Growing gap between rich and poor sees decline in life expectancy for Americans
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Trancendental
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In a completely unrelated story, healthcare insurance company CEOs all receieved larger-then-normal bonuses.
fatherofcaitlyn
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How about piss poor diet and exercise habits?
Eating McDonald's for the last 40 years and lifting the TV remote as your only form of exercise for the last 20 years might shorten life expectancies.
Health Care is great for covering up issues that are caused by poor choices.
Eating McDonald's for the last 40 years and lifting the TV remote as your only form of exercise for the last 20 years might shorten life expectancies.
Health Care is great for covering up issues that are caused by poor choices.
Yeah, but at the same time poor choices are influenced by one's lot in life. If you're stuck working long hours for shit pay it's easy to get depressed, not work out, eat a ton of junk food, fast food etc.
Versus doing ok for yourself and being content and working out, eating well etc.
In the end of the day people have to have personal responsibility though. Life is what you make of it.
But I can see why the structure of society could help explain declining life expectancies among the poor population.
Versus doing ok for yourself and being content and working out, eating well etc.
In the end of the day people have to have personal responsibility though. Life is what you make of it.
But I can see why the structure of society could help explain declining life expectancies among the poor population.
[quote name='fatherofcaitlyn']How about piss poor diet and exercise habits?
Eating McDonald's for the last 40 years and lifting the TV remote as your only form of exercise for the last 20 years might shorten life expectancies.
Health Care is great for covering up issues that are caused by poor choices.[/QUOTE]
Medical expenses are about the same for someone who dies at 50 because of a heart attack and someone who lives to 80 being healthy.
Eating McDonald's for the last 40 years and lifting the TV remote as your only form of exercise for the last 20 years might shorten life expectancies.
Health Care is great for covering up issues that are caused by poor choices.[/QUOTE]
Medical expenses are about the same for someone who dies at 50 because of a heart attack and someone who lives to 80 being healthy.
If our health care system put the proper emphasis on preventative health care, a lot of these problems would be addressed. Most of our health care dollars are spent in treating acute illness which is far less efficient than spending a fraction of that in health care screening and prevention.
BigT
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Unfortunately, in many cases, PROPER preventative care is difficult and requires hard work and lifestyle modifications by the patient... I hate to sound cynical and jaded, but in many cases: good luck!
Sure you can keep pumping more glyburide, metformin, and insulin into a diabetic, but without proper lifestyle interventions, the process just delays the inevitable. Then there is the whole issue of drug compliance: hypertension is the silent killer because it generally carries no symptoms until it leads to heart failure, stroke, etc. down the road. However, meds for htn may cause side effects (ED with beta blockers, cough with ACE-I, etc.)... it's really hard to convince certain patients to take medications that have no concrete and immediate benefit but may have tangible side effects.
The US medical system and society just sucks at preventing chronic diseases. I wish I had the answers on how to combat this...
Sure you can keep pumping more glyburide, metformin, and insulin into a diabetic, but without proper lifestyle interventions, the process just delays the inevitable. Then there is the whole issue of drug compliance: hypertension is the silent killer because it generally carries no symptoms until it leads to heart failure, stroke, etc. down the road. However, meds for htn may cause side effects (ED with beta blockers, cough with ACE-I, etc.)... it's really hard to convince certain patients to take medications that have no concrete and immediate benefit but may have tangible side effects.
The US medical system and society just sucks at preventing chronic diseases. I wish I had the answers on how to combat this...
[quote name='BigT']Unfortunately, in many cases, PROPER preventative care is difficult and requires hard work and lifestyle modifications by the patient... I hate to sound cynical and jaded, but in many cases: good luck!
Sure you can keep pumping more glyburide, metformin, and insulin into a diabetic, but without proper lifestyle interventions, the process just delays the inevitable. Then there is the whole issue of drug compliance: hypertension is the silent killer because it generally carries no symptoms until it leads to heart failure, stroke, etc. down the road. However, meds for htn may cause side effects (ED with beta blockers, cough with ACE-I, etc.)... it's really hard to convince certain patients to take medications that have no concrete and immediate benefit but may have tangible side effects.
The US medical system and society just sucks at preventing chronic diseases. I wish I had the answers on how to combat this...[/QUOTE]
Hey you're a med student, you supposed to be still in the idealistic "healing the sick/save the world" phase
.
