Get out fatty!

It's been the Xordium and Castiel show on OCUK recently in every thread going at the moment, have you both been made redundant or something?

No, I work for myself these days. You will note I post in batches then disappear for day or hours. I post on here when my work is compiling.
 

You are not reading what Magnolia and I have both posted. It indigenous ethnic group in New Zealand where obesity is centred. That is very different from a South African man who is an immigrant.

Again you are arguing for something totally unfeasible. Either you individually assess someone and remove all known risks by a battery of tests that only a millionaire could afford, or you impose populations statistics that is good enough for every speciality in medicine. Or alternatively you pass the burden on to private healthcare providers who will then exclude people based upon those same populations statistics. This is what people do.

Go buy a house and get insurance to cover your wage should you become ill. They assess that on various known risk factors. History, lifestyle, etc.
 
You are not reading what Magnolia and I have both posted. It indigenous ethnic group in New Zealand where obesity is centred. That is very different from a South African man who is an immigrant.

Given that I have not made such a comparison, I fail to see the connection between what I have said and the fact that there is a huge indigenous obesity problem in NZ (which includes Whites btw)..perhaps they should concentrate on the social reasons for that.

Again you are arguing for something totally unfeasible. Either you individually assess someone and remove all known risks by a battery of tests that only a millionaire could afford, or you impose populations statistics that is good enough for every speciality in medicine. Or alternatively you pass the burden on to private healthcare providers who will then exclude people based upon those same populations statistics. This is what people do.

You are not reading what I am writing. I am not saying that the risks should not be considered, but that the groups at risk should be treated as any other applicant in a fair and equal way...as pointed out in the link I supplied. Tests are already carried out that would determine many of the risks, and there is already a system in place which considers the cost over a set period applied to statistical factors...this appears to have been ignored and the application has been denied solely on BMI..which you yourself have said it not a fair marker.

If it was totally unfeasible, why then are they already doing it? Medical reviews are already in place for individual with high risk factors...

1. In the case of acute medical conditions, there is a relatively high probably that the condition or group of conditions will require health services costing in excess of NZ$41,000.00 within a period of five years from the date the assessment is made; or
2. In the case of chronic recurring medical conditions, over the predicted course of the condition or group of conditions, there is a relatively high probability that the condition or group of conditions will require health services costing in excess of NZ$41,000.00; or
3. The Ministry of Education has determined that there is a relatively high probability that the applicant's physical, intellectual, sensory or behavioural condition or group of conditions would entitle them to Ongoing and Reviewable Resourcing Schemes (ORRS) funding; or
4. There is a relatively high probability that the applicant’s medical condition or group of conditions will require health services for which the current demand in New Zealand is not being met (irrespective of actual service costs).

It would seem that the INZ Officers may have ignored their own procedures, procedures that you say are prohibitively expensive, yet are already in place?

Immigration officers cannot automatically decline an application where an individual has failed the standard of health (in the opinion of the INZ medical assessor); they must consider all the circumstances of the applicant to decide whether or not they are compelling enough to justify an exception to INZ health policy being made.

The facts that immigration officers may take into account in their decision to grant a medical waiver include (but are not limited to) the following:

1. the objectives of Health requirements policy and the objectives of the policy or category under which the application has been made;
2. the degree to which the applicant would impose significant costs and/or demands on New Zealand's health or education services;
3. whether the applicant has immediate family lawfully and permanently resident in New Zealand and the circumstances and duration of that residence;
4. whether the applicant's potential contribution to New Zealand will be significant;
5. the length of intended stay (including whether a person proposes to enter New Zealand permanently or temporarily).

Are you seriously saying that in your medical opinion that this man would likely cost the NZ health system $41k over the next 5 years in the absence of any obesity related conditions at present or that he will has a high probability that he will develop such conditions within the annual time-scale of his eligibility assessment?...conditions which could be assessed quickly and easily by his GP at little cost to the individual (we do it in this country for Class 2 Licence applications etc regarding diabetes and other obesity related conditions conditions..the cost is around £100)..particularly as his visa is assessed annually so the costs would be very small if he was to be diagnosed with such in that annual time-scale, not to mention that it would be simple to trigger an assessment should he be diagnosed with a chronic condition likely to cost the Health Service more than the limitations currently set. Which is what happens in respect of Class 2 licensing for example.



