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The Amish health care system

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Re: The Amish health care system

#311

Post by peter_d_sherman »

grandmczeb wrote: post #136
peter_d_sherman wrote: post #130

In general, the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable, such as vitamins, minerals, fruits, vegetables, natural herbs and plants, etc. They could even do double-blind studies on things that are not ingestable, like sunlight, doing enough exercise, getting enough rest, etc., etc. But will they, ever? No they will not. That's because th…

> the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable But... they do? Pretty much everything you mentioned is well studied, although a lot of times it’s hard to get conclusive evidence when the effect size is small.

Why are those things not prescribed then?

Why are only pills, pills with which pharmaceutical companies (and usually doctors, via commission payments) make money, prescribed, and nothing else?

Maybe it's not the Doctors' fault however.

Perhaps the mindset was taught to them via most Medical Colleges and Universities, who accept large amounts of money from big pharma to teach that prevailing, patented-pharmaceutical-drug-centered mindset... and perhaps it was regulated into them by well-meaning, yet exclusionary and limiting government regulations...

I hold Doctors harmless... but they could prescribe less man-made products for profit, and more that are made by nature for free, or pretty close to free...

Re: The Amish health care system

#312

Post by OrderlyTiamat »

MaxBarraclough wrote: post #262
OrderlyTiamat wrote: post #235

Earlier quoted context omitted.

Both obesity in the "english" group and the healthier lifestyle of the amish group are discussed by Scott in this article.

No, they aren't. The article makes no mention of obesity, and does not discuss the Amish's healthier lifestyle. Unless I'm missing something here? Do please be specific if I am. I'm seeing a single relevant sentence: > As far as I can tell, most of the secret is spending your whole life outside doing strenuous agricultural labor, plus being at a tech level two centuries too early for fast food. If that's what counts…

I think you're right, but I'd slightly disagree.

Of course you point does stand, and diet and obesity are important topics to discuss, and perhaps scot should have gone into (a lot) more detail. But that is not to say that every article should focus on those, it seems to me that having articles focussing on these issued as well is not a problem.

Like you said, more than a sentence should be spent on diet.

Perhaps you and I wouldn't be having this discussion if at the top Scot had given a disclaimer that he's only focussing on this one side of the situation and neglecting the other side for the purposes of discussion.

Re: The Amish health care system

#313

Post by grandmczeb »

peter_d_sherman wrote: post #311
grandmczeb wrote: post #136

Earlier quoted context omitted.

> the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable But... they do? Pretty much everything you mentioned is well studied, although a lot of times it’s hard to get conclusive evidence when the effect size is small.

Why are those things not prescribed then? Why are only pills, pills with which pharmaceutical companies (and usually doctors, via commission payments) make money, prescribed, and nothing else? Maybe it's not the Doctors' fault however. Perhaps the mindset was taught to them via most Medical Colleges and Universities, who accept large amounts of money from big pharma to teach that prevailing, patented-pharmaceutical-d…

Because prescribing them doesn’t improve people’s health very much.

Re: The Amish health care system

#314

Post by wan23 »

arkades wrote: post #270
pasquinelli wrote: post #164

Earlier quoted context omitted.

So what's up then? Or if you can't say what's up -- fair enough, you're not an oracle -- what slight scrutiny in particular topples this particular root cause hypothesis?

The primary issues - root cause - of our systemic faults lie in approximately three places: 1. We are fractured. There is no "healthcare system." That's a singular noun. We have a marketplace: that means things like three top-tier specialty centers in walking distance of each other in some areas, and nothing at all in others. About 90% of our problems derive from this. As do a number of our strengths (if you're in Bo…

The healthcare system in the US isn't a marketplace either. For markets to function you have to know how much something will cost before you buy it, and you have to be able to make decisions based on cost. For most Americans, health pricing is a black box indirected by hospitals and insurance companies. And good luck getting an ambulance to take you to a cheaper hospital in an emergency.

Re: The Amish health care system

#315

Post by peter_d_sherman »

grandmczeb wrote: post #313
peter_d_sherman wrote: post #311

Earlier quoted context omitted.

Why are those things not prescribed then? Why are only pills, pills with which pharmaceutical companies (and usually doctors, via commission payments) make money, prescribed, and nothing else? Maybe it's not the Doctors' fault however. Perhaps the mindset was taught to them via most Medical Colleges and Universities, who accept large amounts of money from big pharma to teach that prevailing, patented-pharmaceutical-d…

Because prescribing them doesn’t improve people’s health very much.

How would this be known, without conducting double-blind studies?

