Should patients pay less for “lifestyle diseases”?

Given that ‘lifestyle diseases’ result from choices that individuals make, should they be treated by public medicine?

According to Livestrong.com, the stress of modern day living is causing enormous burden on healthcare globally (1). Environmental factors such as a sedentary lifestyle and poor eating habits have contributed to the growth of lifestyle diseases in the human body system consisting of the endocrine system and the excretory system. A lifestyle disease is associated with your environment, by the way you live your life and choices you make everyday.” Most of the diseases we suffer from today are caused by our poor food choices, bad habits and lack of exercise. Therefore, the function and stability of our human body system are affected by the choices we make everyday. According to a research conducted in 2007, environmental and economical factors such as low income, lack of proper health care, lack of education as well as poor common sense influence a lot of these lifestyle choices. We are constantly bombarded by advertisements on billboards portraying hypnotizing images on a new fast food joint opening up or for the newest Isotonic drink. This further enhances the problem.

Lifestyle diseases

In the United States, diabetes and obesity are the most common endocrine system disease among children. According to Healthorg.com, these endocrine diseases that are caused by lifestyle choices will slowly develop into excretory system diseases, as the body is not able to maintain homeostasis with the endocrine system. For example, a person who consumes junk food regularly and watch television all day will develop endocrine diseases such as obesity, diabetes, heart and joint diseases. If that lifestyle continues, the person will develop excretory system diseases such as kidney stones.

Furthermore, smoking is the most common act in developing countries, such as India that is damaging the human body system. In a recent survey conducted by the health department of Ahmedabad Municipal Corporation in urban slums of the city, it was found that a considerable number of people suffer from lifestyle diseases. The survey found that 71% of the population suffers from respiratory diseases caused by smoking.

These lifestyle diseases are spreading at an alarming rate and are turning into an epidemic.

Context in which these lifestyle disease affects the body

The health consequences of lifestyle diseases are contributing to the declining mortality rate and morbidity. In developed countries, severe obesity leads to an earlier death. According to Livestrong.com, cardiovascular problems are common among obese people (5). High blood pressure can lead to the development of heart diseases, kidney failure and stroke. This is because the heart of an obese person is required to work harder, which leads to the early development of congestive heart failure, cholesterol and diabetes. Obesity also causes respiratory problems, as breathing is difficult due to the decrease in lung size. As can be seen in Figure 1, muscoskeletal problems such as low back pain and arthritis are common among obese people. This is because most of the weight of the body is borne by the hips, knees and ankles that tend to wear out more quickly in obese people, resulting in arthritis.

Besides that, the most common act contributing to the lifestyle disease epidemic in developing countries is smoking. Dr. Verinder Anand, a consultant at Moolchand Medicity said, “the youth believes that smoking acts as a stress buster, but this concept is a compete myth. It actually reduces a person’s stamina in the long run leading to the development of multiple diseases.” According to the European Journal of Endocrinology, smoking has damaging effects on both the endocrine and nervous system of the body. One organ that is affected by smoking are the kidneys. This is because smoking restricts the blood flow to the kidneys making them less efficient. Also, if a smoker suffers from high blood pressure, smoking can increase the blood pressure even more to the point where the smoker reaches the final stage of kidney disease.

However, the most disturbing parts of smoking are the effects it has on one’s nervous system. One of the most known side effects of nicotine is increased respiration and heart rate. Nicotine can also take control of receptors in the brain to control functions such as respiration, muscle movement, including memory.

Therefore, smoking has a tremendous affect on our endocrine and nervous system, resulting in lifestyle diseases caused mainly by bad choices.

Treatment for lifestyle diseases

According to a staff reporter, “the rise in lifestyle-related diseases has prompted authorities to focus on the treatment of those with lifestyle-related diseases.” Some of these treatments include dialysis for patients suffering from kidney failure. According to Livestrong.com, dialysis is used as a life-saving treatment to take over the job of the kidneys once they fail. Like the kidneys, dialysis filters harmful wastes, salt and excess fluid from the blood to a normal, healthy balance. However, there are several complications and risks involved in this treatment.

According to Medscape, risks of all forms of infection are many times higher once the patient is started on dialysis. This means, patients on dialysis are more prone to infectious diseases. Another complication with dialysis is trouble with vascular access. Peritonitis can be caused by an infection in the area where the tube enters the body. This complication can lead to infection, blockage of the arteries and poor blood flow. Moreover, dialysis patients are also at a risk of hypotension, caused by the stress the cardiovascular system is under.

