My brain is still mushy from our three day trip to Portland. Geez. How am I ever going to go on longer vacations? How do other people do it? My travel stamina absolutely sucks.
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Coffee is good for you.
Diet soda makes you gain weight.
Shade is the answer to skin cancer and more exercise the answer to obesity.
Vitamins help. Vitamins don't help.
Screenings help. Screenings don't help.
1 beer is good. 3 beers is bad. (One beer? I don't even start feeling a buzz until 3 beers. As a result I don't drink at all.)
I think I should buy a mail-order medical degree and make random prognoses. I'd be right about half the time. Or just say the obvious things -- "The thing about skin cancer? Stay in the shade. That will be 150.00, please."
Once the medical system has you in their maw, there seem to be no end of tests and procedures and office visits, and the doctors and nurses seem completely unresponsive when you tell them you have a high deductible. (I think they expect you to spend the 2000.00 or 5000.00, and THEN you'll be covered so what are you complaining about? Whereas I'd rather not spend the 5000.00 on tests and procedures that don't really seem to advance my health.)
I think I lost interest when I read a study that said that if you do absolutely everything right, you average an extra 3 years of life.
And Lou Gehrig's disease taking my Mom -- which seemed totally random, and took a person who really had done absolutely everything right.
I'm just fatalistic, nowadays.
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23 comments:
The problem with the medical system is that people do are too willing to do whatever the doctor says without asking questions, evaluating options or getting alternative opinions.
Such as what is the test, what is it testing for, are their alternative ways to maek the diagnosis? Where will the test be done? What will it cost? Are there alternative locations?
I will give an example. I once had a physician that ordered a bronchoscopy. It was initially scheduled for a local hospital. I did some research and had the test conducted at an outpatient surgical center for half the cost.
Agree with RDC on this one. Rarely do we the customers of health care actually shop. Also so many do not take very good care of themselves through poor lifestyle decisions. Scary stats about how $1 out of every $5 will be spent on healthcare. I don't want that to be my case.
"I think I lost interest when I read a study that said that if you do absolutely everything right, you average an extra 3 years of life."
As I always say, longevity is 70% heredity, 30% luck, and the rest is diet and lifestyle.
But seriously: People like to believe they are in control of what happens to them; they also like to believe that the universe is fair and that doing "the right things" (exercise, healthy eating) will be rewarded with long life and "doing the wrong things" (not exercising, eating unhealthy foods, etc.) will be punished with early death.
One of the most deplorable consequences of this kind of thinking is that when somebody gets sick, many of us tend to assume he/she "did something wrong" and blame him/her for the illness. 'Tain't necessarily so. In fact, more often it ain't so.
People in other developed countries fret much less about diet and exercise than Americans do, yet live longer. Why? Well, I'll take a wild stab: It's because they have universal health care, which means when something's wrong with them they don't have to wait until they're almost dead and then crawl to the emergency room for treatment.
RDC: That's good advice, but in small remote communities like Bend you often don't have much choice of physicians (especially in certain specialties) or facilities.
"1 beer is good. 3 beers is bad."
One glass of wine is good. Two is better.
Have you ever thought about trying wine instead of beer? You probably could get a buzz from two glasses. Better for you than beer too -- no resveratrol in beer.
HBM I agree that not everything is in our control, but to be obese (which is the fast rising life style) can be avoided. Also agree in Bend the medical choices are limited. For example my wife needed an oral surgeon for a dental implant. There were exactly two choices who could do the work she needed.
"HBM I agree that not everything is in our control, but to be obese (which is the fast rising life style) can be avoided."
Sure, but don't assume that being thin or of "normal" weight (which of course varies from person to person) is going to make you immune from disease.
As an aside: Despite our "obesity epidemic," deaths from heart attacks in the US have been declining for many years and continue to decline. Some credit the statin drugs, but I'm inclined to give more credit to the decline in cigarette smoking.
"For example my wife needed an oral surgeon for a dental implant. There were exactly two choices who could do the work she needed."
