August 29, 2009
US Health Problems Due To Lifestyle

Changes in medical policy and health care funding will not address the biggest causes of lower life expectancy in the United States as compared to some other industrialized countries. Poor diet choices and lack of exercise are more important than the health care system.

Two teams, one led by Pierre-Carl Michaud of the Rand Corporation in Santa Monica, California, the other by Samuel Preston of the University of Pennsylvania in Philadelphia, have dug into international health statistics to ask why US citizens can expect to die earlier than their counterparts in the richest European nations.

Michaud concludes that the blame lies largely with high rates of chronic disease caused by poor diet, lack of exercise and the lingering effects of tobacco use from a time when smoking was more prevalent in the US than in Europe.

Years of bad habits take their toll. The medical technologies of today can not reverse that damage. Once you get enough mutations to, say, trigger liver cancer you are checking out of the Life Hotel. Organ failures usually cause death because demand for donor organs far exceeds the number of donor organs available. Strokes kill because we can't repair brains and we lack the technology to repair blood vessels before they burst and kill lots of brain cells.

Now, you ought to look at your diet and habits and try to make at least small changes that'll tip the odds more in your favor. Close enough to a store to walk? Want to visit a friend who lives a mile away? How about walking? Choosing between vacations where one is more sedentary and the other provides greater potential for physical exercise? Choose the latter. Then there's food. Try this: Just eat a vegetable before you eat whatever you want to eat. If you do not want to deny yourself junk food at least preface it with something good for you.

Even if you eat the Mediterranean diet and jog 50 miles per week you can drop dead from a stroke or suddenly experience an auto-immune disease that rips apart some internal organs. Even if you become a vegan and swim laps every day you can suddenly experience kidney failure or get diagnosed with advanced stomach cancer. You could go for colonoscopy exams every year and still die from colon cancer. You could go for yearly physicals and go on preventative blood pressure drugs and still develop heart disease. The realm of the biotechnologically feasible today still falls far short of what we need to prevent death from our major killer diseases of today.

What matters for most of us today is not the size of our medical co-pays or deductibles. I know people who've gone without medical insurance for years without seeing a doctor (as compared to myself who goes for years with medical insurance and I still do not see a doctor). No, what matters most is the state of medical technology 10, 20, 30, or even 40 or 50 years from now. What matters is the rate of advance of biomedical science and biotechnology. Lots of factors play into that rate of advance. I am worried about how government policy changes might affect the incentives for new drug and new treatment development in the private sector.

But other things matter as well. Technologies from other industries play a big role in making biomedical advances possible. The rate of advance of computing technologies matters for multiple reasons (even printers can help make miniature microfluidic devices). Computers make CAT scans and other scans possible. Computers make the da Vinci Surgical System possible. Computers automate lots of medical testing lab work. Microfluidic devices are possible because of work in the computer industry to make computer chips. Microfluidic will enable home lab-on-a-chip testing as well as much more rapid and accurate testing in hospitals and clinics.

The regulatory environment is important too. Some economists believe the US Food and Drug Administration slows the development of new treatments and causes net harm. If this is true then for those of us who still have major health care problems only in our futures have an interest in lowering the barriers for introduction of new treatments.

Share |      Randall Parker, 2009 August 29 10:00 AM  Policy Medical


Comments
James Bowery said at August 29, 2009 11:49 AM:

You want medical advancement?

Take the Constitution seriously starting with the “general welfare” clause of the preamble which will be taken to imply that any benefits paid out to the citizenry must be paid out without any discrimination whatsoever—obivating what Charles Murray thought would necessitate a Constitutional Amendment in his plan, but also eliminating all spending that does not fall under the umbra of the Constitution’s enumerated powers. Henceforth, falling under the penumbra of the Constitution is not construed as falling under the powers of the Federal government:

The US Federal Budget is currently around $3e12/year.

Eliminating all unconstitutional activities and privatizing those Constitutionally authorized services, such as the postal service, that no longer need be public monopolies, the budget can be reduced to just 4 basic items, all of which can be funded for well under $1 trillion dollars:

1) Executive is reduced to national border defense and investigation of interstate criminal activity.
2) Legislative
3) Judiciary
4) Interest payments

That leaves $2e12 to divide up among less than 2e8 adult resident citizens.

$2e12/2e8 adult resident citizens = $1e4 or $10,000 dividend per citizen per year

All federal mandates on the States would be repealed as well, freeing them to each solve their problems in their own manner so there is a return to the laboratory of the states intended by the Founders. If one State wants a Drug Administration to test and approve all medical procedures, while another wants to eliminate all medical licensing and malpractice torts, the Federal government would be as powerless to interfere as would those States be to interfere with each other’s preferred policies.

Don L said at August 29, 2009 12:48 PM:

James. I have to say I agree totally.

The federal government has become a monster who's corruption, self interest and appetite for power has reached a point that is threatening to the survival of the republic. Putting it in its proper roll again is a priority, if we want a prosperous, compelling future.

Clarium said at August 29, 2009 5:30 PM:

Could you stop talking about death Randall? Maybe you should read those books by Tim LaHaye and Jerry B. Jenkins to take your mind off of it. Here's a quote (from on of the characters) that will make you not fear death...

