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Subscribe to RSSUp to half of the people who are treated at hospital emergency departments and trauma centers are under the influence of alcohol, experts say. That may be a sobering statistic, yet a recent study found that emergency departments can capitalize on this “teachable moment” to discourage problem drinking in the future.
But laws in more than half the states permit insurers to deny payment for medical services related to alcohol or drug use and that can derail hospitals’ best intentions, experts say. Faced with the prospect of not getting paid for care, some emergency department personnel may sidestep the problem by simply not testing patients’ blood or urine for alcohol.
In the study, published online in the Annals of Emergency Medicine in March, nearly 600 emergency department patients who were identified as hazardous or harmful drinkers (defined for men as drinking more than 14 drinks per week or more than four on any single occasion, and for women as more than seven weekly drinks or three on any one occasion) took part in a seven-minute interview. During the interview, an emergency department staff member discussed the link between a patient’s injuries and alcohol, as well as guidelines for low-risk drinking, and encouraged the patient to discuss what was stopping him from drinking less and to set a drinking goal.
Compared with those who received standard care, patients who took part in the sessions reduced their average number of weekly drinks significantly as well as their episodes of binge drinking and drinking and driving over the next 12 months.
“In the emergency department on a weekend, all the cases may be drug or alcohol related, and yet we don’t do” screening and intervention, says Gail D’Onofrio, the study’s lead author who is chair of emergency medicine at Yale University School of Medicine. “Our goal is to normalize this in the emergency department.”
Although some of the nearly 4,000 emergency departments screen patients for drug or alcohol use, it’s not required. Level 1 and 2 trauma centers, however, which are typically equipped to handle emergency patients suffering from serious injuries sustained, for example, in major car accidents, must screen for problem drinkers. Level 1 trauma centers must also be able to provide counseling.
Such screening and counseling can be effective, says Larry Gentilello, a trauma surgeon who has published studies on injury prevention and substance abuse.
“Most of the people who are injured don’t need to go into treatment,” he says. “They aren’t alcoholics or alcohol dependent. That’s why one counseling session can help them by talking about the risks of drinking.”
The extent to which so-called alcohol-exclusion laws deter emergency medical personnel from screening and counseling patients for alcohol or drugs is unknown.
The laws have a long history. Since 1947, more than 40 states have passed measures allowing health plans to refuse to pay for care if the patient’s injuries occurred while he was under the influence of alcohol or, in some states, drugs, say experts. As people came to understand alcohol addiction and the possibility of treatment, however, it became clear that the laws were counterproductive. In 2001, the National Association of Insurance Commissioners recommended against them.
Since then, at least 15 states have repealed or amended their laws and now prohibit exclusions of coverage for drinking or drugs, according to data from the National Institute on Alcohol Abuse and Alcoholism. Maryland and the District of Columbia are among them; Virginia’s law remains in place.
Regardless of state law, self-insured companies that pay their employees’ health care costs directly can refuse to cover employees for alcohol-related claims.
The laws have ensnared both problem and occasional drinkers.
Gentilello describes the case of a Seattle woman who was celebrating her 25th wedding anniversary and had a few glasses of champagne at dinner with her family. It was a rainy night and she was dressed up and wearing high heels. As she and her husband tried to hail a cab, she tripped on a curb, fell and broke her ankle. In the emergency department, her chart noted that she had a few drinks. Her insurer refused to pay. Washington subsequently adopted a prohibition on alcohol-related claims exclusions in 2004.
It’s unclear how frequently insurers continue to apply such laws to avoid paying claims. Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade organization, says the group doesn’t know what member practice is. Cynthia Michener, a spokeswoman for Aetna, says that “to our knowledge” the company doesn’t apply such exclusions. Other insurers, including UnitedHealthcare and Humana, didn’t provide information about their practices.
But a professor who has written about such laws says there are indications that health plans continue to use them to deny payment.
“There are tons of these cases,” says Sara Rosenbaum, a professor of health law and policy at George Washington University’s School of Public Health and Health Services. “The only evidence we have suggests that these cases go on.”
“There’s no reason to think that insurers, eager to hold down costs, wouldn’t continue” to deny payment based on such exclusions, she adds.
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Leave a Comment:
Simple solution to this..
Hospitals even emergency rooms are not allowed to do any proceedure without your consent. So unless you're unconscious (implied consent) you can refuse the blood test, or breathalyzer. Unless you're in need of blood to replace lost volue there are VERY few reasons to have your blood tested for trauma.
