This is going to make me sound like a callous a-hole

[Nika]

Disneysteve, why do people go to the ER for non-emergency treatment?
Is it because you can't see them the same day, or is it because they don't have insurance?

Why would anyone in their right mind choose to wait for 3-4 hours in the ER waiting room if they don't have to? Especially considering that ER is by far the most expensive option.

[Reggie]

http://www.forbes.com/sites/timworst...systems-money/

As much fun as it might be to scapegoat fat people and smokers, it's not reality.

I almost choked on my lunch. Alcohol, Obesity and Smoking do not cost health care systems money???? hahahahahahahahaha


I can give you thousands of examples of alcohol, obesity and smoking costing quite a bit of money, actually.

And the argument that it costs MORE to treat alzheimers than heart disease is absurd. Heart disease is preventable with diet and exercise. There are also about 100 to 1 cases of heart disease compared to alzheimers. Does it cost more to treat 100 cases of heart disease or 1 case of alzheimers? If we could prevent those 100 cases of heart disease would we save money? OF COURSE WE WOULD.

[Petunia 100]

I almost choked on my lunch. Alcohol, Obesity and Smoking do not cost health care systems money???? hahahahahahahahaha


I can give you thousands of examples of alcohol, obesity and smoking costing quite a bit of money, actually.

And the argument that it costs MORE to treat alzheimers than heart disease is absurd. Heart disease is preventable with diet and exercise. There are also about 100 to 1 cases of heart disease compared to alzheimers. Does it cost more to treat 100 cases of heart disease or 1 case of alzheimers? If we could prevent those 100 cases of heart disease would we save money? OF COURSE WE WOULD.

Some people are born with heart defects. Diet and exercise do not remedy congenital heart defects.

[bjl584]

Some people are born with heart defects. Diet and exercise do not remedy congenital heart defects.

True.

But what are the percentages of people who have heart problems due to genetics versus those that have heart problems due to lifestyle choice? I don't know, but it has to be a rather large discrepancy.

It's true that being healthy won't "save" every single person on the planet, but healthy lifestyle choices, if practiced by everyone, would save huge amounts of money in health care related costs.

[dojo]

T
I also sincerely hope that the OP never finds out the hard way that exercise and a healthy diet cannot prevent the scariest medical conditions. The arrogance of healthy people is really mind-boggling.

The issue many see is that many medical conditions CAN BE prevented with a healthy life-style. Sure, there are serious illnesses NO ONE can foresee or prevent. I mean my grandmother (who NEVER smoked or got anything more than the normal weight for her height) is a chronic cardiac patient (and also had some serious lung issues). We all know people who get cancer (and we're shocked to find out, since we know they never strayed from a healthy 'path'), even kids who couldn't really have done anything wrong at 3-5 years of age. I even have a friend who's insulin dependent and he's never been even overweight. All he did in his life was to try and stay healthy, but his body had another 'idea'.

When it comes to these people, it's impossible to blame them for 'draining' the system or for doing anything wrong. I mean sickness comes to everybody and not all illnesses could have been prevented. Not all sick people are 'wrong' and responsible for their situation, I really don't think the OP implied this.

On the other hand, people who smoke (and here in my country their percentage is still pretty big) and who are not trying to have a healthier nutrition are really putting themselves at risk. When you are being obese, cardiac issues and diabetes are not something you never thought you'd get. They are not 'accidents' (as in many of the cases I talked about before), they are CONSEQUENCES of a lifestyle that needs to be changed. Same with smoking.

Here we were pretty annoyed finding out that drunk people would take up the ER rooms just because their drinking almost killed them. And there were some people who even came with the idea that they should have to actually pay for the medical care they receive. They were clearly not having an illness that couldn't be prevented, they almost drank till they died. Of course, such an idea wasn't put into practice, but it makes you think about the people who might die from accidents or things they couldn't prevent, just because the ER was busy resuscitating the 'party' people.

