Nobody Cares about Your Health

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They voted it into the state constitution...

Missouri voters on Tuesday approved Medicaid expansion to many of the state’s poorest adults, making their conservative state the second to join the Obamacare program through the ballot during the pandemic.

The Missouri ballot measure expands Medicaid to about 230,000 low-income residents at a time when the state’s safety net health care program is already experiencing an enrollment surge tied to the pandemic’s economic upheaval. The measure was supported by 53 percent of voters.
 

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:poop:

[T]he study points to a compelling relationship between the gut microbiome and addiction disorders.

The idea fecal microbial transplants (FMT) can improve human health is not new. Modern medicine has been experimenting with the treatment for well over half a century, and Chinese medical practitioners have used the technique for millennia. Over the last decade, however, interest in fecal transplantation has surged, alongside frequent breakthroughs in gut microbiome research.
And I used to make fun of goofy hangover cures. USED TO.
 
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Innula Zenovka

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Timothy Snyder, the historian and student of fascism and authoritarianism, has just published a new book,


which I've just started reading. It's inspired by his serious illness, which almost killed him, at the end of last year. The first chapter, I discover, can be read in The New York Review of Books:

Part of our malady is that there is nothing in our country, not even life and not even death, where we take the proposition that “all men are created equal” seriously. If health care were available to everyone, we would be healthier not only physically but also mentally. Our lives would be less anxious and lonely because we would not be thinking that our survival depended on our relative economic and social position. We would be profoundly more free.

Since health is so elemental to existence, confidence about care is an important part of freedom. If everyone can assume that treatment will be available when necessary, they can turn their minds and their resources to other matters, make freer choices, pursue greater happiness. If, on the other hand, people think that care is preferential, then those who are on the inside start to take pleasure from the suffering of those who are on the outside. If health care is a privilege rather than a right, it demoralizes those who get it and kills those who do not. Everyone is drawn into a sadistic system that comes to seem natural. Rather than pursuing happiness as individuals, we are together creating a collective of pain.

And so our malady concerns us all. We all take part in the collective of pain. Those of us who are doing better are harming those who are less well-off. When health care is competitive the winners do wrong to others, but they also get worse care themselves. Distracted by their relative advantage, they do not see that by harming others they are also harming themselves. If health care were a right, we would all have better access to treatment and would all be liberated from the collective of pain. Health care should be a right, not a privilege, for the sake of our bodies, and for the sake of our souls.


It really shook me to realise -- though, of course, I knew intellectually -- that the US is country where high quality health care isn't a basic human right, a condition that is, to me, having enjoyed the care of the NHS all my life, unimaginable.
 

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It really shook me to realise -- though, of course, I knew intellectually -- that the US is country where high quality health care isn't a basic human right, a condition that is, to me, having enjoyed the care of the NHS all my life, unimaginable.
Socially the United States is a generation or two behind Europe. For example we were 56 years behind Britain in abolishing slavery, and 44 years behind Germany in establishing old age insurance. And the latter was only because we had a relatively progressive president at the time. I expect we will get there eventually. We *do* have health care for the old, veterans, and the poor through Medicare, Veterans Health Care, and Medicaid. But the rest of our system is pretty messed up.
 
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Innula Zenovka

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We *do* have health care for the old, veterans, and the poor through Medicare, Veterans Health Care, and Medicaid. But the rest of our system is pretty messed up.
That's only part of the story, though. Snyder makes the point very clearly that the reason the US spends so much more on healthcare than do comparable countries yet with far worse outcomes (shorter lifespans in general, and higher mortality rates for particular illnesses and medical conditions) is that a for-profit system isn't a good way to deliver health care.

He writes,
Why are big hospitals so central to basic care? In commercial medicine, hospitals are designed for “providers” (doctors, nurse practitioners, physician assistants) to supply certain deliverables at a certain price. But health is mainly a matter of education and prevention, tasks more easily accomplished away from hospitals. Wouldn’t we all be healthier if we had a broader spectrum of public health and access to physicians throughout the country, and even at home? Physician visits to households prevent illness and encourage people to continue their treatments. People feel better when they can see a doctor personally. Doctors should work from thousands of small offices around the country, or even make house calls. Why does easy contact with a physician seem like a dream?