2nd.. just admit to the doctors whatever substance your on, and request to keep it confidential. It should be anyway, but this adds emphasis. ER doctors mainly run the tests when they have cause to wonder but senses the patient is just lying to hide the substance use.
In general the hospital doesn't care about the legality/morality of substance abuse other then to solve the health problem it might be causing. Their job is to fix this giant walking chemical experiment that is a human. Any strange substances floating around can effect things like anesthesia, antibiotics, and vitals.
Just tell them, and in most cases the only thing it will effect is how accurate the treatment is that you receive. ...and avoiding some tests the docs would otherwise have to run.
(I was an EMT with frequent contact with ER docs. So the above is not just a guess.)
I had a hospital visit where I was so dehydrated I couldn't talk and kept asking for a drink. Instead of giving me a glass of water they kept trying to understand what I was saying and never questioned why they could barely here or understand my voice, that was just who I was.
david b-,
I think a lot of the information given to the insurance companies, has been just a patients word. It's asked, answered and admitted into the medical records. Like you said, they (hospital) just want to know what they are dealing with.
Insurance companies are blood suckers!
If you are drunk or stoned why should others pay for your "accident"?
So now the insurers get to know not only what the tests the doctors run on your blood are, but the results, as well? What entitles them to that? I'd really like to know. So if you have some blood test that shows you have an incurable disease, they get to know what that is, and probably put in in the "Reasons for Denial of Coverage for Pre-existing Conditions" database. That way, when you apply for coverage after changing jobs, for instance, your lab work is public knowledge. What the hell ever happened to doctor/patient confidentiality? If I knew that some insurer denied me coverage because of a blood test result, someone in that insurance company would have some blood drawn by me, with a machete.
Yeah, and how much is the quiet, sleazy, multi-billion dollar INSURANCE LOBBY paying to have this rule??? Breathalyzers in the ERs next?
Breathalyzers administered will be the cost. But most of the people they are talking about only had a few drinks.
"Up to half of the people who are treated at hospital emergency departments and trauma centers are under the influence of alcohol,...". Does anyone think these people are costing society a whole bunch of money for a irresponsible behaviour that YOU choose ?
I'll catch a lot of grief about this but what goes around comes around:
I hear a lot of WHINNING by "social drinkers" and/or drunks about not being treated at an ER because insurance companies don't want to pay for your little boozed up brain? How many of you jumped on smokers because it is a disgusting and stinky habit? Now that the shoe is on the other foot - you are all of the opinion that it is unfair to deny YOU coverage for a habit that is just as disgusting but more dangerous then smoking.
I think it's a great idea for saving money. Why should you, the drinker, get insured coverage while smokers can't even get insurance or have to pay through the nose for what little they can get? Why should one irresponsible behaviour be treated any different then the other irresponsible one?
As you said to smokers: if you don't like the high taxes of cigarettes - just quit. Well if you don't like insurance companies not paying for your irresponsible behaviour - just quit.
What a horrible position. Do you bother thinking about the implications and consequences of your position, or do you just say whatever feels good to you at the time?
Amen Richard that's exactly right but all I hear (or don't) is Crickets.
Andrew547,
Yes I know the implications and consequences of what I said but how many people realize that it is NOT ok to drink and drive? Two or three drinks at any function can be deadly but people seem to think otherwise and many don't understand the actual costs to society from drinking.
You choose to drink and drive or drink to excess and end up in an ER. Why should anyone other then the one who caused the problem pay? Why should I as a driver have to pay such high insurance costs so they can pay for peoples' stupid choices?
You can deny people who smoke insurance why can't they deny drinkers?
Because I said so. Next!
fool,
Your answer says she did raise one.
It just goes to show the difference between social, recreational, and hardcore drinkers. Oh wait a minute here I didn't see that distinguished, there are other categories but I don't think at this extent it matters. Someone that is recreational or hardcore isn't likely to visit the ER or get any kind of emergency assistance for that matter, where somebody that is social is likely to go for a broken nail, or because their hand was caught in a closed window.
The problem here, to the extent these ER visits are actually not being covered, seems to be not the insurance companies but LAWMAKERS - yet again.
And you're still in the forest, Rick!!! Major medical health care is to be for people who have real medical problems, not people who create their own problems through thier own stupidity. That is the reason that the laws are written the way they are so that people who are irresponsible, like drinkers, will suffer the consequences of their own actions.
