4 ms·

Curious if there's been any accounting on the long term impact in terms of cost on the healthcare system. On the one hand, obesity is associated with many othe

Curious if there's been any accounting on the long term impact in terms of cost on the healthcare system. On the one hand, obesity is associated with many other ailments such as heart disease, diabetes, etc. that cost the system a lot of money. On the other hand, well, longer life spans impacting Social Security, Medicare, etc.

swyx 2y ago
??? how is cost on the healthcare system the thing to be worried about over longer lifespan and quality of life? strange thing to focus on lol but i think if you think it thru, 1 should dominate 2, and 2 should be reduced as well.
- CalRobert 2y ago
  People who need to ensure these programs are well funded definitely need to consider it.
- freedomben 2y ago
  Are you prepared to make the doctors work for free?
- rowanG077 2y ago
  Because it's literally a large chunk of the economy? Why wouldn't you worry about that. I certainly don't like to see a society where the young are enslaved by the old to pay for their medical treatment.
- AmericanChopper 2y ago
  Health care costs is how individual people’s terrible lifestyle decisions end up impacting everybody else. If somebody wants to live some awful unhealthy lifestyle it really should be their own choice to do so. Except for the fact that it drives up everybody’s insurance premiums, and in countries where the government either partially or entirely subsidises healthcare costs, it gives the government an outright moral mandate to start nannying everybody’s health choices. If somebody wants to live an obese lifestyle, I really think that’s up to them. But I’d be much happier about it if it didn’t cost me so much money.
  - rickbutton 2y ago
    Do you think addicts should receive treatment? Do you think that people who make bad decisions deserve to live? Do you extract the exact amount of value from society relative to the amount you put in, or do you take more than you give? Are you sure? Please explain. Your perspective is frankly disgusting. I hope you don't have any vices. The point of a society is to pool resources together to improve the collective. Different people in different positions of power and ability have different needs. Hopefully you don't personally have any power to exclude people from that group. I hope that the powers that be don't decide that you deserve less for some reason.
    - AmericanChopper 2y ago
      I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin. But yes, I do think addicts should receive treatment, just as I think obese patients should (and do) receive treatment for all the diseases they end up with. But addicts, like the obese, impose many of the costs of their own bad life decisions onto others. It’s what you’d call a negative externality, and if some magic treatment came along to fix drug addiction, I would also be very happy to see that negative externality addressed.
      - rickbutton 2y ago
        > I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin. Your opinion is that of a petulant child. Many years of research has shown that obesity is not this simple. Many chemical processes take place that influence one's ability to make better health choices, and many external factors put constraints on those choices as well. This is the exact same thing as hard drugs. Being obese is not a moral failing. When you say things like this, you show your true colors. You are not extending humanity to obese people, and it is very obvious. I sincerely hope you reconsider your opinions. I hope you don't have any obese people in your life, or at least hope they don't read these messages. I think they would be disappointed to hear what you think of them. And again, I hope you don't have any vices and are the perfect model of health, otherwise this would be a quite silly opinion to have. EDIT: I've been rated limited on comments so I'll post my last response here instead: I have nothing further to say to this other than that you should consider talking to someone about your clearly deep-seated hatred for those who don't fit your model of participant in society; it doesn't seem healthy. Find an obese friend and show them your comments and watch their face as they read them. I wonder if you will find the humanity in their response that you are lacking here.
- CharlieDigital 2y ago
  I mean, I'm contributing to the Social Security system here so I'd like to know how it's going to impact my long term retirement. There's nothing malicious about it; purely a question of accounting and math.
selectodude 2y ago
We can probably just extrapolate the numbers from people quitting smoking.
rickbutton 2y ago
I wrote a few paragraphs of response to this assuming that you are implying that there is a level of death/disease that is acceptable because treating it would not be cost-effective, but I deleted it because it would be uncharitable to assume you think that. It would be interesting to see this information, but would not be useful to act on. If the answer was "it costs more to keep more people alive" (hint: it does, that is why we let so many die of preventable illness), should we keep less people alive and healthy? The pursuit of economic growth at all costs is a disease far more dangerous than anything you would treat in a hospital.
crmd 2y ago
In my view, the sole focus of the healthcare system should be maximizing human wellbeing. Humanity’s GDP is around $100 trillion per year. There is plenty of money for healthcare with many orders of magnitude to spare for other endeavors. Bean counting here feels like Google in the early ‘00s proposing to make office supply expense reduction a business priority.
- JumpCrisscross 2y ago
  > is plenty of money with many orders of magnitude to spare Putting infinite value on anything is a great way to incentivise a system that delivers little to none of it.
  - rickbutton 2y ago
    There should certainly be measurements taken, costs considered, alternatives approached when building our healthcare system. No one has ever implied otherwise, ever. To imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part. What is the point of building an economy at all if not to improve the lives of the population? Opinions in this thread already seem to be that "people are healthy enough, and if not, it is due to their own choices" rather than "we should carefully consider how to optimize this system for efficiency" while focusing on the actual goal of improving lives for the average person as well as those who need more healthcare.
    - JumpCrisscross 2y ago
      > imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part No it's not. Every doctor triages. And every medical system has internal cost limits, whether implicit or implict, universal or variable, past which it will not treat. Sometimes that's enforced by gatekeeping entire categories of treatments; in other cases we have patients individually reviewed, e.g. for organ transplants. If managing obesity is less expensive than treating it, there is a legitimate question around how the cost of that treatment should be split between the public and the individual. (Whether that cost be an explicit split or gatekeeping the treatment to only the most morbidly obese.) Thankfully, that's not the case--treating obesity, even chronically with super-expensive drugs, is still cheaper than the status quo.
JumpCrisscross 2y ago
> Curious if there's been any accounting on the long term impact in terms of cost on the healthcare system Savings on the order of $100bn per year [1]. > longer life spans impacting Social Security, Medicare, etc. An obese person dying early may well wind up costing the system more than a healthy person dying old. (Most medical costs are incurred terminally. The obese have more-complicated terminal paths.) [1] https://healthpolicy.usc.edu/research/benefits-of-medicare-coverage-for-weight-loss-drugs/ https://healthpolicy.usc.edu/research/benefits-of-medicare-c...