True, a big part is patient compliance but many patients have no incentive to see their primary care doctors. However, my radical view is that if the government were to institute any sort of health care coverage, the most effective and simplest use of tax payer dollars is to just cover the expenses for an annual physical for all Americans, but otherwise leave the private insurance system intact. Detect the problems early and treat them cheaply before they become bigger problems down the road. This saves on expenses by private insurers which in turn leads to lower premiums. Also a little malpractice tort reform wouldn't hurt either.
Sure you can keep pumping more glyburide, metformin, and insulin into a diabetic, but without proper lifestyle interventions, the process just delays the inevitable. Then there is the whole issue of drug compliance: hypertension is the silent killer because it generally carries no symptoms until it leads to heart failure, stroke, etc. down the road. However, meds for htn may cause side effects (ED with beta blockers, cough with ACE-I, etc.)... it's really hard to convince certain patients to take medications that have no concrete and immediate benefit but may have tangible side effects.
The US medical system and society just sucks at preventing chronic diseases. I wish I had the answers on how to combat this...[/QUOTE]
Hey you're a med student, you supposed to be still in the idealistic "healing the sick/save the world" phase
.True, a big part is patient compliance but many patients have no incentive to see their primary care doctors. However, my radical view is that if the government were to institute any sort of health care coverage, the most effective and simplest use of tax payer dollars is to just cover the expenses for an annual physical for all Americans, but otherwise leave the private insurance system intact. Detect the problems early and treat them cheaply before they become bigger problems down the road. This saves on expenses by private insurers which in turn leads to lower premiums. Also a little malpractice tort reform wouldn't hurt either.
pittpizza
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Let me ask you something BigT: What do you feel is the relationship between wealth and health?
Can the poor just not afford health? Work too many hours at a shit job to have time to hit the gym like a wealthy professional might during a 2 hour lunch break?
Maybe a big one is that they can't afford it b/c they rolled the dice and lost on health ins. Or perhaps it wasn't a gamble b/c they could never afford it even if it was at the top of their priority list?
You see, the liberal in me wants to believe that we as a society have the resources to give poor people good healthcare, yet at the same time, I'm a strong beleiver that a good diet and exercise is a recipe for health. Still, a good diet and exercise can be costly (both in finances and in time) so it muddies the waters.
Can the poor just not afford health? Work too many hours at a shit job to have time to hit the gym like a wealthy professional might during a 2 hour lunch break?
Maybe a big one is that they can't afford it b/c they rolled the dice and lost on health ins. Or perhaps it wasn't a gamble b/c they could never afford it even if it was at the top of their priority list?
You see, the liberal in me wants to believe that we as a society have the resources to give poor people good healthcare, yet at the same time, I'm a strong beleiver that a good diet and exercise is a recipe for health. Still, a good diet and exercise can be costly (both in finances and in time) so it muddies the waters.
BigT
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[quote name='dopa345']Hey you're a med student, you supposed to be still in the idealistic "healing the sick/save the world" phase .
True, a big part is patient compliance but many patients have no incentive to see their primary care doctors. However, my radical view is that if the government were to institute any sort of health care coverage, the most effective and simplest use of tax payer dollars is to just cover the expenses for an annual physical for all Americans, but otherwise leave the private insurance system intact. Detect the problems early and treat them cheaply before they become bigger problems down the road. This saves on expenses by private insurers which in turn leads to lower premiums. Also a little malpractice tort reform wouldn't hurt either.[/quote]
No, I'm a somewhat bitter and dysthymic underpaid and under-respected resident... I wish I still was a med student, especially a 4th year (easy schedule and don't care about much after interviews)! Although, I can assure you that outside of while writing my personal statement, I was never in the "healing the sick/save the world" phase.
You speak of catching problems early, and that is correct. But many people, even with free physicals probably wouldn't bother going. They feel otherwise fine, and unless they notice the sequelae of htn or diabetes down the road, they likely won't show up. A more basic mindset in society has to change... just go to any fast food joint or restaurant and you're almost guaranteed a >1200 Calorie meal. And realistically, what percentage of people really do any sort of exercise?
I'm probably pretty biased at this point, because 90% of what I see is inpatients (save for 1 afternoon/wk clinics). But, once people have developed disease states we're pretty decent at stabilizing them and delaying their effects, but most of our treatments amount to bandages placed on a flawed base... but then again changing people's behavior is very difficult.
