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Our main problem in health policy is overemphasis on medicine (2007)

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Re: Our main problem in health policy is overemphasis on medicine (2007)

#51

Post by lambdaba »

gahn wrote: post #46
lambdaba wrote: post #27

Earlier quoted context omitted.

I am only replying to your incendiary comment to say that your characterization is insulting and wrong, "fucking keto diet"(s) are having results for many people, whether you like it or not Others, please research this person further, he's not a "loon" / "crackpot" just a regular smart young person who also happens to be a cancer researcher. BTW, keto also cures epilepsy, and that's known since the early 20th century…

Had to login just to counter the epilepsy part of this comment, though I think it applies to the rest of the topic wrt cancer as well. Keto diets can, in some cases, help epilepsy patients, particularly those with certain seizure types or genetic basis. But, like with cancer, epilepsy is complicated both in presentation and cause and to pretend that keto is any way a cure for epilepsy outside of a small minority of p…

It sometimes is enough, sometimes not. But it does have SOME undisputed efficacy and it's an area of legitimate research.

Re: Our main problem in health policy is overemphasis on medicine (2007)

#52

Post by lambdaba »

gahn wrote: post #50
lambdaba wrote: post #14

Earlier quoted context omitted.

But those "fit, healthy" (the genuinely so, I'm not sure I even agree with the characterization for many of the mediatized cases), are OUTLIERS. Yes, you are never invincible, but it's 100% correct to characterize Covid as a disease of the metabolically dysfunctional. Sadly, this is a HUGE percentage of the population of the world nowadays, which seems to be the point of the article (disclaimer: in true HN tradition,…

What lifestyle diseases are you thinking of that are commonly treated with immunosuppressants? Diseases like psoriasis and rheumatoid arthritis are commonly treated with immunosuppressants and are not considered lifestyle diseases.

these both OFTEN have dietary triggers that are possible to discover with certain elimination diets

again, I'm not here to go on long arguments while being called a loon, which I'm bound to when touching this subject

sticking closer to home, tldr; I had MS, treated it with an elimination diet and other lifestyle changes, barring this intervention, I'd be on immunosuppressants

but I didn't intend to make this the larger part of my argument, as the main issue is with people facing blood sugar control problems brought on by "extremely western" (sugar|processed|junk)-food-laden diets

Re: Our main problem in health policy is overemphasis on medicine (2007)

#53

Post by nradov »

colinmhayes wrote: post #34

This is why we need medical payments to be capitated, not fee for service. The way medical care currently works has horrible incentives. Medical providers have an incredible informational advantage so patients just do whatever their doctor tells them. Since doctors get paid for doing things they routinely tell people to do things that are proven to have little efficacy. Medical providers should instead be paid per pa…

The healthcare industry is gradually shifting from a fee-for-service model to a value-based-care model. This will take a long and we'll probably always have a hybrid model with varying levels of financial risk spread across insurers, providers, patients, and government.

As an incremental step forward bundled payments are a good approach. For common interventions like a hip replacement the insurer gives the provider a single lump sum for everything instead of having separate line items for surgery, anesthesia, medical device, antibiotics, hospital stay, physical therapy, etc.

Re: Our main problem in health policy is overemphasis on medicine (2007)

#54

Post by lambdaba »

tsimionescu wrote: post #45
lambdaba wrote: post #42

Earlier quoted context omitted.

What's noteworthy is *vascular* health is particularly important, thus chronically-elevated blood sugar which is *eminently* resolvable by lifestyle intervention, is the main culprit. So I don't follow your comment.

Jumping from vascular health to blood sugar level is a non-sequitur. There are many other aspects of vascular health. And nothing is easy about a lifestyle intervention, it is in fact one of the hardest and least likely to hold kinds of medical treatment.

chronically-elevated blood sugar is quite probably the #1 cause of vascular problems (heck, it's highest association is with hypertension, these go hand in hand), hypertension is itself often associated with a common magnesium deficiency (stiffness is what happens when magnesium is insufficient and calcium is overexpressed, I mean this is the basic role of magnesium in the cell, "relaxing" the contraction brought on by calcium), this is schematic and a layman view but I believe basically correct

Re: Our main problem in health policy is overemphasis on medicine (2007)

#55

Post by clairity »

colinmhayes wrote: post #37
michaelbuckbee wrote: post #35

Earlier quoted context omitted.

This is tricky to implement as it introduces other perverse incentives: namely that health care providers stop treating very sick people. You see this in some cases with surgeons already that have a very high success rate. They'll only opt for surgery if it's a relatively minor need, but if it's complicated or there are potentially complicating issues they'll pass.

