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

To: spiral3 who wrote (9504)	9/15/2009 7:31:02 AM
From: Lane3	Read Replies (1) \| Respond to of 42652

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. So, then, the claims made for prevention (IIRC the context of the discussion was diet with a bit of reckless behavior) would be more aptly made for early detection. That's a start. 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. A person with a healthier lifestyle will likely be healthier longer and incur less cost during most years. What I have been challenging is the notion that a healthier lifestyle somehow produces a lower lifetime cost. A person with a healthy lifestyle is less likely to have chronic problems or be afflicted by the lifestyle diseases. But that doesn't mean his chances of contracting a costly disease are less. If you live long enough and something else doesn't get you first, you will probably get cancer. Cancer is usually a costly disease. Heart disease may be a costly disease if you string it out for a few decades. But if you have a massive heart attack at 50 and die, it is pretty cheap. As for my certitude, the question on the table <g> was the certitude that prevention would save money. I challenged that. That certitude is mistaken and it is wrong to promote it so actively and glibly. Of that I am, indeed, certain. I have made no claims at all let alone with certitude about what the relative cost would be, only that it isn't the obvious slam dunk for prevention that is claimed. I take that back. I have made one claim and I don't think you can successfully challenge it. I claim that the lowest cost to the health care system is the guy who ignores his health utterly all his life and dies youngish and suddenly from trauma or a massive heart attack. Prevention in that case is a negative indicator. Proper prevention means less sick people, which means less expense. It’s not that complicated. It may or may not be complicated but, regardless, your assertion is unjustifiable. You are correct that at any one point in time, fewer sick people will reduce current cost, all other things being equal. But you need to demonstrate that over a lifetime that the healthy person won't incur the same or greater costs. You haven't done so. You are defending a feel-good meme about virtue having rewards and I have challenged it. 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. And that's why I haven't presented certitude about the relative cost. I know of no data on that so I have made no claims. the problem is in identifying the correct target group. So it's a problem of aggregation. Well, you could frame it that way, but in order to aggregate you have to test everybody so that little insight buys you nothing. You've expended the cost of testing regardless. 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. No, I didn't. Because the claim is being made for savings within the health care system and it was that claim I was challenging. You assume everyone is going to get horribly sick I assume that everyone is going to die of something and that the vast majority of those deaths will expend health care money, often outsized amounts of money. 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. That's pretty speculative and probably simplistic. Based on the commentary on this thread, there is a strong and active counter-direction and I see no indication that it derives from the healthiness of the lifestyle. 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. I never said that. I simply challenged the counter claim. Please feel free to present compelling evidence and argument if you can. The onus is on those making the claim, not those challenging it. 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. I see that you are still side-stepping the fact that the question I said was on the table was, in fact, on the table. The industry does not determine which questions are addressed on this thread. That is done by the participants, however competent or incompetent we are at choosing them.