The profession which claims, “first do no harm”, has weighed in on controversial issues surrounding health care.

A survey of British physicians has revealed a paradigm shift in how medicine views patient responsibility.

“Lifestyle rationing” has become a way of qualifying patient care.

Health care budgets hit by rising costs and a huge increase in preventable chronic illness is reaching it’s limit.

The survey by doctors.net.uk, which claims nearly 192,000 members, found that 593, or 54 percent, of the 1,096 doctors who participated answered yes to this question: “Should the NHS be allowed to refuse non-emergency treatments to patients unless they lose weight or stop smoking?”

Doctors who approved gave a few examples, The Observer said:
Denying in-vitro fertilization to childless women who smoke was justified because the procedure was only half as successful for them as for non-smokers.
Obese or alcoholic patients should be expected to change their behaviors before undergoing liver transplant surgery.

White, elderly, women with private health insurance are spending the most health care dollars, the federal government reported.

$2.6 trillion the nation spent on health care in 2010 translated into just over $8,400 per person.

But that is not the whole story.

A different study just released by a separate federal agency shows that second number doesn’t actually mean very much.

Specifically, in 2009, just 1 percent of the non-institutionalized population accounted for 21.8 percent of all U.S. health spending. And just 5 percent accounted for half the total spending.

Meanwhile, the bottom half of the population accounted for a mere 2.9 percent of total health spending in 2009.

More Americans want to repeal the new health care law than to keep it.

Americans have weighed in and the Obama health care is not popular with the majority.

A Gallup survey of more than 1,000 U.S. adults found that 47 percent favor the repeal of healthcare reform, versus 42 percent who want the law kept in place. Eleven percent had no opinion.

But the survey also showed that 50 percent of Americans believe the federal government has a responsibility to make sure everyone has health coverage, compared with 46 percent who do not.

The results, which have a 4 percentage point margin of error, suggest a sharply divided U.S. public as the Supreme Court prepares to begin hearing legal arguments next March from 26 states and an independent business group that want the law struck down as unconstitutional.

Conversations doctors don’t want to have include the end of options for the terminally ill.

Whether it’s lack of training or cultural resistance to discuss death and dying there are huge gaps in patient care at the end of life.

In this country, we tiptoe around the D-word until so late in the game that even now, when more than 40 percent of Americans die under hospice care, about half do so within two weeks of admission. Even expert hospice teams can’t provide many of the elements of a good death — and they believe there is such a thing — in mere days.

We can blame some of this evasiveness on physicians, trained to save lives. But families bear some responsibility, too; they may not seek or seem to welcome a frank assessment. Either way, while many patients do have breakpoint conversations, ignorance often rules.

Ill Americans are not getting the care they need.

In a country with the most sophisticated health care system many often forgo care in lieu of taking care of other expenses.

“Despite spending far more on health care than any other country, the United States practically stands alone when it comes to people with illness or chronic conditions having difficulty affording health care and paying medical bills,” Commonwealth Fund president Karen Davis said in a statement.

“This is a clear indication of the urgent need for Affordable Care Act reforms geared toward improving coverage and controlling health care costs.”