swyx 2y ago

??? how is cost on the healthcare system the thing to be worried about over longer lifespan and quality of life? strange thing to focus on lol but i think if you think it thru, 1 should dominate 2, and 2 should be reduced as well.

CalRobert 2y ago
People who need to ensure these programs are well funded definitely need to consider it.
freedomben 2y ago
Are you prepared to make the doctors work for free?
rowanG077 2y ago
Because it's literally a large chunk of the economy? Why wouldn't you worry about that. I certainly don't like to see a society where the young are enslaved by the old to pay for their medical treatment.
AmericanChopper 2y ago
Health care costs is how individual people’s terrible lifestyle decisions end up impacting everybody else. If somebody wants to live some awful unhealthy lifestyle it really should be their own choice to do so. Except for the fact that it drives up everybody’s insurance premiums, and in countries where the government either partially or entirely subsidises healthcare costs, it gives the government an outright moral mandate to start nannying everybody’s health choices. If somebody wants to live an obese lifestyle, I really think that’s up to them. But I’d be much happier about it if it didn’t cost me so much money.
- rickbutton 2y ago
  Do you think addicts should receive treatment? Do you think that people who make bad decisions deserve to live? Do you extract the exact amount of value from society relative to the amount you put in, or do you take more than you give? Are you sure? Please explain. Your perspective is frankly disgusting. I hope you don't have any vices. The point of a society is to pool resources together to improve the collective. Different people in different positions of power and ability have different needs. Hopefully you don't personally have any power to exclude people from that group. I hope that the powers that be don't decide that you deserve less for some reason.
  - AmericanChopper 2y ago
    I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin. But yes, I do think addicts should receive treatment, just as I think obese patients should (and do) receive treatment for all the diseases they end up with. But addicts, like the obese, impose many of the costs of their own bad life decisions onto others. It’s what you’d call a negative externality, and if some magic treatment came along to fix drug addiction, I would also be very happy to see that negative externality addressed.
    - rickbutton 2y ago
      > I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin. Your opinion is that of a petulant child. Many years of research has shown that obesity is not this simple. Many chemical processes take place that influence one's ability to make better health choices, and many external factors put constraints on those choices as well. This is the exact same thing as hard drugs. Being obese is not a moral failing. When you say things like this, you show your true colors. You are not extending humanity to obese people, and it is very obvious. I sincerely hope you reconsider your opinions. I hope you don't have any obese people in your life, or at least hope they don't read these messages. I think they would be disappointed to hear what you think of them. And again, I hope you don't have any vices and are the perfect model of health, otherwise this would be a quite silly opinion to have. EDIT: I've been rated limited on comments so I'll post my last response here instead: I have nothing further to say to this other than that you should consider talking to someone about your clearly deep-seated hatred for those who don't fit your model of participant in society; it doesn't seem healthy. Find an obese friend and show them your comments and watch their face as they read them. I wonder if you will find the humanity in their response that you are lacking here.
CharlieDigital 2y ago
I mean, I'm contributing to the Social Security system here so I'd like to know how it's going to impact my long term retirement. There's nothing malicious about it; purely a question of accounting and math.