Go buy a house and get insurance to cover your wage should you become ill. They assess that on various known risk factors. History, lifestyle, etc.

And no one is saying that they should not continue to so, but simply not do so in an unfairly prejudicial way. It is also not prohibitively expensive either in most cases unless you have a specific and very high risk factor of a specific disease..obesity is not a factor that would require someone to be a millionaire to afford PHS.

Some migrants who do not fit the criteria applied already are required to have PHS upon entering NZ, it should not be difficult to alter the eligibility of those on Annual Work Visas from countries without reciprocal health arrangements. It would then be up to the individual whether they wish to take that cost or not as part of their decision to enter NZ.
 
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Given that I have not made such a comparison, I fail to see the connection between what I have said and the fact that there is a huge indigenous obesity problem in NZ (which includes Whites btw)..perhaps they should concentrate on the social reasons for that.

Because you said should they kick out everyone who is overweight? Which is ironic considering the most overweight group is the one that the white shoved out of the way when they were immigrants.

As for the rest - you are asking for individual assessments - if you want a truly individual assessment then as I keep saying you have to rule out everything known for that person. Otherwise you just use populations statistics. Which is something you seem unhappy with. There is nothing to say they are just using solely weight to the exclusion of everything else. Nothing. We know they use age. Also a risk factor.

Let's say they know something else that is not printed in that article. Let's just imagine that they may - one even may suspect the bias of the report would not acknowledge this. How much of the $41000 do you think would be used if the chap went into renal failure or had heart disease over the 5 years - just say renal failure and ignore the rest - basic treatment no diagnostics or anything like that - what percentage.

I'll save you the time of googling to 500% it would use - yep just on one of those potentialities it would be gone in 1 year and that's ignoring everything else.

Now if I were an immigration official with more information available to me than what is detailed in that article I would say this bloke is a bad bet.
 
Because you said should they kick out everyone who is overweight? Which is ironic considering the most overweight group is the one that the white shoved out of the way when they were immigrants.

No I didn't, I was illustrating the unfairness of such an arbitrary application of data...not suggesting that they should actually kick out everyone.

As for the rest - you are asking for individual assessments - if you want a truly individual assessment then as I keep saying you have to rule out everything known for that person. Otherwise you just use populations statistics. Which is something you seem unhappy with. There is nothing to say they are just using solely weight to the exclusion of everything else. Nothing. We know they use age. Also a risk factor.

That is not what I was saying at all....just that the risk factors should trigger such assessments, not that they should be ignored or that all applicants should be assessed for everything. This is something that happens routinely in most developed countries already...there is no reason why it cannot be applied in this case either...especially given the relatively low cost of checking for diabetes or IGT etc.

Let's say they know something else that is not printed in that article. Let's just imagine that they may - one even may suspect the bias of the report would not acknowledge this. How much of the $41000 do you think would be used if the chap went into renal failure or had heart disease over the 5 years - just say renal failure and ignore the rest - basic treatment no diagnostics or anything like that - what percentage.

There is absolutely no evidence of that, and given that his application is assessed annually, would allow far less risk in that cost being applied.

I'll save you the time of googling to 500% it would use - yep just on one of those potentialities it would be gone in 1 year and that's ignoring everything else.

So someone with a BMI over 30 is 500% more likely to contract full blown diabetes or have a heart attack within a year when no evidence of the conditions are evident at time of assessment?

Do you have evidence of those statistics? As they contradict stats from Diabetes UK...which show far longer timescales for increased risks in those kind of ballpark figures and that it is highly dependent on the level of obesity and other factors such as overall health and diet.

