3 ms·
You’re blaming it on lack preventative care, but the truth is that there is very little preventative care that is shown to be effective at anything more than bu
by timr 2mo ago
You’re blaming it on lack preventative care, but the truth is that there is very little preventative care that is shown to be effective at anything more than burning money. The few things that are effective (e.g. vaccines) are largely inexpensive, and don’t require “insurance” as we know it.
Most of the things that are predictable and lead to long-term bad outcomes are behavioral (i.e. diet and exercise; smoking cessation; quitting drugs), and therefore both largely unaffected by medical care, and heavily confounded with socioeconomic status. Your doctor cannot make you eat better and exercise and quit smoking.
In the developed world, if you don’t die at birth or succumb to diseases of lifestyle (diabetes, heart disease, addiction) or accidents, you basically then die of cancer. The lifestyle diseases cannot be prevented by a doctor, and we have essentially no ability to prevent cancer. It’s all just acute treatment.
North Americans in particular hate to hear this, because they have an almost religious faith in doctors based on decades of bad TV. Honestly, though, doctors are pretty impotent when it comes to prevention of illness, and it is ironically this desire for treatment that is helping to balloon costs.
- breakyerself 2mo agoNo ability to prevent cancer? Ever heard of the HPV vaccine? I had polyps removed from my colon 10 years ago. There's a decent chance those would have developed into colon cancer by now. Prevention is a major part of reducing deaths from cancer. See also the effects of increasing taxes on tobacco products or restrictions on the use of asbestos.
- timr 2mo agoThose are the exceptions, not the rule. But also, you're wrong: most polyps would not become cancerous -- only 5%-10% ever do. As a preventative intervention on otherwise healthy people, colonoscopy is one of the most effective things we do, and it's not that effective [1]. You've also included vaccines (which I explicitly mentioned) and "taxes" (which are not medical interventions), so you've completely missed the point. [1] The NordICC trial found an impact of 0.03% on risk of death from colorectal cancer, which was insignificant. It did find an 18% risk reduction for getting colorectal cancer, but this didn't translate into a survival benefit. https://www.nejm.org/doi/full/10.1056/NEJMoa2208375 https://www.nejm.org/doi/full/10.1056/NEJMoa2208375
- LorenPechtel 2mo agoLifestyle can help, it's not a cure-all. I'm one of the 20% with the lipoprotein A gene. Mimics high cholesterol. Diet and exercise still help but that just slows the clogging.
- musicale 2mo ago> diet and exercise GLP-1 drugs do seem to help people change their diet (or at least intake), even in this environment of unhealthy, hyperpalatable foods that we have created.