...so aside from some rich west-side hypochondriac, most people really wouldn't have much incentive to see primary care even if it were free: people go to see the dentist for cleaning and the optometrist for contacts/lenses fitting because they derive a tangible and immediate benefit from these services... a routine visit to the primary care doc usually does not provide this.
.True, a big part is patient compliance but many patients have no incentive to see their primary care doctors. However, my radical view is that if the government were to institute any sort of health care coverage, the most effective and simplest use of tax payer dollars is to just cover the expenses for an annual physical for all Americans, but otherwise leave the private insurance system intact. Detect the problems early and treat them cheaply before they become bigger problems down the road. This saves on expenses by private insurers which in turn leads to lower premiums. Also a little malpractice tort reform wouldn't hurt either.[/quote]
No, I'm a somewhat bitter and dysthymic underpaid and under-respected resident
... I wish I still was a med student, especially a 4th year (easy schedule and don't care about much after interviews)! Although, I can assure you that outside of while writing my personal statement, I was never in the "healing the sick/save the world" phase.You speak of catching problems early, and that is correct. But many people, even with free physicals probably wouldn't bother going. They feel otherwise fine, and unless they notice the sequelae of htn or diabetes down the road, they likely won't show up. A more basic mindset in society has to change... just go to any fast food joint or restaurant and you're almost guaranteed a >1200 Calorie meal. And realistically, what percentage of people really do any sort of exercise?
I'm probably pretty biased at this point, because 90% of what I see is inpatients (save for 1 afternoon/wk clinics). But, once people have developed disease states we're pretty decent at stabilizing them and delaying their effects, but most of our treatments amount to bandages placed on a flawed base... but then again changing people's behavior is very difficult.
...so aside from some rich west-side hypochondriac, most people really wouldn't have much incentive to see primary care even if it were free: people go to see the dentist for cleaning and the optometrist for contacts/lenses fitting because they derive a tangible and immediate benefit from these services... a routine visit to the primary care doc usually does not provide this.
BigT
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[quote name='pittpizza']Let me ask you something BigT: What do you feel is the relationship between wealth and health? [/quote]
It's more complex than it would seem and difficult to study because of intrinsic and extrinsic confounders.
Health insurance is great for catastrophic events (some diseases come on just because of bad luck) and for basic health screening visits. But on average, I would submit to you that a person with no insurance who takes care of his/her health through the basics (diet and exercise) would do better than a person who has insurance and does not take care of himself/herself.
It is a complex relationship. And some studies have shown that poor whites have a higher life expectancy that rich whites (I'd assume that they are less sedantary and probably eat less): http://www.medicalnewstoday.com/articles/51741.php
I would assume that typically the people who carry out studies on healthcare's impact on society are usually within the medical system and may be biased to overestimate our "positive" impact... I'm more of a cynic and pessimist...
It's more complex than it would seem and difficult to study because of intrinsic and extrinsic confounders.
Lot's of wealthy professionals also work long hours at pretty sedentary jobs. Resident physicians work ~80 hrs/wk with 1 day off throughout residency (usually mid to late 20s). Then when they get a job, they often need to put in pretty significant hours afterwards, depending on the field and type of job. I'm sure many lawyers and those in business also put in long hours with similar stress levels. Plus, I would imagine that the diet of a rich person in the USA is unlikely to be healthier than that of a poor person (in fact they may end up eating more Calories while frequenting restaurants more often).
Health insurance is great for catastrophic events (some diseases come on just because of bad luck) and for basic health screening visits. But on average, I would submit to you that a person with no insurance who takes care of his/her health through the basics (diet and exercise) would do better than a person who has insurance and does not take care of himself/herself.
It is a complex relationship. And some studies have shown that poor whites have a higher life expectancy that rich whites (I'd assume that they are less sedantary and probably eat less): http://www.medicalnewstoday.com/articles/51741.php
I would assume that typically the people who carry out studies on healthcare's impact on society are usually within the medical system and may be biased to overestimate our "positive" impact... I'm more of a cynic and pessimist...
I think it should start with educating people when they're young. Schools should stop giving out such garbage food for lunch. I remember being in high school and seeing other kids eat a bag of chips and have some soda for lunch. P.E. should also probably be made made longer.
bread's done