Now if I were an immigration official with more information available to me than what is detailed in that article I would say this bloke is a bad bet.

Or that information may well indicate the opposite. And given the chaps weight loss of almost 20% since his initial application, this would show a significant decrease in his risk of developing such conditions. The simple fact of applying retrospective changes in application criteria is unfair in itself.
 
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No I didn't, I was illustrating the unfairness of such an arbitrary application of data...not suggesting that they should actually kick out everyone.

No it was not illustrating that at all because there is a difference between:

a) someone who is citizen of a country who has health needs the state is responsible for
b) an immigrant with health needs the state doesn't want to be responsoble for

...especially given the relatively low cost of checking for diabetes or IGT etc.

You have no evidence this hasn't been done or other things haven't been done. All you have is this sparse article that if it were in any other thread you'd be saying we aren't getting told the whole story.

Please don't tell me the assessment says: To apply for another year you have to answer this one question: Are you fat?

There is absolutely no evidence of that, and given that his application is assessed annually, would allow far less risk in that cost being applied.

As above.

So someone with a BMI over 30 is 500% more likely to contract full blown diabetes or have a heart attack within a year when no evidence of the conditions are evident at time of assessment?

Nowhere did I say that. You linked the $41000 over 5 years threshold. I made the point that would be used in one year just on treatment for one potential outcome.

Do you have evidence of those statistics? As they contradict stats from Diabetes UK...which show far longer timescales for increased risks in those kind of ballpark figures and that it is highly dependent on the level of obesity and other factors such as overall health and diet.

No because I never said that read the above comment.

Or that information may well indicate the opposite. And given the chaps weight loss of almost 20% since his initial application, this would show a significant decrease in his risk of developing such conditions. The simple fact of applying retrospective changes in application criteria is unfair in itself.

Or maybe just maybe there is more to this case than meets the eye. Great he's lost 20% of his weight but he is still 160kg.

Are you seriously saying that is not a potential burden on the health-care system. Because if you are saying that you are saying there are no health implications from being that frickin obese which is just plain crazy.
 
Rich countries just pay you gold to lose weight. Damn I've lost nearly 4kg in the last 2 weeks :(

MW

They should do something like everywhere, its a great idea.

Entry fee is £20 and if you can lose 10kg you get x gold / money / vouchers for sports gear or something

Losing 10kg (1.5 stone) would be very hard for me thought as I only weight 11.5 stone on a pretty big frame
 
No it was not illustrating that at all because there is a difference between:

Actually it was...I know what my intent was...and it has now been clarified if you had any confusion over it.

The two different groups you introduced do not impact on my statements as the indigenous population is not subject to immigration.

Interestingly though many of those citizens were once immigrants themselves however, or are second/third generation immigrants...particularly the only demographic who are actually increasing in incidences of obesity related illnesses, those of Asian ethnicity.

You have no evidence this hasn't been done or other things haven't been done. All you have is this sparse article that if it were in any other thread you'd be saying we aren't getting told the whole story.

It is not only based on that single article, however. Others have been posted including one which states they used BMI in at least one case and another which lists the criteria applied. We can only make an objective opinion on what we know, not what we do not...if other information comes available then that would impact how we approach it.

Please don't tell me the assessment says: To apply for another year you have to answer this one question: Are you fat?

No one said this and it has nothing to do with the relatively low cost of a medical assessment for the individual to check that risk over that period....this is routinely done at very small cost to the individual in this country for various criteria including Class 2 Licensing.

What appears to have happened, in the absence of other information, is that new criteria based on BMI has been applied as part of the overall health status of the applicant..this has been supported by another source given earlier. You yourself stated such criteria was a bad measure to use. Make you mind up, it is either one or the other.

Nowhere did I say that. You linked the $41000 over 5 years threshold. I made the point that would be used in one year just on treatment for one potential outcome.

Yes you did say that the 500% applied to a 1 year period in the absence of other factors.

The threshold is the current one, I am arguing that it would be simple to alter such thresholds to account for individual choice in how they fund their health provision within the current exceptions and waivers that are applicable...the links to such were given.