Re: The Amish health care system

#316

Post by philwelch »

austhrow743 wrote: post #186
erentz wrote: post #154

Earlier quoted context omitted.

M4A gives everyone, rich or poor, the same base standard of coverage. And if you want coverage for other things that aren’t included under Medicare then you can get supplemental private insurance for it. That’s absolutely not outlawed.

If that's the case then they really screwed up with the term "single payer", and a lot of Bernie's own supporters were wrong. Lot of crap all over reddit about ending private insurance for the last year.

It’s not the case, but it’s apparently still not worth engaging with the Bros.

Re: The Amish health care system

#317

Post by cmendel »

swiley wrote: post #310
cmendel wrote: post #192

Earlier quoted context omitted.

My apologies, I didn't mean to come off harshly, it's approx 3 am here so I'm not exactly a ball of sunshine. Do doc's need to spend 4 years doing an undergrad before med school? Maybe. There are a lot of things that you need to learn before you can learn what you need to be a doctor. Do you need to know physics? Eh, only kind of. I'm not terribly familiar with the system in the UK, but at least where I went to schoo…

If it's anything like CS there's maybe a couple of semesters of applicable material and a bunch of filler to extract money for the university.

Good news! It's not anything like CS.

Things you need to learn, not an inclusive list, before med school: Chemistry, drug interactions, A&P, Ethics, Statistics, Maths, and Biology.

That's (6, 2, 1, 2, 3, 4) 18 courses minimum. Remembering that they have to be done sequentially rather than concurrently and you're looking at, bare minimum, 2 years rather than 2 semesters.

This is as it should be. To bring it back to your CS example, if you are making a web app and you fail to secure your attack surface, the worst that happens is that folks get their info stolen. If you fail to do your drug interaction math correctly, people die.

Re: The Amish health care system

#318

Post by grandmczeb »

peter_d_sherman wrote: post #315
grandmczeb wrote: post #313

Earlier quoted context omitted.

Because prescribing them doesn’t improve people’s health very much.

How would this be known, without conducting double-blind studies?

Again, pretty much everything you mentioned has been studied quite a bit. Yes, even with double blind studies (e.g. [1] to pick one at complete random). Some of the things you mentioned (diet, exercise, sleep) literally have entire subfields of medicine devoted to them.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514135/

Re: The Amish health care system

#319

Post by iguy »

andruby wrote: post #213
iguy wrote: post #203

Earlier quoted context omitted.

Right, this difference of scale is enormous. Back when hospitals couldn't do that much, and were not far from being hotels with better hygiene & worse food, then how to pay for them wasn't such a hard problem. But now US healthcare is 17% of GDP (if I recall correctly) and this proportion rises with GPD, unsurprisingly, as more other needs are already met. It isn't going to go down. Pensions are in a way similar. Whe…

You say it won't come down, but that's because the US is in it's own ballgame. In most other advanced western country healthcare "only" accounts for 7~11% of GDP. The chart on [0] is incredible. I also shows how much that percentage has grown over the last 45 years. [0] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... [1] Source data OECD: https://stats.oecd.org/Index.aspx?DataSetCode=SHA

I agree it's higher, and while some of this is waste, some of the higher proportion is explained by the US being richer.

Whether it will come down, I guess that's partly a forecasting guess. Will the healthcare sector be a smaller part of the economy in 10, 20 years? Employ fewer people? I would be extremely surprised if this happened in any advanced country.

Re: The Amish health care system

#320

Post by bmelton »

pmiller2 wrote: post #306
bmelton wrote: post #305

Earlier quoted context omitted.

I'm not pushing a spin at all. I care approximately zero about the current healthcare debate or its future direction. I think my initial statement was apolitical and factual. If it's being interpreted otherwise, that's by inference, not implication. But to the point of why people might be wondering about changes to their healthcare policies, well, perhaps it's because they've been listening to the politicians. If fol…

Mischaracterizing M4A as a policy is what I'm considering "right wing spin," not "reputably sourced facts and direct quotes." Yours are exactly the words I would expect to hear from scaremongers in Washington telling people M4A "takes your freedom of choice away." If you can go to any doctor or medical facility and have your coverage accepted, and also have as much supplemental coverage as you want, again, how is tha…

> Mischaracterizing M4A as a policy

I did not do that

> Yours are exactly the words I would expect to hear from scaremongers

I quote the author and it's scaremongering? Yeah, count me out of this conversation altogether. You've uncharitably interpreted what I'm saying, and are doubling down on the sort of rhetoric I explicitly stated having no interest in.

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