million years an alien spaceship will land on this burnt out rock and will only find a giant tombstone.

RIP

THE HUMAN RACE

WHO NEVER GAVE A <deleted>

[phetaroi]

Did you alcoholism is a disease? Darwin's theory is also a load of nonsense.

In general, no, Darwin's theory (did you notice it was referred to as a theory?) is far from nonsense. What is nonsense is what many/most people think Darwin's theory of evolution says.

Edited November 8, 2009 by phetaroi

[phetaroi]

I believe any society is judged on the way that it treats the most unfortunate of it citizens.

You can not legislate morality.

Do unto others as you would have done unto you.

I don't think your thesis is very well thought out.

I do agree that a society is at least partly judged on how it treats its most unfortunate citizens. It's how one defines "unfortunate citizens" that makes the difference to the posit. For example, most drug addicts (since that is one of the sub-topics here) became drug addicts of their own volition. After all, almost all of us did not become drug addicts. If they voluntarily became drug addicts, why should they be classed as an "unfortunate citizen"?

Yes, you can legislate morality. We have laws against murder, child abuse, and tons of other moral issues.

[thaimite]

Do unto others as you would have done unto you.

I believe the original quote which makes much more sense swas

Do NOT do unto others as you would NOT have done unto you.

[cognos]

Tall foreigner..you are astute in your observations..I stand corrected, as the west has built in things already for chronic self abusers, as you pointed out

[LivinLOS]

But where does it stop..

Do we also not treat the drinkers ?? Or how about the people who are crowding accident and emergency on a saturday night with cuts and fights from drinking ?? I mean they chose to go out in that environment ??

Or the guy who crashes a sportbike.. I mean he chose to ride the bike ??

Or the skydiver who breaks an ankle ??

Or the guy who has a heart attack because he has a bad diet ??

Or the guy who has a bad back because he doesnt exercise enough ??

Its easy to see everyone elses problems as 'self induced' and your own as merely circumstance.

[thaimite]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

I believe drug users should be given the maximum help and treatment, but dealers should be shown the full force of the law.

How to tell the difference?

Put them in a cell for 24 hours with whatever substance they are found with.

Next day if they have consumed all, it was for personal use and treatment is prescribed if not then they are treated as dealers.

As few may overdose this way, but ....

edit

I also meant to say that in general I agree people should be responsible for their own actions, and pay accordingly. e.g. scrap laws about crash helmets an seatbelts, but if you are in an accident and not wearuiing a belt / helmet, then you pay for the treatment, not the insurance or health plan.

Edited November 8, 2009 by thaimite

[sgunn65]

I won't get into the arguments about addiction being a disease as my views have been aired on this forum many times and i also treat drug users and alcoholics here in the LOS for a living.

But as the op said the injuries sustained are self inflicted. If that is the criteria to determine whether someone should pay, ask your selves this.

If a rugby player breaks a leg should he also pay??

Just like the drug user he:

Started off with one game

He knew it was dangerous

He knew he could get hurt playing rugby

He continued playing in the full knowledge of the risk

He has probably been injured before but went back to it nonetheless

Apart from the social and legal elements what is different?

Edited November 8, 2009 by sgunn65

[neverdie]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

And people who eat too much, or the "wrong" kind of food (according to the "experts)?

Or people who put their lives at risk mountaineering?

Or people who choose a (high risk) career in the armed forces?

Or divers?

Or people who drive on busy highways?

It's a slippery slope, once you get on it. We can all make choices that will put our lives / health at risk. Yes, some are more obvious than others, but the principle remains the same.

"You have had a heart attack because you insisted on jogging, although you are past 50 years old. Therefore the fault is yours, you brought it upon yourself, so you must pay."

A slippery slope indeed.

I understand the sentiment about letting "crackheads" pay for their own treatment. As someone paying taxes to pay the bill, or as someone waiting in in the emergency room to be seen, I can understand the feelings one might have about that..

But I think I have to agree with nisakiman here. Where do we draw the line? I would not go with the example of the military as military, police, firemen, etc are in high risk jobs, but for the public good. That line is easy to draw, in my opinion, but the questions on the hiker, diver, driver, fast food eater, and such are very valid.

I can just see the signs on the side of the highway.

* Speed limit 100

* Keep Left

* Wear Seatbelt

* No insurance or hospital cover if you use this highway

* Road works

* Traffic Accident ahead

* BIB on roadway

You'd virtually need to stop and study each sign before you proceeded onward

I agree that its a slippery slope but absolute nonesense that anyone would consider including people in the armed forces in the same group as junkies and asssholz.

[wamberal]

On the one hand, I agree. Let Darwin's Theory work, and stop interfereing in our species' evolution.

