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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (9502)	9/14/2009 9:18:21 PM
From: spiral3	1 Recommendation Read Replies (1) \| Respond to of 42652

I was just trying to explain the economics of living longer to counter the flaw in the assumption that prevention saves money. Yes you were trying to do that but failed miserably imo. That flaw only shows up because your entire concept of prevention is flawed. A colonoscopy or similar screening is not going to prevent you from getting sick so what you’re actually talking about is not prevention, but early detection. Despite what the medical industrial complex wants you to believe, these two are not the same thing. Take a shot at my assertion if you like. Explain how the lifetime health-care costs for someone who lives longer before eventually dying would be less, if you can. Firstly, I'm saying its a longer term possibility, and not an unreasonable one. I admit to perhaps lacking your degree of certitude but do you honestly think in general, that someone who has pursued a healthy lifestyle is not going to be a healthier person, that the chances of them getting a costly disease is less. Would you rather be the 60 year old guy who eats right and exercises, or the slob who goes for a colonoscopy every few years. I’d say the chances of them getting sick are quite different. Because they might not have been tested adequately, you are failing to distinguish early detection from the much much much lower cost preventative interventions that can be made through diet, exercise. For ex. exactly which drug co is going to fund the study comparing the effectiveness of their high bp product against proper preventative measures. Proper prevention means less sick people, which means less expense. It’s not that complicated. By far, and this is documented in the CBO report you mentioned in one of your posts, the most cost effective way of reducing costs or best value is delivered through prevention, the problem is in identifying the correct target group. So it's a problem of aggregation. And it's only a problem if you’re calling early detection, prevention. Proper prevention works for almost everybody, it scales exceptionally well, with low costs. The fact is that the chronic diseases that are costing us so much money, indeed crippling us in more ways than one, are not our genetic destiny, so your idea that sooner or later one is bound to get cancer if something else doesn’t get you, is baloney. Of course someone who has gorged themselves silly on trash for the past 50 years is going to get sick. Of course we tend to break down as we get older, but your idea of this expensive inevitability is not written in stone. Japan for ex. has a much older population than we do, yet they live much longer, apparently in better health. Their health costs are probably half of ours. It’s been suggested that diet is perhaps the distinguishing feature, compared to other nations. I think you underestimate the savings possible through long term lifestyle modification. I don’t think you necessarily understand or explained or accounted for the serious financial impact of the true cost of chronic disease in the US. Nearly three quarters of our health care costs are related to chronic diseases that for the most part are very responsive to inexpensive lifestyle modifications. So anything that can cut this down a good percentage, and yes I believe that proper prevention can significantly reduce diabetes, obesity, CAD and cancer, is important. I'm not saying that every single case of these diseases is caused by one's lifestyle, but it is massively relevant when it comes to saving costs on a national level. In addition one thing you definitely did not take account of is the current cost to the US economy of lost productivity because so many people are sick. This is probably around equal to the costs of the healthcare itself. You can wish them away or ignore them, but these are real costs and should be counted. Put those numbers into play and your no net benefit idea starts to look mighty shaky. You assume everyone is going to get horribly sick, I’m not that fatalistic, I’m willing to admit a wider spectrum of experience or possibilities, especially if such a person has followed a healthy lifestyle all their life. Perhaps you’ve been living in such a sick society or have been so entranced by the disease care model for so long that you’ve forgotten that it’s possible to die healthy. If such a more healthy person were to get horribly sick in their seventies say, they are not going to last that long, compared to someone who gets diabetes in their teens or their twenties and who lives with it for 40 or 50 years. That is going to cost a lot of money. We are not going to let them die young. That is reality. People who’ve looked after themselves are also imo less likely to opt for an expensive alienating medicalized setting when it’s their time to depart. Possibly driving down end of life costs. I think that over time more and more people are going to choose this option. If you still believe proper prevention is incapable of securing better, less expensive outcomes, or that the carrying costs of a healthy population are higher than an unhealthy one, I would like to see the quality of your evidence or at least a coherent argument beyond what you’ve advanced so far. But don't try to tell me that the question on the table is irrelevant just because it's not the question you'd prefer. In case you never noticed, the medical industry does not ever go for the lowest costs, anything above that, involves doing something, so it's not a matter of which question I prefer, it's a case of what actually happens and how your prior chosen frame corresponds.