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PaperclipPerfector  6mo ago (text post)   25610 thread views

Culture War Roundup for the week of May 20, 2024

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Americans have a lower life expanctancy than Costa Ricans, Thai people and Chileans. The US and China have roughly the same life expectancy.

Yep.

Most medical interventions don't matter that much for people without lifestyle disorders. Skin cancer, for example, collectively only takes 9 days off U.S. life expectancy. So if we CURED skin cancer it doesn't move the needle. Rinse and repeat with a bunch of other diseases.

On the other hand, the existence of diabetes likely lowers U.S. life expectancy by years, and that's with all the treatment. Did you know that 1% of the U.S. budget is spent on dialysis and the average 40 year dialysis patient only lives 8 years?

All in all, we spend like $5 trillion a year just to undo all the damage from our lifestyle diseases. It's pretty sick.

The crazy pill is that most medical interventions don't matter that much for lifestyle disorders, either, because for the most part, they can't undo the damage from our lifestyle diseases. I was just listening to this podcast with a couple MDs, and he was talking about chronic conditions generally, and a bit about obesity, specifically:

We don't really have the infrastructure to help with prevention, so you talked about how in medical school, we didn't have a single course on dying. We also didn't have a single course on nutrition or exercise or stress management or the psychology of eating and our relationship to food and how you can help patients make better choices with nutrition and things like that, so I don't buy the narrative that we have an obesity crisis just because people are fat, dumb, and lazy. I think that we live in a toxic food environment, and we don't have a healthcare system that's really geared to help people out of it, because frankly, physicians aren't compensated to do that. You just don't have the billable structure in which you can do these things, so instead, I think we focus on where our tools are, and our tools are drugs. Drugs become a good tool to use in a chronic condition setting.

Moreover, they often have patients who don't want to change their disordered lifestyle and wouldn't carry through with doing it even if the doctor had training and a billable way of doing it. So, they sort of default to, "When the chickens come home to roost, I guess we'll give you a drug to help manage your symptoms somewhat."

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