Monday, October 26, 2009

One Size Doesn't Fit All . . .

Thanks to loyal reader, good friend I've never met and fellow GBer, Jen, I got to read this article today.

The article, if you don't want to read the whole thing, is about the idea that the obese could/should be charged more for emergency medical care because of their size and the added challenges to serving the obese in the field.

I'm about to say something "controversial" . . . I totally agree that the obese should be charged more for ambulance care NOT as a way to punish them or to discourage obesity or to improve profit margins for medical providers but, more importantly, because fair is simply fair.

When I first went to work for IBM and we moved to Connecticut I went to Rochester Big and Tall on my first day trip on to the island of Manhattan. I was a size 68 suit and a 22x36 dress shirt. I wanted a new suit for my new job. And I almost dropped $1,438 on a Ralph Lauren suit (before taxes, alterations and whatever other fees found their way on to my tab). I thought better of it. I went home and got online. The same suit for a size 42 regular was only (ONLY?!?!) $1,125. $300 cheaper. And WHY? Perhaps (just perhaps) because of the four or five square feet of fabric that Mr. Lauren saved between the two suits. PERHAPS it was because if you are silly enough to spend over $1,000 on a suit the rest of it is all just pops and buzzes. MORE likely it is because they wanted me to pay a premium as a morbidly obese man to have access to designer clothes in an upscale store on the island of Manhattan even thought it was technically the same suit.

Apply the same general rule/attitude to ambulance service. It is not just a stretcher - it is a stretcher that has to be stronger and bigger. It is not just a hoist in to the "truck" - it is hoisting a bigger load in to the "truck" - it is not just medical experts doing their job - it is medical experts doing their job in an already confined space while working around a larger patient.

This is not, to be clear, the same thing as the post a few months ago where the guy suggested the obese person go to the ZOO for an x-ray (that was just medical ignorance on their part). This is not, for the record, the same thing as mandating the obese buy an extra seat on the plane even if the plane is not at capacity. This is not, obviously enough, the same thing as saying that hospitals MUST make surgical gowns bigger so that my large, large butt is not exposed as I patter down the hallway after my gastric bypass surgery (that, to be clear, is why God gave us sweatpants and/or two gowns you can wear in opposite directions).

Nope. This is more about the idea that we obese folks have to pay more sometimes for the "same" things that our skinnier friends, family and fellow humans get at standard pricing.

Besides - if you are in medical crisis and need an ambulance does it really matter how much it costs to get you out of harm's way and to medical safety anyway? ESPECIALLY if you are obese?! I say charge me a premium but make sure that the gurney will hold me, the EMTs can adequately serve me and the ambulance can drive fast, fast, fast when I need it to.

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