On the other hand, using your Canadian emergency room example, the crackhead's "self inflicted" injuries are perhaps just as valid an illness as the "normal citizens" because many addicts can not help themselves. They made a mistake years ago and now suffer the disease of addiction.....like your BiL. It's not the vomiting of blood that is the highest priority to treat but his addiction.

There may also be a very practical reason behind the Thai way. Dead people can't pay. Makes sense.

There are plenty of misconceptions as to what "survival of the fittest" means. Darwin was referring simply to the importance of reproduction. He was talking about those who have the most offspring, they are the fittest in terms of his theories.

A crackhead could have dozens of kids, unfortunately, as could an alcoholic, or almost anybody. They might die young themselves, but that is kind of beside the point. They have passed on their genes, and that is what counts as "survival".

[thaimite]

I agree it's a slipery slope, but that is no excuse for not doing something.

At the end of the day people have to start taking responsibilty for their own actions.

Trip on a crack on the pavement? The court awards you a free eyesight test!

[phetaroi]

Do we all sit in the treetops enjoying the fruits of the forest while those who have fallen wade through the swamp without offering an olive branch?

None of us know what troubles lead a person to begin destroying themselves. Some compassion is surely needed at all levels of society or we may as well be chimps.

Easy to condemn people but its a long hard road to recovery for any addict.

I don't really agree for a number of reasons.

My nephew...who always was a little jerk (and that's putting it politely), eventually committed some felony (I never asked what it was and was never told) and ended up in Florida state prison for a short stretch. After he got out he found it impossible to hold almost any job very long. Usually it had to do with the employer finding out he was an ex-con. Of course, that meant he lied on his application, so he would be fired. One of those rare days when we were actually having a conversation he related his job odyssey and said, "You know Uncle Terry, life is so difficult and unfair." I replied, "No, S...., it really isn't. Everyone I know basically followed the law, did at least a little college, got a job, and got on with their life. You chose not to do college. You chose to commit a felony you knew could result in prison. Now you are paying the price. I'd say life was entirely fair to you."

Now, lest you think I have no heart, I can compare that to my own son who -- one day chose to do something totally out of character -- and got caught and also went to jail. To some extent ruined his life. He was wrong and he paid and continues to pay. The difference, my nephew had a long pattern of making bad choices. My son made one bad choice. He pulled himself up by the bootstraps, so to speak, and is doing alright now.

I also think few of us have any understanding of what addicts go through, or even if someone who drinks or take drugs is an addict. My father was a pretty good man who drank...a lot. After retirement from the military, for example, he drank a quart of Black Velvet a day...and that was just what he drank at home, not mentioned every late afternoon/early evening when he would make the rounds. He also smoked 3-4 packs of cigarettes a day from the time he was a young man until about age 60. What was interesting, he could stop drinking anytime he chose to, and for any good reason would...for a specific period of time he decided upon, after which he would begin drinking again. One day at around age 60 he called and said, "Guess what I did!" Of couse, I had no idea. "I quit smoking!" Wow. After all these years. Did you use the patch or what?" "No, on I just stopped. period." And for 20 years he never smoked again. At age 80, when it was nearing the end but he was still living at home, I went to visit. I was surprised that he was smoking again. "The doc says I won't last the year and there's not much more in life I can still enjoy, but I can still enjoy an occasional smoke." All of his life, in terms of his addictions, he could still make choices.

[phetaroi]

I actually agree with sentiment that chronic drug addicts (those who have dropped of treatment or return to drugs after free treatment is provided) should not be allowed free medical treatment. Though it should be made available free to those who respect themselves enough to stay clean or never start in the first place. And yes that includes alcoholics as well.

If Crack Heads would die quicker Crack would be less of a problem.

And people who eat too much, or the "wrong" kind of food (according to the "experts)?

Or people who put their lives at risk mountaineering?

Or people who choose a (high risk) career in the armed forces?

Or divers?

Or people who drive on busy highways?

It's a slippery slope, once you get on it. We can all make choices that will put our lives / health at risk. Yes, some are more obvious than others, but the principle remains the same.

"You have had a heart attack because you insisted on jogging, although you are past 50 years old. Therefore the fault is yours, you brought it upon yourself, so you must pay."

A slippery slope indeed.

This, I think, is the challenge. Where to draw the line. Yet, to me there's an awfully big difference between choosing to start using cocaine and choosing to drive on an interstate highway.

[cognos]

I won't get into the arguments about addiction being a disease as my views have been aired on this forum many times and i also treat drug users and alcoholics here in the LOS for a living.

But as the op said the injuries sustained are self inflicted. If that is the criteria to determine whether someone should pay, ask your selves this.

If a rugby player breaks a leg should he also pay??

Just like the drug user he:

Started off with one game

He knew it was dangerous

He knew he could get hurt playing rugby

He continued playing in the full knowledge of the risk

He has probably been injured before but went back to it nonetheless

Apart from the social and legal elements what is different?

change rugby to hockey and that me..point taken