It's clearly a very sensitive topic. People SHOULD receive care and no one should have to suffer without getting medical attention, IMO. Yet we can all make some changes in our lives so that our 'encounters' with these medical issues are not as often and clearly not preventable.

[hamchan]

And the argument that it costs MORE to treat alzheimers than heart disease is absurd. Heart disease is preventable with diet and exercise. There are also about 100 to 1 cases of heart disease compared to alzheimers. Does it cost more to treat 100 cases of heart disease or 1 case of alzheimers? If we could prevent those 100 cases of heart disease would we save money? OF COURSE WE WOULD.

Alzheimer's usually requires round the clock care in an assisted living facility until the patient dies. Heart disease doesn't. And no, it's not always preventable.

But the point is that it does cost more to have 101 people living long enough to need assisted living than to have 1 person with Alzheimer's and 100 die young from heart disease.

And yes, BTW, you do sound like a callous a-hole. Congrats.

[Petunia 100]

True.

But what are the percentages of people who have heart problems due to genetics versus those that have heart problems due to lifestyle choice? I don't know, but it has to be a rather large discrepancy.

It's true that being healthy won't "save" every single person on the planet, but healthy lifestyle choices, if practiced by everyone, would save huge amounts of money in health care related costs.

I don't know how many heart problems are due to genetics versus lifestyle choices.

I do not agree with the point of view being offered. I do not think that those with heart problems due to unhealthy lifestyle choices ought to just crawl into a corner and die rather than incur a medical bill.

I do agree that we all should choose healthy habits over unhealthy ones.

[Nika]

We live in an environment were if you don't consciously swim against the stream every day, you will be overweight.

And the blame is not consumer's alone. Really, if you go to any restaurant, you will get double, triple or the quadruple calories than the meal is supposed to be. It is pervasive and constant.

And enormous agro-business subsidies are given to growing food that are making us obese.
We the taxpayers are subsidizing fast food cheeseburgers, chips and soda's through subsidies to corn, soy and wheat. Food manufacturers are also very misleading and aggressive in their advertisement for foods that make them the most profit. That will never be fresh produce - it has the lowest profit margin. Heavily processed foods with long shelf life are the profit makers.

And a lot of consumers are just trusting. They believe that Nutella is a hazelnut cream that is a "part of a balanced breakfast". Sure, but it is the unbalanced part of the balanced breakfast. In reality is is mainly a "palm oil and sugar" cream, not a hazelnut cream. That pop tarts and pizza pockets are acceptable foods for children. That cereals are a nutritious breakfast (when it is just a box of cheap processed grain, with sugar and additives). People are not raised to think that way. A lot of people just don't understand they are lacking nutrition. And this way of eating is ingrained, it became cultural in a way.

It is tempting and it is everywhere. To eat healthy you have to go out of your way.

Oh, today I am going out for dinner end eating a calorie bomb. So I had a greek unsweetened yogurt for breakfast, home-made chunky guacamole and an apple for lunch. And will put in 2 hours at the gym, just to SPLIT 2 appetizers with DH (with beer). And even after all that planning, I will probably be over maintenance calorie limit for the day. And people are expected to get appetizers, entrees, drink and desserts.

Sure, there is a personal responsibility component. But the thing is, you have to fight against the "norm" to stay fit and not overweight. We do, because no matter how valid these reasons are, at the end of the day, I'll be the one fat if I don't.

But we have resources that make it easier -- I train, I have a treadmill for when I have to run at night, my neighborhood is safe to run in normally, we can afford fresh produce and seafood...

And eating out, even having a high calorie meal, if it is made freshly by a human from raw ingredients, it is not as nutritionally bad (while still can be pretty bad in terms of calories). But these things are not as cheap, and not as readily available.

[bjl584]

I don't know how many heart problems are due to genetics versus lifestyle choices.