You stated that being obese made him 5 times more likely to contract diabetes in that annual period.....you have not given any supporting evidence for that...the only evidence I can find states similar outcomes but over significantly longer periods (10 years or more for people with a BMI over 35 rising significantly as their BMI increases).

And what actual practical risk is 5 times? What is the actual chance that you will contract such conditions in the absence of other criteria compared to someone with a normal BMI under 25?

And as you stated 500% was the consideration the INZ official used IGNORING other information and now you are trying to assume other undefined, unknown and assumed medical issues as reasons why he is being deported deported....earlier I mentioned Asians..who have a statistical 6 times greater chance than white people of contracting diabetes, would it also be fair to apply that criteria to them?

I would say not...which is my point..fairness in applying criteria based on risk...not that the risk doesn't exist. For example if a demographic shows increased risk, then simply test the individual on a periodic assessment timetable as part of their visa conditions, as stated this is not necessarily prohibitively expensive in the case of screening for Heart Disease or Diabetes or several other conditions which are commonly related to obesity...we do it for less than £100 in this country.

Also We have only the information at hand on which to base an objective opinion...you are attempting to introduce unknowns in order to force your own opinion without evidence to support it...I am quite happy to consider new information as it is given, and nothing in my statements contradicts that, in fact it supports the idea that an individuals personal criteria is or should be considered..something you have been arguing against and yet are now attempting to assume has already happened despite your earlier statements saying it was unfeasible.

The immigration official stated (according to the report):

An immigration spokesman said Mr Buitenhuis's application had been rejected because his obesity put him at "significant risk" of complications including diabetes, hypertension and heart disease.

Nowhere did it mention other factors other than his weight as being the reason why his application was rescinded even though he had the opportunity to defend there decision if there were.


Or maybe just maybe there is more to this case than meets the eye. Great he's lost 20% of his weight but he is still 160kg.

Your facts are off again...he weighed 160kg when his first and subsequent annual applications have been accepted....he currently weights 130kg and has had his application renewal rescinded despite this. He is a lower risk than previously, quite significantly so and therefore they have applied changes in his application retrospectively...which in itself is unfair,not only does it not allow him requisite time to conform to new criteria, it ignores his lower risk factors over time and his personal history...it is applying a criteria arbitrarily. I think that is unfair, particularly when done retrospectively and given the Immigrations official statement stating it was risk factors attributed to obesity rather than any specific criteria applicable to the individual.

Are you seriously saying that is not a potential burden on the health-care system. Because if you are saying that you are saying there are no health implications from being that frickin obese which is just plain crazy.

Clearly I am not saying that, I am saying that there are alternatives to deportation based solely on risk factors based on BMI and Obesity...and there are already procedures in place within the NZ immigration guidelines that allow for this, guidelines that it appears were ignored. I am also saying that the potential risk can be mitigated, both by the individual with lifestyle changes as defined as a condition of his renewed visa and/or through PHS provision.
 
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You are what you eat. Put the effort in to eat better and the results will speak for themselves. Anything else is just an excuse.

It isn't complicated, in fact it is the simplest thing in the world. Consume less calories than you use and you will lose excess fatty tissue.

Every other rationalisation is ******.

Nate

You quoted my post, but you apparently didn't read it.

Having re-read it, I suppose it does look a bit like a trap to catch the unwary reader, but that wasn't deliberate. I had casually assumed that people posting here wouldn't have a problem with reading all of a very short post, rather than reading half of one sentence from near the beginning of it. Apparently I was wrong, judging by both of the replies to my post.

I find it amusing that some people are so unable to understand something quite simple. Radical lifestyle changes and ignoring physiology are nowhere near as trivial as some people make them out to be.
 
An INZ spokesman said Buitenhuis was rejected because his obesity put him at "significant risk" of complications including diabetes, hypertension, heart disease, obstructive sleep apnoea, some cancers, premature joint disease, impaired glucose tolerance and an enlarged fatty liver.