selectodude 2y ago

We can probably just extrapolate the numbers from people quitting smoking.

rickbutton 2y ago

I wrote a few paragraphs of response to this assuming that you are implying that there is a level of death/disease that is acceptable because treating it would not be cost-effective, but I deleted it because it would be uncharitable to assume you think that. It would be interesting to see this information, but would not be useful to act on. If the answer was "it costs more to keep more people alive" (hint: it does, that is why we let so many die of preventable illness), should we keep less people alive and healthy? The pursuit of economic growth at all costs is a disease far more dangerous than anything you would treat in a hospital.

crmd 2y ago

In my view, the sole focus of the healthcare system should be maximizing human wellbeing. Humanity’s GDP is around $100 trillion per year. There is plenty of money for healthcare with many orders of magnitude to spare for other endeavors. Bean counting here feels like Google in the early ‘00s proposing to make office supply expense reduction a business priority.

JumpCrisscross 2y ago
> is plenty of money with many orders of magnitude to spare Putting infinite value on anything is a great way to incentivise a system that delivers little to none of it.
- rickbutton 2y ago
  There should certainly be measurements taken, costs considered, alternatives approached when building our healthcare system. No one has ever implied otherwise, ever. To imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part. What is the point of building an economy at all if not to improve the lives of the population? Opinions in this thread already seem to be that "people are healthy enough, and if not, it is due to their own choices" rather than "we should carefully consider how to optimize this system for efficiency" while focusing on the actual goal of improving lives for the average person as well as those who need more healthcare.
  - JumpCrisscross 2y ago
    > imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part No it's not. Every doctor triages. And every medical system has internal cost limits, whether implicit or implict, universal or variable, past which it will not treat. Sometimes that's enforced by gatekeeping entire categories of treatments; in other cases we have patients individually reviewed, e.g. for organ transplants. If managing obesity is less expensive than treating it, there is a legitimate question around how the cost of that treatment should be split between the public and the individual. (Whether that cost be an explicit split or gatekeeping the treatment to only the most morbidly obese.) Thankfully, that's not the case--treating obesity, even chronically with super-expensive drugs, is still cheaper than the status quo.

JumpCrisscross 2y ago

> Curious if there's been any accounting on the long term impact in terms of cost on the healthcare system Savings on the order of $100bn per year [1]. > longer life spans impacting Social Security, Medicare, etc. An obese person dying early may well wind up costing the system more than a healthy person dying old. (Most medical costs are incurred terminally. The obese have more-complicated terminal paths.) [1] https://healthpolicy.usc.edu/research/benefits-of-medicare-coverage-for-weight-loss-drugs/ https://healthpolicy.usc.edu/research/benefits-of-medicare-c...