Several years ago I needed sinus surgery; I found there were exactly two ENTs in Bend who did it. I chose the one I did (very good doctor, BTW) because the other one seemed more interested in the plastic surgery side of his practice (facelifts and nose jobs) than the medical side -- pretty common among ENTs these days, I understand. Follow the money.
good news boyz
geithner announced resignation
the chickens are now running from the fox den
i give the us economy 2 more months and holy hell come
i'm not serious about this being good but its a harbinger that the end of dollar is near
buy gold and bury before jul 15
so much to say on this issue
first bend is the worst place in the usa to be
has the highest rate of non-essential surgery in usa most insurance firms have bend docs on the secret 'black-list'
no solution vote with feet, like pubic educ usa spends most gets worst
here in malay i can go to a world class hospital for a day in icu and have all tests known to man on exit i get a $15 bill tops
the most important is the docs & nurses care about people in se asia, allow me to say that china med is as evil as usa
the problem with usa healthcare is that its ran by insurance which is essentially the mafia
in se-asia you can buy med insur but nobody does i have bought because as a white guy i want to carry a card that says you'll be paid
i pay $1000 year for the same thing usa would charge me $3000 a month, essentially to cover the big one if needed
i mentioned a day in icu for $15 bucks allow me to say that includes a bucket of med on exit
breakdown
doc gets $5
med $5
house $5
you always settle on exit
i have never had to use my insur, which also includes life, like i said its only i have card that shows the hospital will get paid, i asked my favorite hospital who paid with no bullshit and thats how i chose insur
dentistry is a dream mostly done by sweet caring females with better equip than usa, cuz its all made in asia, panaoramic xray film & digital $10
usa med is evil pure & simple this is why it can't be fixed rotten to core med school & law school are same-same only sociopaths are admitted been this way since ama & law guild created. Today usa law&med essentially is ran & occupied by caligula. Change can only come from mass extermination of all. Sorry but in this case i have to sympathize with mao-tse-tung forced re-education camps for existing & cuban style entry for young is the future. Of course before we can create bounty of cuban docs we would need to destroy the useless us education biz which roadblocks non-sociopaths by high entry. What i'm saying is med educ should be free & given to any woman with credible iq.
HBM,
Have you looked at the number of physicians in Bend? They are the medical destination for central oregon and have a pretty high per capita count of both specialists and GP's. Even then you have Portland about two hours away with a good selection. Are you saying that the opportunity to save a few thousand dollars for a procedure is not worth a 2 hour drive.
Actually the primary reason for the lagging in longevity in the US these days is obesity.
Obesity may stem longevity in future
Published: June 24, 2011 at 1:47 AM
Many assume each generation of Americans will live longer but U.S. researchers say a new forecasting method indicates obesity may stem this progress.
Eric N. Reither of Utah State University in Logan, S. Jay Olshansky of the University of Illinois in Chicago and Yang Yang of the University of North Carolina in Chapel Hill say most Americans enjoy better health than in the past, with significant declines in death rates from the top three causes of death -- heart disease, cancer and stroke. However, death rates provide "only a limited, 'two-dimensional' vision of the future by failing to take into account the potentially different risk factors accumulated by people who are still alive," the study authors say in a statement.
Using heart disease mortality data from the National Center for Health Statistics, the researchers illustrate how traditional projection methods fail to account for the impact of the U.S. obesity epidemic on the longevity of younger Americans.
Lots of peer reviewed papers on this subject at Pubmed (replaced the old grateful med site at NIH)
Such as:
Americans are living longer, but obesity and diabetes are rising.
Correction to my last message a 3 hour drive to Portland.
The place where I go for my medical work, including my annual physical is about 2.5 hours away from where I currently reside(Stanford Medical Center)
A primary problem with our medical system is our medical insurance system. There is virtually no incentive for patients with medical insurance - especially those with low deductibles or co-pay to price shop their medical wants (notice I said "wants" which includes needs). And the same system provides major incentives for the medical professionals - especially doctors - to maximize any and all medical procedures and tests per patient. Big Pharma and Big Hospital also make out like bandits with our current medical insurance system. The only real cure: a real and tightly managed single payer medical insurance system administered like so many other advanced countries by our federal government. Too bad Big Pharma, Big Hospital, Big Docs and Big Medical Insurance will never let this actually happen.
Buster: "here in malay i can go to a world class hospital for a day in icu and have all tests known to man on exit i get a $15 bill tops"
'Course if ya want the instruments sterilized it'll cost a little extra.
RDC: "Have you looked at the number of physicians in Bend? They are the medical destination for central oregon and have a pretty high per capita count of both specialists and GP's."
