“Preventative medicine” is a broad term.”

Absolutely. Some methods of which would (a) cost money, (b) some would save money, and (c ) some would save money *with cooperation only*.

I suppose the core of my objection is that (b) is entirely offset by (a), and history shows that (c ) just doesn’t happen.

The main areas these results would be visible are diabetes (clearly tied to food choices), heart disease (clearly tied to food choices and stress), cancer (clearly tied to inflammation, often caused or compounded by food, stress or environmental toxins), and hypertenstion (clearly tied to food and stress). This, of course, doesn’t cover all of our diseases, but it covers the biggest costs in our health care system and the biggest room for improvement.

Let me quibble not with that assessment per se, but with your perspective on that assessment.

I agree completely that those four “bad boys” you’ve listed represent huge costs and all are lifestyle related; and with the exception of cancer, successful treatment for all are clearly defined by today’s state of medical science.

The biggest costs in our health care system are caused by aging. You are probably aware that 80% of our health care costs are consumed by senior citizens, or thereabouts. So, any discussion about our ability to abrogate those costs has to also include the *age* of the patient. Put another way, we are not being bankrupted by fat diabetic type-A 20-somethings; we are being bankrupted by senior citizens (who may also be fat and diabetic) who are past the age where lifestyle changes are going to have much impact on what health care costs they consume.

So, any discussion of the positive cost benefits of preventative medicine must be tempered with the understanding that even a fully successful emphasis on preventative will not save money in the 2020–2040 timeframe, but perhaps in the 2060–2080 timeframe.

What I propose is that it is the role of business to generate profits, it is the role of the government to assess long-term goals and create policies that help business profit by moving society toward those goals.

I agree in principle with that, although I would jump off that wagon if the burden government places on business in the process of moving to those goals is egregious.

These subsidies don’t force choices on anybody, but they help create a situation where the cheapest, easiest food choices are the unhealthiest ones.

You’re preaching to the choir on this one.

For people living paycheck to paycheck (half of America), whether to eat healthy or unhealthy isn’t a choice. That low cost isn’t honest though, nor are company profits. It’s profitable because the companies don’t have to pay the cost of mitigating environmental damage or health damage. That’s left to taxpayers.

Ehh……. I have to disagree. If you want to eat cheap in America, the cheapest way to eat is to be primarily a vegetarian who uses chicken as their primary protein source three days a week. A family can be well, healthily, and CHEAPLY fed using sacks of potatoes, vegetables, legumes, and chicken.

The core of the problem is that we (poor or rich) choose not to. We choose to spend our money on packaged foods for the sake of convenience (which is where the high fructose corn syrup and sodium problem comes in) and because our kids whine if they don’t get sweets or McDonalds.

My point is that the government can and should adjust the system to account for these realities and incentivize businesses to make healthier products. This shouldn’t be done through restricting choices, but by using our economic system encourage healthier ones (by adjusting our subsidy system, taxes or tax credits for food producers, etc.).

Hmmm. I would love to get rid of all ag subsidies, it should be said. But get rid of corn subsidies, you’re not just attacking the high fructose corn syrup problem, you’re attacking corn itself, which today is a relatively inexpensive and relatively healthy vegetable choice.

So, I really don’t see how you use incentives to get where you’re going. The packaged food problem needs to either be direct or ignored; you have to tell packagers “sorry, you can’t put that damn corn syrup in your products anymore”. And if you do, you have to deal with the fact that Archer Daniels Midland gets probably some stupidly high percentage of its profits from the production of that shit, and they know how to hire lobbyists.

The goal of the system should be to cease our policies which favor unhealthy lifestyles and to shift them to favor healthy lifestyles.

I guess “easier said than done” is where I am on all this.

The most cost-effective place to create change is in kids and young adults, who are currently learning awful habits (from our policies) which will have to be unlearned later, if we’re to keep them away from chronic disease.

The culprit’s the parents who teach bad eating habits to their kids. Consider the possibility that this is not an economic problem, but a sociological one; bad food is hard-wired not just into an economy, but a culture; and we as parents reproduce that culture from generation to generation, sometimes out of ignorance, but sometimes because it’s just the easy way out. (It’s easier to stop at McDonalds for dinner than cook, after all.)

Undoing the policies that do this, along with evening out the prices of healthy vs. unhealthy products can create a situation where healthy choices are as easy as unhealthy ones. That type of a change can pay huge dividends.

Well, as I’ve already mentioned, eating healthy is cheaper than eating crappy. So…..I don’t know how we mess with the prices to fix that.