For obese patients, the goal of obesity treatment is to reach and stay at a healthy weight through regular exercise and a balanced diet. However, in patients with morbid obesity, the only feasible treatments are prescribed weight-loss medications. But like all medications, there are side affects. These side effects include headaches, dizziness, fatigue, constipation and nausea.

Should ‘lifestyle’ diseases be treated by public medicine?

Based on a research study, despite the fact that lifestyle choices have caused various diseases in the human body system, people have become too dependent on subsidized prescriptions and medications prescribed by public hospitals that they do not want to change their lifestyle for the better. According to Healthorg.com, people now days want to treat the symptom and not the cause of the problem. They tell the doctor to prescribe them with stronger painkillers. This adds to the burden of our health care systems, as medical insurance premiums increases, the lack of hospital beds and medical professionals. So, it all boils down to this question; why should public hospitals provide subsidized treatment to patients suffering from lifestyle diseases due to their bad choices when there are people who cannot afford insulin for diabetes caused by a genetic disorder?

There are two sides to this argument. Firstly, according to a study published in the Archives of General Diseases, an estimated 58% of human body system diseases may be attributed to environmental factors and 38% to genetics, as represented by the pie chart on the right. Therefore it is the duty of doctors to investigate the cause of the disorder or disease whether it is due to environmental factors or genetics. For example, type 2 diabetes is not only caused by lifestyle choices but also can be hereditary. Thus, it is up to the doctor to investigate and identify the cause of the disease whether it is due to lifestyle choices or genetics. This procedure can be done through screening and tests. Therefore patients who are suffering from diseases caused by genetics or are stress-related such as cancer, should be prioritized to receive subsidized medications instead of patients suffering from lifestyle related diseases influenced by their choices. This procedure will also prevent pubic hospitals from bankruptcy from bearing the cost of lifestyle diseases. Then again, according to a study conducted by WHO, although public hospitals provide subsidized medicine, the quality of the medications are not as good as the medications sold in private hospitals. Therefore, although patients suffering from lifestyle related diseases who constantly obtain subsidized medications despite the fact that they can afford to pay for medications sold in private hospitals, their health might not necessarily improve or they may suffer from side affects of that treatment.

However, is it still right to provide subsidized medications to patients suffering from lifestyle diseases influenced by outside factors? Lifestyle diseases such as high-blood pressure and hypertension can also be influenced by uncontrollable factors such as peer pressure, stress and bully. According to the study by the New-Delhi-based research group, “India’s rapid economic expansion has sparked a surge in workplace stress and lifestyle diseases.” Long working hours, night shifts and a sedentary lifestyle makes employees prone to heart diseases and diabetes as well as mental depression. Therefore, should these lifestyle diseases that are not influenced by their choices, but uncontrollable factors be treated? Yes, because they have the chance to heal if treated. In America, the electric chair was banned on being a cruel and inhumane punishment due to ethical reasons. This is because, the condemned prisoners have the right to be healed and rehabilitated instead of sentenced to death.

But what about the economical issues, such as for those who are suffering from lifestyle diseases but cannot afford the treatment? Some people feel that compassion and pity should be given to those suffering from lifestyle diseases, such as people in LEDC’s who cannot bare the cost of the medications/treatment. Despite that, they would rather spend money to fund their bad habits, when the money that they use to buy cigarettes or junk food should be used for their medications instead of depending on public health cares to provide them with subsidized treatments. Dr Lee, a member of the Free Enterprise group said, “patients must live healthier lives or help meet the cost of their care from their own pockets.” In Denmark, individuals are expected to pay for their own prescriptions. This is because they believe that charging people for the cost of their prescriptions would encourage them to take more responsibility of their own health.

Then again, prevention is better than cure. According to a research study, “Many are not aware that a change in lifestyle is an important factor in the emergence of diseases.” Therefore, public awareness and campaigns on healthy lifestyle habits should be prominent to teach people to remain healthy, to promote physical activity and improve health around the globe. Education should also be provided to teach people especially in LEDC’s to make wiser choices, and to differentiate the good and bad as well as the consequences of their actions. In America, schools are now spending their time and money to educate children about proper diet, physical activity, consequences of tobacco consumptions and learning to cope with stress to reduce the risk of health issues. Furthermore, the right to subsidized prescriptions for those suffering from lifestyle diseases should be removed. In fact, all health care systems in all countries should run like in Demark whereby patients are encouraged to take full responsibility for their own health. In addition, people who can afford private health insurance and treatments should also stop freeloading off the public health system and let people who really cannot afford and are suffering from genetic diseases use it.