Using your logic Notapol people who are obese, have diabetes, high cholesterol, lung cancer and on and on would also need to be denied insurance coverage. Unless you are living the perfect life and have no habits you should probably keep your mouth shut. Do you eat meat and have high cholesterol? Salt the crap out of your food and have high blood pressure? Did you smoke, ever, and end up with lung cancer? Not pay complete attention to what you are doing and got injured? Everyone is irresponsible at times and we all have habits that have consequences. Many, many health issues are due primarily to behaviors. Only perfect people can get coverage? Name one perfect person, and I'll show you a lair.
Rick,
Beg to disagree with you. EVERYTHING is about money and insurance companies are amoung the greediest. Next to bankers that is.
Michigan,
As you say, everyone is irresponsible at times but that does not mean we ignore it. Year after year people are killed by drunk drivers, social drinkers that couldn't control their vehicles, wife beaters, child beaters, murders commited with drunk, etc., etc., etc.
When is society going to say - drink at your own risk and then back it up by making THEM pay the consequences, both financial and personal.
Republicans reject universal healthcare, preferring to live in a world where private insurers can deny coverage to those who show up to the emergency room with alcohol in their system.
(Reason #356 to never vote Republican ever again)
Hello! That is the PROBLEM!
Obama 2012
Andrew,
Universal healthcare will solve everyuthing? NOT! Where is the money coming from to finance this wonder medical care? Universal OR private healthcare can not work on their own. There needs to be some sort of mixture of both systems. And the hell with political party crap which will do nothing but hinder progress. Both parties are responsible for the healthcare mess we currently have.
Richard:
Blah, blah, blah. Look at countries that have universal healthcare like Canada, Australia, and the UK. They live 3 years longer than Americans and spend literally half as much on healthcare as we do.
No one said its a solution to "everything", but its a solution to our total lack of a functioning healthcare system.
How about not paying for a bleeding ulcer because it was a self inflicted injury? Yep, happened. Woman was drinking in a bar, her ulcer kicked up, ambulanced to the hospital and the ins co tried denying it for that reason because she was drinking and knew she shouldn't.
Actually, I'm not totally against their decision (she shouldn't have been drinking!), but they did reverse and pay. I can also hear people typing agreement that she'd have deserved it, but before you do, substitute sugar and diabetes and see if you still agree.
People are stupid. Ignore them.
A medical condition is a medical condition regardless of cause. Period.
Alcoholism is a medical condition as well....
Jo-An,
Alcoholism is NOT a medical condition; it is a psychological problem that people self-treat with alcohol.
Are you saying mental health is NOT a medical issue?
Jo-An,
Exactly! You come down with the flu, you go to a medical doctor. You injure yourself (whether due to alcohol or not), you go to a medical doctor.
To treat the root cause of alcoholism you go to a psychologist or psychiatrist, not a medical doctor. Hence it is not a medical issue but a mental one. And unfortunately, too many people suffering from a mental illness WON'T seek the appropriate care because this society places a stigma on mental illness that they do not for a medical illness.
Jo-An,
Let me clarify the issue: the results due to alcoholism IS a medical issue. The cause of alcoholism IS a psychological issue.
Not sure that is true, it's been determined to be genetic.
I do agree that people "self medicate" with alcohol and other drugs, when some mental health treatment would be better suited.
Jo-An,
Can not buy genetics as the cause for alcoholism. No alcoholics in my family yet I am a recovering one and always will be. I drank (falling down drunk, lampshade type) for 25 years from 1967 to 1992. I quit one day and have not had a drink to date. But I do know that my issue with booze was a psychological one when I decided to find out why I did all that dumb-ass stuff and got professional help. I was medicating childhood and combat problems and didn't know it.
You know the best counselor for a drug addict is another addict because they know where the person has been and why they were there. And in their experience they have found the problem to be psychological time after time after time. I have that experience
Richard,
Congratulations on becoming and staying sober!
I have some first hand experience with mental illness and self medication, and it's not pretty. One thing I have learned, is the person has to "want help" or all the best intentions are wasted. You can't mandate someone to stop drinking or taking drugs, they have to want to stop.
I couldn't agree more! And again, I applaud you for getting and staying sober.
Jo-An,
Thank you! To stop drinking was easy; to find out why was a hell of a lot harder.
You said:
"One thing I have learned, is the person has to "want help" or all the best intentions are wasted. You can't mandate someone to stop drinking or taking drugs, they have to want to stop."
