Just wondering, would this qualify for people with Gigantism, or for people with bone problems like John Merrick's? Fibrodysplasia ossificans progressiva (FOP)? People who need extensive medical apparatus like ppv?

Their conditions would make them especially heavy...

There are amongst us people who are obese but who have a metabolic problem. Truly a metabolic dysfunction. These people eat very little but the weight just packs on. It is a small percentage, but there really are those for whom a "diet" will not work.

It is hard to be obese.

ohh...yes, yes they should. Then it'd be like flying first class...lol.

Seem to be the only one, but I have a problem with that before we get onto anything else.

Yeesh. People, get a healthcare reform already. They way you treat your sick is sick.

That aside, this is pretty much plain and simple BS. People without legs need extra help - gonna charge them for the lift into the ambulance? People in comas need extra care - gonna charge them over the odds for that?

And if that doesn't sway it for you, doesn't this run absolutely contrary to Truth, Freedom and the American Way? Essentially what is happening here is that The Government is telling people how much to weigh.

With all due respect, you really have no idea what you're talking about. It's that belief that makes it so easy for less kind people to view the obese as the last group to discriminate against. It's all a matter of choice right? WRONG!

I have always been very large and will always be very large. I was over 11Lbs when I was born. My mother fed me a very balanced diet and I spent every last minute possible outside playing, running and bicycling with my friends. I played football, was on the track team, wrestling team and marching band in high school. Yet, I was always the fat guy. I let myself go with overeating in my twenties (the munchies will do that to you) but still walked many, many miles every week. When I decided to get back into fighting shape I casually walked 20 miles a week, backcountry hiked another 20, biked at least 50, swam about 5, and was in the gym 6 days a week doing aerobic activity and hitting the weights hard, often twice in one day. I hit 240 and stayed there for months. I varied my routine, I reduced my caloric intake and thought "thin" thoughts. Didn't matter because my body was perfectly happy at that weight. I am 5'8" and I had a 44" waist but was way below the average for body fat. Yet I was still considered obese. I left that vigorous exercise routine years ago and have put on many pounds since then. Yes I dont get the activity I need and sometimes over eat, but I've proven that even with hard work and dedication and good health I will always be the fat guy.

I know many, many people who are way more lazy and eat lots of really crappy food yet are rail thin. I know somebody that drinks a Mt. Dew and smokes a cig the very first thing they do in the morning, eats donuts for breakfast and Hot Pockets for lunch and plays video games for hours a day, yet he weighs less than 150Lbs. When he has a related health problem and heaven forbid needs emergency care, should the emergency crew charge him more because of his real choices?

Now if I actually had a mental disorder or a eating disorder, like most truly grossly obese people have, would it still be my choice? Is it up to the emergency crew to determine that?

Yes, a lot of people who are fat are so because of bad choices, heck most fat people are that way because of poor choices. But the truly obese usually are just built that way or have some sort of mental problem that allows them to get that way and then traps them once they are there. I've already said it but I guess I'll just keep having to repeat it, saying that obesity is simply a matter of choice just shows gross ignorance. Before you make a statement like that again, please talk to some truly obese people, go to a support group, talk to a physician or psychiatrist who specializes in eating disorders.

I think big guys are hot! ;)

All of you! You know who you are... Do everything right, eat healthy and exersice and still be obese?

I don't buy it...

Look at your portion size of your Healthy Diet! 3 pounds of broccoli in one sitting is still 3 pounds.

If you have a 'condition' then go to a doctor and get the meds to fix it.

YES! IT IS A f**kING CHOICE!

At my adult peak physical condition my diet consisted mostly of one cup of brown rice, one chicken breast, one cup of broccoli, one dry salad, an orange, an apple and a banana a day and sometimes a smoothie on heavy workout days. I was 240 pounds, had body fat around 10% but I also had a 44" waist and since I am only 5'8" I was still considered grossly obese. I was at that weight for 3 months and even ate less to see if I could lose more. My Dr. said to stop because it was unhealthy. He said that although I was a large man I was still starving myself and if I kept pushing it I would be causing much more harm than good.

So to conform to your beliefs and standards and your idea that it's a choice I would have had to destroy my body.

Oh and I have a good friend that was recently diagnosed with schizophrenia. They are unemployed and therefore uninsured and can't afford their meds. I'll be sure to tell them that it was their choice to have their job eliminated and their choice to not be able to afford the meds for treatment.

F#CKING IGNORANT!

Seriously to everyone out there claiming that being obese is purely by choice....have you ever had to struggle to lose weight? And I'm not talking 5-10 lbs, have you ever been 50 lbs overweight and lost it? If you have then you can talk, to the rest of you who have never been overweight, who can eat what you like and not gain an ounce...I hope that one day your metabolism catches up with you. I was once young and skinny, I ate whatever I wanted and hardly excercised. Ten years and two kids later, I count every calorie I eat, I hit the gym and still no weight comes off. My doctor recently had my thyroid tested and it is underproductive. Not to the point where I need to take meds, but he said it may be contributing to my weight loss (or lack there of) issues. I've been trying to beef up on B vitamins since then and have noticed that I have had more energy, but the weight remains. Hopefully the vitamins will do the trick, just have to keep trying.

5'3" - 150lbs... the weight for my height is 130lbs; that's 20lbs over that I am still struggling to loose. I have hit a plateau at 148lbs and I travel, when I return from traveling, I am as heaving as 160lbs.

A funny story about that... my sister has hyperthyroidism which negates every effort she has made to maintain a stable healthy weight for her height. YES! She does takes meds and will continue to do so for the rest of her life...

