ACA Repeal/Replace: Progressives Face Moral Dilemma

[Bob Butler 54]

(08-17-2017, 04:57 PM)Warren Dew Wrote:

(08-17-2017, 07:35 AM)Bob Butler 54 Wrote: Just stumbled into a main stream press article favoring main stream medicine.  I figure we've had enough dissing of main stream medical that their case might best be made.  Anyway, CNN reports Choosing alternative cancer therapy doubles risk of death, study says, but it covers other concerns such as favorable life styles.

Leaving aside the bogus "logic" - of course your 5 year survival chance is better early on than it is later when you've already lived a few of those first 5 years - the point of diet and lifestyle is prevention of cancer, not treatment afterwards.  Yeah, Steve Jobs died because he tried to treat cancer with a vegetarian lifestyle.

However, there's a simple supplement which has been shown in randomized controlled trials to reduce cancer incidence by 77%.  You don't have to worry about survival chances if you don't get the cancer in the first place.

Here in the New England area more than elsewhere, I hear Tom Brady lauded as a champion of working to maintain health and fitness.  Eat avocado ice cream?  You can’t complain about his results.  However, most can’t match his intensity and commitment.

I’ve got a friend who complains that her breast hurts.  She’s eventually going to have a doctor look at it.  She’s also a heavy smoker who is afraid of syringes.  I think of her, alas, as a much more typical example of a human being than Tom Brady.  She doesn’t work anywhere near so hard on maintaining health and fitness.

Should we all be more like Tom, working hard to maintain our health?  Sure.  Yes.  Definitely.  Should we build a health care system designed for Tom or for ordinary folk?  I’d say ordinary folk.

Should you get some sort of discount on health care if you take really good care of yourself?  In principle, I’m open to it.  Maybe its a tax break, or maybe it is lower premiums.  The exact form it would take depends heavily on which of Kinser’s / PBS's four basic schemes you are working under.  If the discount is on the table, is some sort of penalty to be considered for doing stuff like playing NFL football?  Is the concussion related threat of brain damage to be considered in even Tom’s case?

And sure.  Preventative medicine is fine.  One of my prescriptions isn’t for a specific problem, but my doctor read a study saying people taking that pill live longer.  They have no clue why.  He’s also been pushing me towards a baby aspirin regimen.  People with thinner blood just have few strokes.  I’ve just had bleeding bowels in an earlier phase of life before I cut back on fat.  I’m dubious about thinner blood just now.

More of that sort of avocado ice cream stuff should be shared with all and done by all.

But no matter how much avocado ice cream he eats, Tom is eventually going to retire from the NFL.  You can change the odds.  You can put off the inevitable.  You can make health a high priority in your life style.  Fine.  (I’m tempted to say “You go girl!” but the gender is wrong.)  You can go that route no matter what health plan the country adopts.

But it just shifts the odds some.  Eventually you’ll suffer a trauma or a disease which is considered a pre existing condition.  Believing otherwise is a delusion.  If not you, a predictable percentage in your demographic will lose their bets of their health and fortunes and crap out.  Suddenly sharing risks and costs will seem attractive, and it would be up to the bulk of us to bail out the person who gambled and lost.

Sure.  We should all exercise more, eat less and eat avocado ice cream sort of stuff.  That’s true regardless of Kinser’s / PBS's four choices.  If you could suggest how to make it so, please do so.  Lots of folk both in and out of main stream medicine would applaud if you could do it.

But the basic question remains.  Do we design health care for the healthy and wealthy with economic values who are willing to gamble lives and fortune on the chance to save a buck?  Or are we concerned about health care, real people, you know, folks who live in the real world and need care.  If we bend over backwards for the healthy and wealthy gamblers, those less healthy and wealthy get thrown under the bus, and the healthy and wealthy gamblers end up under the bus too, eventually.  The basic question remains.  Are we looking to share risks and costs, or are we looking to give some a free ride which they ought to know will end eventually.