Outcomes for very sick people being worse is taken into account so providers aren't punished if their success rate is lower for those patients. We have all the data we need to know what the outcomes should be for a provider over the course of a year. Anyway, providers have to precommit to their pool of patients, so it's not like they can just pick the lucky ones. Capitation is admittedly a much more complicated way t…

you're not fixing the distortive incentives with this scheme, just transforming them. 'capitation' incentivizes hoarding of patients, most obviously by incentivizing the minimization of treatment times and associated costs but also through outright fraud (by falsifying records, etc.). so you're essentially trying to maximize patient outcomes by capping costs, which is a terrible proxy metric all around.

to actually improve healthcare, we'd need to increase spending per person (by an order of magnitude or more, using more team-based medical care rather than 1-on-1), for not only direct care costs, but also research and development. what we absolutely need none of is deadweight losses, like profit-maximizing medical administration, big pharma, and the whole medical insurance industry. medical 'insurance' has become a complete misnomer, as it no longer serves to mitigate the distasterous effects of low probability, high impact events, but as a socialization of routine medical care, which is not insurance at all.

Re: Our main problem in health policy is overemphasis on medicine (2007)

#56

Post by lambdaba »

NoPie wrote: post #22
paulpauper wrote: post #17

A lot of $ is spent on medicine because medicine works. Alternatives such as diet, exercise either are spotty in efficacy or do not work. Medicine offers a quick fix and in some cases the only fix. Someone who has cancer will need to be treated with medicine, not diet.

Diet and exercise will work much better to prevent obesity than any medicine on market. It is just that long-term adherence to these things is very much determined by culture and will be much harder for Americans compared to Japanese, for example. There are new discoveries in diabetes medicines recently but again, you will do much better by not getting diabetes in the first place. The same goes for smoking which can…

I mean, it's not complicated, when we allowed the tobacco industry to manipulate people for profits while hiding the disastrous health consequence of their products, people got ill in larger numbers

It's the same for the processed food industry. It's time will come, soon, too, as healthcare systems everywhere are failing because of it.

Re: Our main problem in health policy is overemphasis on medicine (2007)

#57

Post by astrange »

NoPie wrote: post #22
paulpauper wrote: post #17

A lot of $ is spent on medicine because medicine works. Alternatives such as diet, exercise either are spotty in efficacy or do not work. Medicine offers a quick fix and in some cases the only fix. Someone who has cancer will need to be treated with medicine, not diet.

Diet and exercise will work much better to prevent obesity than any medicine on market. It is just that long-term adherence to these things is very much determined by culture and will be much harder for Americans compared to Japanese, for example. There are new discoveries in diabetes medicines recently but again, you will do much better by not getting diabetes in the first place. The same goes for smoking which can…

Not "diet and exercise", just diet. Exercise doesn't contribute more than ~10% to weight loss (it helps for many other things but not that) - and if you're having trouble with the diet then it makes it more difficult because you get hungry, which sometimes cancels the entire thing out.

Re: Our main problem in health policy is overemphasis on medicine (2007)

#58

Post by danachow »

lambdaba wrote: post #51
gahn wrote: post #46

Earlier quoted context omitted.

Had to login just to counter the epilepsy part of this comment, though I think it applies to the rest of the topic wrt cancer as well. Keto diets can, in some cases, help epilepsy patients, particularly those with certain seizure types or genetic basis. But, like with cancer, epilepsy is complicated both in presentation and cause and to pretend that keto is any way a cure for epilepsy outside of a small minority of p…

It sometimes is enough, sometimes not. But it does have SOME undisputed efficacy and it's an area of legitimate research.

Lol "sometimes is enough, sometimes not" is a bit of a backpedal from definitively putting cancer into remission.

If it's an area of legitimate research for cancer treatment, then why do you lead with a reference to an individual crackpot - instead of even a poorly designed peer-reviewed study in a low impact forum.

Of the millions of possibilities, why do you assume that it was the keto diet of this individual that lead to their remission? Do you lack the imagination that it would likely be something else?

Re: Our main problem in health policy is overemphasis on medicine (2007)

#59

Post by [deleted] »

lambdaba wrote: post #32
danachow wrote: post #26

Earlier quoted context omitted.

> and this is someone working in the medical field Well, yes, even a crackpot can claim to be working in the field. This in no way supports your claim of “routine” cures through diet. There is no evidence that a fucking keto diet will cure cancer* and it doesn’t pass any sniff test as at the end of the day your body still runs on glucose. This is pretty much an insult to anyone not fortunate enough for their cancer t…

Third point, and I'm going to end it here: I myself suffered from Multiple Sclerosis when I was younger; it was retrospectively very easy to correlate, at least in a large part, with diet and lifestyle. The changes I had to make to be in remission were DRAMATIC but worth it. I don't think I would've been insulted to read about people in similar situations experiencing remission from lifestyle adjustments, in fact, I…

[deleted]

Re: Our main problem in health policy is overemphasis on medicine (2007)

#60

Post by lambdaba »

danachow wrote: post #58
lambdaba wrote: post #51

Earlier quoted context omitted.

It sometimes is enough, sometimes not. But it does have SOME undisputed efficacy and it's an area of legitimate research.

Lol "sometimes is enough, sometimes not" is a bit of a backpedal from definitively putting cancer into remission. If it's an area of legitimate research for cancer treatment, then why do you lead with a reference to an individual crackpot - instead of even a poorly designed peer-reviewed study in a low impact forum. Of the millions of possibilities, why do you assume that it was the keto diet of this individual that…

I was referring to epilepsy.

I will not get into further arguments with you re: the "crackpot", insult. Have a nice day.

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