I do not agree with the point of view being offered. I do not think that those with heart problems due to unhealthy lifestyle choices ought to just crawl into a corner and die rather than incur a medical bill.

I do agree that we all should choose healthy habits over unhealthy ones.

I never claimed that anyone should crawl into a corner and die. They should receive treatment. And that treatment shouldn't destroy them financially. But, there needs to be incentives to being healthy.

[ua_guy]

I never claimed that anyone should crawl into a corner and die. They should receive treatment. And that treatment shouldn't destroy them financially. But, there needs to be incentives to being healthy.

It is sad that incentives are needed to be healthy. Having good health itself is an invaluable gift.

[JoeP]

It is sad that incentives are needed to be healthy. Having good health itself is an invaluable gift.

But you can "be" healthy if you take pills! Just gotta go see your doctor and ask if those pills are right for you. At least that's what I get from the commercials forced upon me when I try to watch a little news. Just don't worry about the side effects like dry mouth, stroke, death, spontaneous diarrhea.

Sure, my last few posts have been cynical, but the truth is there are so many factors keeping us away from simple activities that keep us healthy: television, tweeting, facebook, internet in general, chronic multitasking, smart phones with apps, video games, artificial sweeteners, forums like this

I think back 30 years and we had lots of biking, walking, reading...and much less of the above.

[Petunia 100]

I never claimed that anyone should crawl into a corner and die. They should receive treatment. And that treatment shouldn't destroy them financially. But, there needs to be incentives to being healthy.

I didn't mean to imply that you had. Sorry.

[hamchan]

What constitutes a healthy diet isn't the same for everyone in every situation either. Since my husband has kidney disease he has to limit his protein, sodium, and potassium to considerably less than what most people are advised to get. The potassium is especially hard because a lot of healthy (and in many cases cheap) foods contain high levels of potassium. Avocados, potatoes, bananas, dairy, beans, lentils, tomatoes. He has to really limit those foods. The scary thing is his doctor never told him that. I had to find out by doing my own research.

[disneysteve]

Disneysteve, why do people go to the ER for non-emergency treatment?
Is it because you can't see them the same day, or is it because they don't have insurance?

Why would anyone in their right mind choose to wait for 3-4 hours in the ER waiting room if they don't have to? Especially considering that ER is by far the most expensive option.

That's part of the problem. They don't see it as the most expensive option. It's covered by insurance so the patient doesn't care.

Why do they go? I honestly have no idea. If I had a choice of going to my doctor or going to the ER, I'd sure pick the doctor but millions of people choose the ER. And no, it isn't because I can't see them. They never even call the office to try and get an appointment. They just go to the ER. Most people treat ERs as walk-in clinics. Studies have shown that up to 90% of ER visits are for non-emergent problems.

When I was a family practice resident, I did all of my elective rotations in the ER because it was essentially a 24/7 family practice clinic. I saw patients who sprained their wrist a week earlier, kids with sore throats, people who ran out of their blood pressure medicine. I saw patients who had seen their doctor earlier in the day, gotten medicine, but weren't better yet (imagine that - not healed in 12 hours) so they came to the ER at 3am. And this was back in 1991. The situation today is no better.

[disneysteve]

1. Obesity in the US is staggering

A number of years ago, a patient of mine went to Greece on vacation. I was talking to her when she got back and she said one thing that impressed her most was she didn't see a single obese person in 2 weeks. The supermarkets there were the size of our gas station convenience stores (think 7-11 or Wawa). That's where people did their weekly shopping. The store carried all of the essentials but didn't have a 20-foot aisle of soda and another of candy and another of chips, etc. She also saw how everyone walked everywhere. People didn't drive unless they were traveling a fair distance or hauling stuff.

2. Medical care in the US is EXPENSIVE

Medical Tourism is a booming industry. People travel to other countries for elective surgeries. Even with travel costs, they spend a tiny fraction of what the same treatment would cost at their local hospital and they get top-notch care in state of the art facilities.