He also had a long standing issue with a knee joint, which could cost up to $20,000 to replace.

"It is important that all migrants have an acceptable standard of health to minimise costs and demands on New Zealand's health services," he said.

The INZ spokesman said further investigations about applicants' health were triggered when they had a Body Mass Index (BMI) level of over 35. Buitenhuis has a BMI of over 40.

"Unless it is in the extreme, obesity will not in itself cause an applicant to fail health screening requirements, but INZ's medical assessors have to consider to what extent there might be indications of future high-cost and high-need demand for health services," the spokesman said.

So shock horror we didn't get the whole story especially the knee thing. His BMi caused him to get further evaluation it was on that he failed not a flippant disregard on a single criteria. Guess he forget to mention that one ... the potential $20000 surgery requirement.

So he not only is at all the risk conditions he has a knee problem that may prove very expensive that I am kind of guessing being very overweight is hardly going to help.

I wonder why they have made this decision (which is under review anyway). In fairness he seems like a motivated and hard working chap and kind of the mentality you would want from an immigrant. Not like a lot we get over here. (and a lot of the locals)

Aren't you supposed to be a doctor of some kind as well? :confused:

Pray tell what is exactly wrong with what you replied to there. I am intrigued.

He is 5 ft 9
He is 20 stone


That is not healthy no matter which way Castiel wants to spin it.
 
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So shock horror we didn't get the whole story especially the knee thing. His BMi caused him to get further evaluation it was on that he failed not a flippant disregard on a single criteria. Guess he forget to mention that one ... the potential $20000 surgery requirement.

Which is fine and what I was saying all along...you must admit that until now this information has not been presented and we can only go on what has been prior to this. I even stated they appear not to be following their own procedures..if they are, and the BMI is only there to trigger further screening then that would satisfy the criteria I have been presenting in this thread as fair, and what you stated was prohibitive and impractical.

Do you have the link to the further info?

So he not only is at all the risk conditions he has a knee problem that may prove very expensive that I am kind of guessing being very overweight is hardly going to help.

Indeed not, however I am still not convinced that retrospective application of new rules with regard current previously accepted immigrants is entirely fair, at least without giving them suitable time in which to comply with such criteria.

I wonder why they have made this decision (which is under review anyway). In fairness he seems like a motivated and hard working chap and kind of the mentality you would want from an immigrant. Not like a lot we get over here. (and a lot of the locals).

As I said, this is the first time this information has been presented, including the review. We can only objectively give an opinion on the facts as we know them..as and when new facts come to light then we can refine and alter our opinion to reflect that.

He is 5 ft 9
He is 20 stone


That is not healthy no matter which way Castiel wants to spin it.

It also doesn't automatically assume that he is unhealthy either, as the linked research has demonstrated.
 
It also doesn't automatically assume that he is unhealthy either, as the linked research has demonstrated.

So you are saying the "facts" you have presented would demonstrate that across populations a group of 20 stone 5 ft 9 in people would not be unhealthier than a group of 10 stone 5 ft 9 in people. Please don't tell me you think this.

As I am sure you'd never argue that then you come back to your assertion that it should be individually assessed on risk but the you come to a whole new ballgame as I've said before ... an expensive ballgame.

You move the burden of expectation of what can we expect for a population and then apply that to an individual as an expectation as a member of a population. Which is you'd do to treat. Towards. Ruling out risk facts by diagnostic test -you are then excluding risk factors in the individual. It's a different paradigm.

Can't blame the bloke for being flexible with the truth though I'd rather live in NZ than SA anyday.
 
It also doesn't automatically assume that he is unhealthy either, as the linked research has demonstrated.

See there is some merit to your arguments and evidence and you'd have some wiggle room on this argument if they were trying to kick out even a 15 stone man, but even if it were pure muscle there is no way to cut it so that 5 ft 9 and 280lbs is healthy, it's a strain on the entire body to carry that on such a frame.
 
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