This is creating a habit of rushing through meals as fast as possible. Habits like this will make it hard for him to properly deal with stress.

I completely agree on this matter.

He is learning habits around food that make him far more likely to develop chronic disease when he’s older.

Yea, but see above. The trash-can analysis of what happened when we actually did start feeding the kids in school better shows that it’s not the school teaching the kids to eat bad, it’s the parents.

When he gets to high school, there will be soda machines in the hallways,

We can agree on this one too. But you have to admit, we’re nibbling around the edges, here, as far as the larger problem is concerned.

If the health-care system was non-profit, with a strong motivation to improve health and lower costs, creating policies that encourage healthy products and lifestyles becomes an obvious priority.

I can tell you from travelling the world that the health care system being profit or nonprofit has nothing to do with this. People all over the developed world have the same issues; the reason why they are the worst in the US is because (compared to Europe) we don’t walk (or bike) to our destinations nearly as much or as far, and the reason for THAT is (a) the structure of our cities, and (b) our climate is substantially warmer.

Another example? Let’s use India. I lived there a year. Like all developing nations, India has a long cultural history with and affinity for sweet bakery products, the types of which they have been baking for hundreds, if not thousands, of years.

So, the cultural “addiction” to sugar is already there. But that wasn’t a problem in India traditionally, because if there’s one thing Indians do is WALK. It was/is not unusual (or considered difficult) to walk miles to work or school and back again. And they do so in a nation which is (most of the time) bitchin’ HOT.

Well, the last two decades have brought change. Now, everyone (it seems) is putting around on motorbikes and small cars. What now happens?

Now, imported packaged foods in India are stupidly expensive, and Indian packaged foods rarely have the quantity of high fructose corn syrup that ours does. Nor do they subsidize “bad agriculture” like we do.

Conclusion? The solution to our disease problems does not lie in “preventative medicine” or “changing the way we eat” as much as it lies in “changing how we live our lives”, meaning our activity levels.

Here’s what else your son is learning to do in school: He’s learning that life is about getting out of bed, getting into a motor vehicle, then plopping his behind into a chair for eight hours, punctuated only by short walks to the potty and to lunch. When he’s an adult, he will likely get out of bed, get into a motor vehicle, then plop his behind into a chair for eight hours in his job.

We agree on the health problems we face; we do not agree on the solutions. I am in favor of reasonable changes in the way we do school, regulate the nutrition of our packaged products, etc; I do not believe for a moment that any of that does any more than nibble around the edges of our health problems.

As for the timeframe, I’d love to implement the Green New Deal by 2050, but that isn’t an option. The science gives us a ten-year window on climate change.

Then we’re dead; may as well learn to accept it.

Why? Because it’s a planetary problem based on gross quantities of pollutants for which the US is not the primary contributor. (We are the primary contributor on a per capita basis, but that’s just statistics.)

The core of the problem is that you have three billion Chinese and Indians who want to live like the Americans they see on TV. So, if you want to address climate change, you have to tell three billion people that they must continue to live in relative poverty compared to Americans. (That’s a bad look, considering the racism angle, eh?)

But, bottom line is that it’s not going to happen. So, we have to live (or die) with the reality of that.

The same is true with the medical system. We’ve known for most than a decade that the current system will not be able to handle the mass retirement of the baby boomers. We’ll have less workers supporting more Medicare recipients. Many (or most) of those workers will have student loan debt and poor paying jobs. We’ve chosen to ignore that reality for the past decade. The boomers will be retiring en masse over the next fifteen years.

Well, I’m 64, and “we’ve” been talking about this issue for my entire adult life. But capitalism can handle this part; more and more workers will choose the health care system for careers, because that’s where the jobs will be — — and even today, those jobs are NOT “poor paying”. The med tech who is taking your blood after your annual checkup, who is low person on the health care totem pole, is making 25–50K based on experience……and all they needed was six months of community college courses to get the education he or she needed.

Kids today are expected to be the first generation since the Dark Ages to live shorter lifespans than their parents. Changes in lifestyle are needed right now, in drastically different ways than we’re currently doing it.

Again, we agree on the problem statement. We disagree on the solution.

Costs of cleaning up the environment are usually presented as costs with no benefits beyond aesthetics and morality. My point is only that these costs would have some benefits to the health care system as well.

Agree here too.

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Data Driven Econophile. Muslim, USA born. Been “woke” 2x: 1st, when I realized the world isn’t fair; 2nd, when I realized the “woke” people are full of shit.

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