Same exact thing goes for smoking and after 52 years of doing it, I'm working on my last remaining vice.
Yup! Wanting help is the first step. Without it any chance of overcoming any addiction is useless.
Good job and good luck! Addiction is a powerful force!
You are a strong man!
:)
Hey Richard,
Psychiatrists are medical doctors.
Thought you should know...
This is pretty scary. Because drinking isn't illegal, and neither is getting drunk. What is next, not covering injuries caused by lack of sleep, or over-medication? What about the person who is burned because he fell asleep with a cigarette in his mouth? Is that next...many behaviors carry risk..and accidents do happen. What about the person who sky-dives, or para glides, or the football player or cheerleader who knowingly enters into activities where they can get hurt.
I also worry about the teenager/young adult college student who has no idea what alcohol can do. My son was at a party and drank too much and went into seizures and paramedics had to come...he didn't realize how sick he could get.
Song,
Smoking is legal also but smokers are denied insurance. (Do you know that a smoker can not even rent a car because all rental companies are "smoke free"?)
Why is it different for drinkers? I'll bet you 5 will get you 20 that a rental company (your choice) will rent a car to someone who has a valid license but has one or possibly two DUI convictions on their records. Why do these companies rent to them and not to smokers? Hypocritical society at best!
Smokers can get insurance, they have to pay higher premiums, smokers can rent cars, they just can't SMOKE in them!
Jo-An,
If I smoke I have to pay higher insurance costs. True. So tell me just why don't drinkers (who are more prone to accidents) pay higher insurance costs also? THAT is discrimination.
As far as renting a car - have an alcoholic sit in a bar and NOT drink.
It's against the law to drink and drive, so I don't do it! I've been drinking a VERY long time, I've NEVER had an accident or incident caused by MY drinking, so why should I have to pay MORE?
I don't smoke, so I get a discount on my insurance because I'm unlikely to develop lung cancer.
I also don't want to rent a car or hotel room that STINKS from smoke!
Jo-An,
If you had never had an accident you are just plain lucky but the behaviour is none the less very risk prone and should carry higher costs.
Smoking is not the ONLY cause of cancer. Go outdoors and breathe all that pollution (aside from that of a smoker) in the "fresh" air. Your home could very well contain asbestos and you wouldn't know it but it could be a cause for your cancer. The environment just is not as clean as people think it is, unfortunately.
If smell is the only issue I can only say this: yes smoking stinks (I, a smoker admit it) but each and every day I have all my facalties intact as well as all the brain cells I have left. I don't make a fool of my self in public as drinkers do. I don't endanger other people on the road because I know full well what I am doing behind the wheel. I am not prone to violence when smoking unlike drinkers are.
And finally, a smelly car or room can always be cleaned but drinkers can not "clean" what they have done or said while drunk. They can not revive those dead brain cells they killed over a Bud Lite.
I pay for drinkers through my insurance. Why should I have to pay that much if I am not a drinker? It works BOTH ways.
Don't assume I drink and then drive! I don't!
I love it when Americans and others criticize and condemn the use of marijuana, a drug that causes little or no harm to those who consume it, while they continue to sit around and suck down the most abused drug in the world, that drug being alcohol. Alcohol use has caused more death, violence, misery and broken marriages than any other drug.
Consumers of alcohol are drug users; it's as simple as that. Alcohol is a drug. It simply happens to be legal.
most insurance also won't pay for complications from piercings or tattoos...so if you get MRSA or an infection in the cartilage of your ear and it has to be amputated, you are on your own.
This will most likely cause the amount of visits to go down.. I can remember you went to the ER if you were close to dead or seriously injured.. Now ppl go witha common cold....
There seems to be a lot of grey here. The article doesn't go into a lot of detail. If they are talking about withholding insurance payments due to even trace amounts of alcohol then that is absurd. I would hope that they have both a minimum BAC for denial and only deny payment for reckless trauma. After all, it would be absurd to deny payment for a person injured in a commercial airplane crash landing or a bus crash due to any amount of BAC. It is just as absurd to penalize an inebriated person for the flu, a seizure, or meningitis. This article really doesn't do anyone any favors by leaving out so many details.
Seems to me, the point of the article is, insurers are just finding MORE ways to deny payments! The article says more and more ER's are not doing blood tests to determine if alcohol or drugs are in the patients system, so they make sure they get paid.
