Consider four scenarios:
• A middle-age woman is repeatedly brought by ambulance to her community emergency room because of alcoholic intoxication. Eventually, she develops liver failure due to cirrhosis and needs a liver transplant if she is to survive.
• A man weighs in excess of 450 pounds. As a consequence of his weight, he experiences diabetes, sleep apnea, disabling arthritis of his hips and knees and chronic heart failure. He is wheelchair-bound, oxygen-dependent and requires multiple in-patient admissions yearly.
• A young man, addicted to prescription narcotics, is transported to an emergency room because of overdosage. Later,he fails to keep outpatient appointments at a mental health clinic.
• A woman who smokes two packs of cigarettes a day requires repeated hospitalization to treat problems related to emphysema and chronic bronchitis. She must use oxygen continuously at home.