There are large numbers of practitioners in certain specialties (notably a swarm of orthopedic surgeons) but in other specialties the pickings are pretty slim. For example, there are only two ENT groups, one urology group, two allergists and a couple of oral surgeons.
"Are you saying that the opportunity to save a few thousand dollars for a procedure is not worth a 2 hour drive?" (Later corrected to 3-hour drive, although I've found it to be at least a 3.5-hour drive.)
It might be if I really could save "a few thousand dollars." But I haven't encountered that situation.
Also, if you have to go in a number of times for follow-up procedures, as I did after my sinus surgery, making a six-hour drive every time can get rather wearing, especially if you're not well to begin with.
"Actually the primary reason for the lagging in longevity in the US these days is obesity."
The article you quote speculates that obesity may stem the increase in longevity IN THE FUTURE; it does not say anything about why CURRENT life expectancy in the US is lagging behind that of other developed countries. In other words it does not support your claim.
Things are dirty in China hbm, but quite clean in Malay, singapore, and thai, ... Just stick with the not so big city's. Pick your hospital in advance with the 'sniff test' like you would do anything else in life.
I must admit that the hospitals are filthy in china.
But quite clean in se-asia, even by western standards, and the dentistry I have seen is better in my mind.
I have seen the 'small corner clinics' can be quite filthy, I remember I had a dog-bite and needed a tetnus and went to a 'clinic' and the 'doc' had a cigarrette in one hand, a mobile in another, and a scaple near the cig, and 'cleaned' my wound, ... but then every thing is washed quite well with tinc-of-iodine,
But honestly the big private hospitals are quite competitive in mid-size city's, and 'cleanliness' can be same as found in Bend OP.
With regards to serious surgery, sure you would have to go to KL or BKK, but then if I had a serious problem in Bend I would go to PDX.
Can't stress enough that Bend has the worst doc's in the USA.
Too bad Big Pharma, Big Hospital, Big Docs and Big Medical Insurance will never let this actually happen.
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Well at least we can all agree 'BIG' is the problem.
MED is BIG BIZ and has been so since about 1915 when opium and cocaine was made illegal, and the BIG-BIZ created the prescription monopoly and the rest is history. Now we have a nanny-state that protects us from ourself. SOFT-FASCISM Ron Paul call's it! BIG FASCIST companys making our lives safe by taking ALL our money.
Small of course is what works, and has always worked, and self medication, and self maintenance. I agree with hbm that the obesity arg is bullshit, as a lifelong athlete I know all too well it don't mean shit. Even as a boxer being in shape only means that when you get hurt your recovery may be quicker.
Hell yes americans are fat & lazy, but that's not why they have to spend so much on health-care. The fact is the US is controlled by SOCIOPATHS that have monopolized all essentials like health. You have unions like the AMA that have created BIG-PHARM, BIG-DOC, BIG-MED-INSUR, ...
Now today we have a FUCKING MESS.
Most sad in my mind like public edoocation, we spend the most but get the worst back, like hbm's non-sense about sterile. Let's fucking remember that ALL the fucking test equipment for MED is made now in ASIA. The arg that US is somehow cleaner is BULLSHIT considering that all that fancy equipment was made with dirty asian hands.
Thanks very much, but if I'm sick I would prefer to go to a SE-ASIA hospital, with about 15min wait time, and walk-out with a $15 bill tops. Last time at BMC in Bend, I waited with my INSUR-CARD 8 hours to see a doc, and still had to go to RAYS to get the MED, and ended up with a $400 bill and wasting the whole fucking day. Just a bad poison oak problem, all I needed was some presidone, but I had to see a doc, wait all day get a prescription, .... poison-oak seems to be put you on the bottom of the triage list @BMC.
Let's see, if I had a skin problem in SE-ASIA I would walk to a corner RX, and all PHARM folk speak english, show the problem, and for a buck walk out with a bag of pill's. Same with Mexico or CUBA or most of the world. But the USA has this FUCKING 'GATE', ... I know, I know we're all too fucking stupid and need a doc. But like dunc's argument started, the doc's never really listen nor care, so what's the point?
HBM,
In the full article they cover impacts that are not currently identified in how data is usually looked at. This includes one of the issues with obesity and longevity is the number of people dying at a young age due to obesity. Longevity numbers get very much impacted by the number of deaths at a young age. While the number of deaths are not sufficient to show up in major categories, they are sufficient to skew longevity calculations. Juvinile obesity is resulting in a increasing number of deaths in the 20's and 30's.