I've been in the mental health and substance abuse industry for the past 14 years. Help me out here...are you telling me that ERs can intentionally fail to ask about drug and alcohol use when people show up in the ER? Seems to me that this is fraud and/or malpractice at the very least. And we wonder why our healthcare system is broken. Trained medical professionals failing to do their job. Incredible.
Isn't there a "failure to diagnose" problem with avoiding warranted tests? Malpractice, indeed. How many unnecessary tests may be run if the doctor doesn't know which foreign substances are in a person's body? Will the insurance companies pay for the additional tests, or will they start saying "You should have tested for alcohol first"?
So, in the long term, if people know that insurances won't pay for alcohol and drug-related injuries, they will avoid the ERs that test for alcohol and drugs? Sign me up. Publish the list.
If I can go to an ER and not have to sit nearby while some dude vomits on his shoes or detoxes in the bathroom, I'm ready. I'll bet you that the line is shorter, the staff is friendlier, and that the facilities are in better shape.
ER's still give treatment, they just don't get paid! You will still have vomit in your shoes...
Jo - If you know that an ER WILL test for alcohol and drugs, wouldn't you avoid that ER and go to another hospital (where they won't test) if you were a chronic alcoholic?
Alcoholism is a disease, so I believe "they" would have every right to seek treatment. This article is about regular people having a few drinks and breaking a bone, no about alcoholics.
Jo - No argument about the disease of alcoholism. If you are an alcoholic and need treatment, I'm all for interventional or rehabilitative treatment. Also, interestingly, no argument about the "people having a few drinks and breaking a bone". The example in the article is absurd.
Was just pointing out that if some ERs screen and some don't, it will create an interesting situation where some ERs may be more inundated with repeat offenders while others may have a lighter burden because they will be avoided by the people who are concerned about alcohol and drug related injuries.
Which, in order to keep cosmic balance, will mean that I'll be commenting on MSNBC in a few years about the reasons for treatment disparity between ERs that test and those that don't.
Wholly,
Please, please, PLEASE stop that! Alcohol IS a drug. People just don't get it - anything that alters your state of mind is a drug! Crack alters your mind. So does cocaine, meth, herion, oxycotin and ALCOHOL.
Don't add to the confusion by saying "alcohol AND drug"; they are the SAME.
Sorry, Richard. Alcohol and other drugs testing.
Richard,
You left out caffeine and chocolate.
The article states that up to half the folks visiting the ER are under the influence of alcohol. A "teachable" moment??? How about soaring new profits for the medical insurance companies...??you can BET they'd love to deny HALF of all ER claims.
You KNOW it!
dlmmm,
How about having insurance that will pay for the ER by not drinking and doing stupid things that cause trips to an ER?
Now there is a teachable moment but people aren't willing to learn what works and what does not work. They just gotta have their drug of choice.
Richard, it is infinitely more complicated than that. Who (and how) is going to determine whether the alcohol or drugs in your system precipitated the incident that lead you to seek ER care? Quess what...nobody will need to..the insurance company's policy will just EXCLUDE any coverage because of the alcohol or drugs. IF you think this is the way the folks you pay your premiums to should be operating, I hope to heaven that you are never a drunk passenger in the back seat of a taxi cab that gets hit by something running a stop sign or celebrating your anniversary at home with a glass of champagne when you fall over with a heart attack.
dlmmm,
Me thinks who is at fault can be establilshed in your sceneriio.
But the point of this whole thing is this: people are whinning about being denied something but they just can't or don't give a damn when it's someone else; like a smoker perhaps. It ONLY matters when it impacts them. (I apologise for the pun.) That is my point. Deny one group but don't dare deny any other group! THAT is just plain bullsh!t.
To damn many lawyers getting involved with things like this and gumming up the works. If you need treatment, you should get treatment and if you have the right insurance to cover it, it should get paid for.
This isn't about lawyers, this is about MEGA Insurance companies, doing everything they can not to pay a claim!
And how do you think the insurance companies find all the loopholes and such to get out of paying that claim? Lawyers. There's too damn many lawyers. They suck.
Let me say first I disagree with this "exclusion" i feel it's nothing more than another "loophole" for health insurances to get out of paying for there customers health care,even though the customers are paying the premiums on them. That being said......if your going to exclude paying for people because they happen to be drinking when this happens and because it is a CHOICE....then how about exclusion for fat people??? or people that have been smoking cigarettes or marijuana for that matter because these are ALL CHOICES PEOPLE MAKE!!.......why is it ok and fair to discriminate against one group and not another????? this is the true HYPOCRISY....and it's a bunch of crap
derrick,
Why is it ok and fair to discriminate against smokers and not drinkers? In case you haven't heard a majority of voters drink but only a minority smoke. So like a schoolyard bully, they are going to pick on the weakest (read smallest group) because it won't cost the politicians very many votes.