She has lost weight...

I, on the other hand... do not... I exercise and count my calories... I am loosing the weight, SLOWLY which is what you are supposed to do...

This loosing weight thing, it's tough work. That's right, it is WORK.

1 pound = 3500 calories.

To loose 1 pound in one week, you have to BURN 500 calories A DAY!

THAT Is a LOT of work... but it's doable...

So.... The argument is that people shouldn't pay for the services they use, but that they should be absorbed by those not using the services?

I don't need special equipment or additional workers to move me, but the cost of an ambulance ride is going to be a little higher for me so that those who do need it don't have to pay for it?

I don't need a chest tube either (hypothetically) should I pay for that too? I don't need chemotherapy... I don't need skin graphs... I don't need an amputation. Should I share the burden on those too?

XS was considered a youth size and was, in many instances, cheaper than an adult S (some brands charged the same).

Hello, Mr. ContradictsHimself.

You open this paragraph with admitting that most people are responsible for getting fat, but then close it with claiming the opposite?

Of course there are exceptions to every rule, but the average person just does not become extremely fat by eating healthy and exercising. If someone is, then they have the CHOICE to see a doctor and a nutritionist and a dietician to determine the problem. I'd be laughed at if I refused to see a doc for a broken limb or appendage and then complained it was hurting or looked goofy - so if a person is genuinely living health but IS unhealthy, why not defer to professionals? That's why they are there, after all.

And while I normally try to avoid bringing anecdotal evidence into debates, since you started it I'll throw one out there - I've yet to see any person complete a rigorous summer fieldwork program without losing fat. Something about that whole calories in > calories out equation seems to ring true. If it didn't, I think it's pretty obvious there's a problem that should be brought to the doc's attention.

I think my frustration that more effort isn't put into ongoing healthcare and preventative care is starting to show.

Lol During my last stint in the field, this is the thought that kept me going when I was exhausted to the verge of tears. I would think, Man, this work blows right now, but burning around 5000 calories a day means I can have a strip of bacon with breakfast and STILL fit into my slim jeans when I get home!

In all seriousness, what is truly average? 50 years ago average isn't the same as today's average. We're basing our system on outdated methods.

All I'm saying is this; I think its mighty unfair that I or anyone else of my 'weight class' should be treated so horribly. Previous points have been made, What about people with gargantuan elephantiasis or people with hormonal imbalance issues that can't just be prescribed medicine and make them all better?

There are exceptions to every rule and not everyone fits into the cookie cutter lifestyle we so happily try to apply ourselves to. We are a changing time and have to accommodate for those changes. Not make people pay for things they cannot control. Not discriminate people for an illness or a birth defect they cannot control.

In short, this is just f**king bulls**t and another way for the government to make money off the suffering of others.

Unless you weigh in excess of 350 pounds, you aren't in this "weight class." Most overweight people aren't...this is a very select situation.

I'm confused. Are you saying that people with health problems should not have to pay for the medical treatment that they need? Who do you suggest foots the bill then? There is no discrimination in this so far as I can see. No one is saying that they are charging by the pound. There would be a lot of people who got off easier than me if that were the case. They aren't doing it to be mean. It isn't a "fat tax" to punish people. They are asking that if a person needs 8 workers to lift them, that they help pay for the additional people.

If EMSA didn't make money off of the suffering of others how would they make money?

*standing ovation*

I too, work very hard and the weight comes off slowly. I too, am at a plateau. I am just 20 pounds overweight.

It isn't easy. I make choices and trade offs every day. I am concious of everything I put in my mouth. I choose apples over apple pie, sugar free jello over a chocolate bar.

I measure EVERYTHING. I eat a true serving of what my meal is.

I work my body out hard and still in a year, I have only lost 30 lbs. I lowered my Trigycerides thru diet and exercise and I got off my BP medication.

It can be done.

I have picked up large patients. It takes extra people to handle the cot. Two people cannot lift a 700lb person. SO, you are taking another truck out of service to transport them.

WE, the poor people who go out and get them risk blowing out OUR backs trying to get them out of a house. And we are not rich, by any means, Haven. I made a mere 10 bucks an hr to be a paramedic full time.

I say it is fair.

I say you were underpaid, but I didn't mean "making money" in a "getting rich" sort of way. I only meant that people think it is shameful to take money from people with medical problems, but those are the only people EMSA deals with. Where else would the money come from?

They do make their money. But I can honestly see where charging extra is appropriate. Not all people use every piece of equipment on my squad. They don't get charged for it. It starts out as a base price and we charge for mileage.

After that:

If we have a full arrest and need back up and second squad shows up with two new pairs of hands.

If you are 20 yrs old and having chest pain, you get hooked up to cardiac monitor, which is 200.00

You get an IV. All my patients pretty much got IV's because the hospital was going to start them anyways.

Intubation, Oxygen, using the portable ventilator (to keep my hands free from squeezing the bag for you to breath every 12-15 seconds), and all the other stuff we use to help you in your time of need is charged as used.

I don't see this as any different. As I said, it takes extra hands and it is an extra risk to the people moving that person.

I used to cringe walking into houses sometimes. People were not bariatric cot heavy, but they were heavy enough. 300 lbs on my 200 pound cot divided by two people on squad is rough.

My back used to cramp up just looking at them. And I have had many back issues from all the lifting I did have to do. Proper body mechanics for lifting are pretty much thrown out the window in EMS.

People do not convieniently lie supine for you in an open area. They are wedged in small ackward places for the most part.

I do not miss my paramedic days. Neither does my back.