It also impacts infant mortality due to obese mothers. Which impacts the number even more.
What really start to show the impact is when you start looking at longevity by state. The top 4 in the US for males are:
4- Colorado
At an average life expectancy of 76.1 years old.
3- Utah
The beehive state has an average male life expectancy of 76.5 years old.
2- Minnesota
The north star state has an average male life expectancy of 76.5 years old.
1- Hawaii
The Aloha states has an average expectancy of 77.1 years old.
Which are also states that tend to be lower on the obesity level, and higher on the active life style lists.
You can get the major surgery done remotely and then have followup visits with a local physician.
RDC: I don't know where you got your longevity data, but according to Wikipedia the top 10 (in descending order) are Hawaii, Minnesota, Connecticut, North Dakota, Massachusetts, California, Vermont, New York, New Hampshire and Utah. (See http://en.wikipedia.org/wiki/List_of_U.S._states_by_life_expectancy) Six of those states -- Massachusetts, Connecticut, Colorado, New Hampshire, New York and Minnesota -- also are in the top 10 for per capita income and two others -- California and Hawaii -- make the top 20. So it looks to me like longevity is more positively correlated with income than with "active lifestyle." (You offer no evidence, BTW, to prove the four states you cite have more active lifestyles.)
"You can get the major surgery done remotely and then have followup visits with a local physician."
That's ridiculous for at least three reasons.
1. Physicians want to do the follow-up on their own patients.
2. It isn't possible to drive following major surgery, and often even after relatively minor surgery done under anesthesia. That means you either get someone to drive you to and from Portland or you stay in a hotel overnight -- maybe two nights, if your surgery is scheduled early in the morning.
2. Surgery often is followed by complications. To illustrate, I'll tell you the gruesome story of my sinus surgery.
I had the procedure done on an outpatient basis at the Bend Surgery Center. The procedure went smoothly, but afterwards I couldn't urinate (a not uncommon complication following general anesthesia) so I had to go to BMC's urgent care clinic that afternoon to have a catheter inserted (a procedure I wouldn't recommend to anyone). I went home attached to a bag and had to go back to BMC the next morning to have the catheter removed -- also an unpleasant procedure, though not as bad as the installation.
Meanwhile, because my sinuses were packed with gauze and clotted blood, I couldn't breathe through my nose for several days.
Would I want to go through that while staying in a hotel in Portland? Not bloody likely.
"Last time at BMC in Bend, I waited with my INSUR-CARD 8 hours to see a doc"
Eight frickin' HOURS??? Frankly I don't believe you. Longest I've ever had to wait there was about an hour.
Of course poison oak is not a life-threatening illness.
HBM,
Medline. Your numbers are total, mine as indicated are for males. Note the first two line up.
Active life styles also correlate with income. Obestiy inversly correlates with income. Lots of studies on that subject.
One can always find reasons why they cannot do something. It allows them to remain in their nice comfortable box.
Doctors are willing to have someone else followup. You just need to coordinate it with both prior. Hate to tell you, but if you cannot drive three hours due to anasthesia, you shouldn't be driving even 5 minutes. In every case of surgery I have known they will not discharge you unless someone is there to pick you up and drive you home. The other option is in patient are a very long waiting period prior to discharge.
Lets see 125 for a hotel room vs a couple of thousand for the procedure.
That is why you see what you see for billing.
RDC: "One can always find reasons why they cannot do something. It allows them to remain in their nice comfortable box."
Getting snotty, are we?
Okay, I'll concede the point on the follow-up visits. But that leaves two of my points that you didn't even address. True, I'd need someone to drive me home after surgery in Bend -- but it's a lot easier to get someone to do that than to get them to drive me to Portland and back.
"Lets see 125 for a hotel room vs a couple of thousand for the procedure."
Uh, are you saying I could have the procedure done FOR FREE in Portland and all I'd have to spring for is a hotel room? Yeah, that'd be a hell of a deal ... if I could get it.
You claimed initially that I could save "a few thousand dollars" by having surgery done in Portland. That sounds like a wild exaggeration. To take my sinus surgery as an example again, the whole deal cost only about $3,000. I'd have to be able to get it done virtually free in Portland to save "a few thousand dollars" by going there.
I see no reason to assume medical care is significantly cheaper in Portland than it is in Bend -- much less free.
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