And don't get me started on the idea that these very same politicians care about our health! That is the farthest from the truth. It's all about money. Each year every state gets a damn large amount of money from the MSA settlement and the politicians talked the American Medical Association into backing this by telling them of all the wonderful programs that will help people stop smoking. All the campaigns to prevent children from starting smoking that can be financed by a portion of this money.
Know what happened to all the money set aside for advertising, healthcare programs to stop smoking, campaigns to keep children from starting to smoke? Those very same politicians (read states attorney generals) wrote the agreement stating that a state "may set aside funds" and not "will set aside funds". Therefore a state may or may not provide money for these items! That way the politicians can legally steal any and all of the provided MSA funds and use it any way they want to. Not true? Well why did the California Medical Association try to get a proposition on the ballot for a tax increase on smokes? THEY stated the reason for their doing this was to raise money for programs to help people stop smoking! Sacramento kept all the money the state got and used it from their own agendas.
Just a little corporate whore media propaganda to precondition the citizen serfs to let them know what is coming. So now, the criminal empire partnership of the mega corporations, government, and money changers, will not even provide emergency medical care, let alone pay for it whether you have insurance or not. The legalese pretext for denying care & coverage matters little; today it may be alcohol, tomorrow because you consumed a donut; the bottom line is you will bow down to the fascist empire.
I went to the ER a couple of years ago...about 8AM on a Sunday..after being tripped by my cats (in hot pursuit of a mouse they'd brought into the house) After sitting in the waiting room until 4PM, I was finally seen and diagnosed with TWO broken ankles, 5 broken metatarsals and a large tear to the lateral meniscus of my left knee...please note that I said diagnosed not treated...the "treatment consisted of a moon boot for one foot, advice to see an orthopedist and questioning about how "much" I'd had to drink that day. (that I had spent sitting in agony in their waiting room) I would have been better off (including financially) at home getting drunk to dull the pain and kill the time until I could see an orthopedist the next day. I can not even describe how angry and insulted I was over the question on TOP of the lack of treatment and wait.
That is FUNNY!
Why not make alcohol,cigerettes, anything over 5mg sugar in it. illegal. Automobiles causes accidents, make automobiles illegal, make motor cycles illegal, If humans are the problem, make them illegal.(Oops we already have some of them in America.) Whatever is in favor of the lobbyist of the insurance companies.
Maybe we should work harder on making lobbyist illegals.
deb - you are seeing the reason why socialism erodes freedom. Yet so many never connect the dots.
What is also scary is that fearing a large emergency room bill DESTROYING the rest of their lives, the people just decide not to go for treatment at all.
This is a mostly alarmist story. "Up to half of the people who are treated at hospital emergency departments and trauma centers are under the influence of alcohol,..." What does that actually mean. It means almost nothing! In the example given, a woman in high heels breaking her leg, it is almost as likely that she could have fallen had she not been drinking.
Instead of not covering a person who has a blood alcohol level that would cause impairment, why not have a higher deductible for those situations.
Dale,
Means nothing? Get out from under your rock!
I thought alcoholism was a disease? Well no matter, the first illegal denied and dies - the family sues and the ER's are back treating everything.
So, is a surcharge going to be imposed on an obese person who refuses to change that bad behavior? No one is making that person over eat and not exercise! However, I see that there are a record number of surgeries for stomach stapling, bands, etc... Start making people who are having elective surgery pay out of pocket. Maybe they'll think twice about that second or third helping!
You and all your fellow judgmental Health Nazis can go take a flying leap! Yeah, it must be really painful to be as completely prudent and priggish as you. Maybe you should go to the ER and see if they can reduce the swelling of your head. Oh, that's right! You did it to yourself. So, looks like you'll have to pay up to. I'm sure you believe in eugenics, too. What goes around, comes around, and you'll find that out sooner or later.
My insurance doesn't pay for any weight loss treatments. Drugs, lap band surgery, nutrition classes, or weight management classes; however, they do pay for all issues extra weight causes.
If you are drunk or stones why should others pay for your "accident"?
Looks like you're "stones" yourself. I ain't paying.