Can you imagine, Rafe, Jesus coming back to get us before we die?

Just replace "Rafe" with "Randall." You do not have to worry about death.

Randall Parker said at August 29, 2009 5:56 PM:

Clarium,

Death, like many other problems, becomes a bigger problem the less you directly confront it and address the underlying causes. It is irresponsible (though understandable) to turn away from it as you do.

Similarly, you turn away from why a Swedish welfare state can't work here. If wishes were horses dreamers would ride.

Clarium said at August 29, 2009 6:56 PM:

I was joking about the that. I most certainly do not believe in that stuff (premillennial dispensationalism and the rapture or any religious doctrine for that matter). Did you laugh when you read that quote? It is very funny actually. I actually love the character of Nicolae Carpathia, and that is the only thing I like about those books (and the three movies).

Yes, I love Sweden and I love their "labor market political activities." Yes, I know a welfare state is impossible in the US, I sometimes need to vent it out, and show my love for "labor market political activities."

odograph said at August 30, 2009 6:51 AM:

There was a time, maybe 30-40 years ago, when everybody thought AI was inevitable. I'm afraid life extension is a bit like that, and those howling at the moon are really howling at a "hard problem."

Changes in diet and exercise (as well as environmental problems) are indeed hitting us even as we find how hard is to "cure cancer" and the like. We have indeed researched our way to a lot of point-responses which do in many cases have have high success rate, but it's been a slog. There hasn't been anything (tick spittle?) that solves the problem class.

And so ... my moral response would be to get basic health care to all, and sure let the rich spend their dough beyond the basic ... until they finally freeze their heads.

odograph said at August 30, 2009 6:54 AM:

Re. "environmental problems" consider the balance must be made in fish eating. Some is good for my heart/brain, too much pollutes me.

James Bowery said at August 30, 2009 8:59 AM:

Life extension, intelligence increase and space settlement would all be reality today if the Federal government adopted my citizen's dividend as of the 1960s.

Civilian government R&D creates a systemic disincentive for competence in society for those activities.

Engineer-Poet said at August 30, 2009 11:00 AM:

What's your weekly ration if you count it in fish tacos, Odo? ;-)

Randall Parker said at August 30, 2009 11:36 AM:

odograph,

Speaking to you from the late 1800s I have to say there was a time, maybe 30-40 years ago, when everybody thought human flight was inevitable. When will people learn this is not possible?

Early AI researchers were naive about how big a problem they were facing. But that hardly proves the problem unsolvable. Rather, I look around and see computers doing more and more things that humans used to do. The trend looks set to continue.

Cure cancer: I knew it was hard a long time ago and so did some researchers. An old biochemist and NAS member explained to me how he was part of the Nixon War On Cancer planning sessions at the NIH and how he (and other researchers) knew then Nixon's goal was not obtainable for decades. He said we have to work out basic mechanisms of cellular growth regulation before we will be able to intervene to reassert control. But he saw it as a solvable problem.

The (huge) mistake was the rush to develop treatments rather than work on mechanisms. We didn't have the tools needed to tackle the problem.

Similar with rejuvenation. We needed to know, for example, the identity of the genes that maintain pluripotency. We needed to know about interference RNA and lots of other pieces of the puzzle before attempting development of rejuvenation therapies.

Just because a problem is hard and requires decades of accumulation of technologies does not mean the problem is unsolvable.

Brett Bellmore said at August 30, 2009 5:10 PM:

"The (huge) mistake was the rush to develop treatments rather than work on mechanisms."

No offense intended, but as somebody who's just been diagnosed with cancer, (Prostrate, Gleason 3/3, PSA 7.2, localized... I'm told I'm almost certainly going to be cured.) I assure you that if the people running the "war on cancer" had said, "Screw treatments, we're going to concentrate on the underlying science.", they might have been lynched.

odograph said at August 30, 2009 6:00 PM:

Well, you can be an optimist, that's ok Randall.

But beware selection bias. To really understand the limits of innovation you need to start with a 1800s predictions of the future.

My observation is that we don't get plenty that we "want" but get so much other stuff that we don't care.

iTunes are more fun than moon colonies anyway, right?

Randall Parker said at August 30, 2009 8:20 PM:

odograph,

I do not see my optimism as irrational. I look at the many order of magnitude fall in DNA sequencing costs and continued progress in microfluidics and it seems very much like the computer industry but with a faster advance rate. I look at induced pluripotent stem cells and advances in understanding cellular differentiation and see replacement organ growth tech as inevitable.

Moon colonies: The energy costs of getting there are too high. Big energy stuff (e.g. flying cars) didn't happen. What did happen? Advances at the small scale. What do we need to reverse aging? Advances at the small scale.

odograph said at August 31, 2009 8:00 AM:

Would anyone claim rationality at this point? Recent studies show that the weight of a clipboard used to take a survey affects the results:

http://trueslant.com/ryansager/2009/08/27/whoa-this-is-heavy/

We are pants-wearing monkeys and fortunate that our irrational minds seem to orbit sometimes-near a rational ideal.

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