The pressure and complication of insurance and record keeping force doctors to form groups. These groups are then purchased by private equity firms to form larger staffing companies, or purchased by hospitals, which are then purchased by other hospitals. Regional oligopolies swallow whatever is in reach, as private equity firms race to make a profit before moving on. Whether a hospital was adequately staffed during the coronavirus pandemic had to do with national balance sheets, not local needs. None of this has anything to do with the basic labor of being a doctor.
It's not simply a matter of ensuring health care is free at the point of delivery, but also of finding a way of delivering the care on the basis on what's needed rather than what's profitable. Certainly the fact the UK is so densely populated as compared with the US helps a lot, but unless you choose to live somewhere really remote, you're always close to a regular primary care physician (General Practitioner, or GP, as we call them), because the National Health Service provides local medical centres and practices, so I've only ever needed to visit a hospital when I require specialised tests or treatment. And when I have needed specialised treatment for cancer, the hospital that did the initial tests and diagnosis sent me to another hospital for treatment, not because they lacked the facilities or competence but because the hospital to which they referred me had a particular expertise in my form of cancer, while they were specialists in treating other types.

At no point, at least not at I was aware, did anyone's quarterly profit and loss account feature in the calculations.

That's why I'm so sceptical about people who claim, somewhat improbably, to be socialists who want to fix US health care simply by taking over responsibility for people's medical bills rather than having the government, not private business, provide the actual health care on the basis of what communities and patients need rather than what's best for private investors.
 

danielravennest

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That's why I'm so sceptical about people who claim, somewhat improbably, to be socialists who want to fix US health care simply by taking over responsibility for people's medical bills rather than having the government, not private business, provide the actual health care on the basis of what communities and patients need rather than what's best for private investors.
Eliminating the insurance middlemen would be a step towards a rational system. My sister-in-law was an office administrator for an eye surgeon, and most of her job was filing and negotiating with insurance companies to get paid. The local big hospital has half a dozen office cubicles in the admissions area *just* to take insurance information and ID, so *they* can be sure someone will pay.

US doctors are also very highly paid. They have to be, because of the rapacious cost of medical school. So perhaps we can start at the beginning and not saddle them with huge debts to become a doctor.
 

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While on average US doctors are well paid, the lowest pay is for primary care physicians (or GPs). This leads to a lack of generalists and makes it more likely that a more expensive specialist will be required for a great many procedures. That adds referals that take more time and require more travel if you are not in a metropolitan area.
 

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Not sure I'm completely on board about this, but the argument is well made.

In December, two conservative justices on the Fifth Circuit United States Court of Appeals came to a truly insane ruling that could undermine the entire Affordable Care Act. The case involves the now-toothless individual mandate. Explaining all the ways this ruling is a shockingly bad-faith assault on the basic idea of constitutional governance would take too long, so I will leave that for others. The crux of the decision is this: Since Republicans lowered the individual-mandate penalty to zero dollars, it is no longer constitutional, and that somehow could mean that the entire Affordable Care Act should be unconstitutional. (The Fifth Circuit actually punted on this crucial second step, leaving it to a lower court to decide whether the whole ACA should be thrown out.)

Speaker Nancy Pelosi now needs to step up to end this nonsense.
 
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The named it AccuVein? :kittyball:

(Infared!)
 

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The comments... ha

I can't read the complete article because of the paywall, but it intuitively makes sense that strong legs relative to overall body size mean fewer falls. ...also, everyone should do squats, even if it's just bodyweight.
 

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I can't read the complete article because of the paywall, but it intuitively makes sense that strong legs relative to overall body size mean fewer falls. ...also, everyone should do squats, even if it's just bodyweight.
 
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After receiving the viral therapy, several of the dogs had their tumors disappear entirely and lived into old age without recurring cancer. Given that around 85 percent of dogs with oral cancer will develop a new tumor within a year of radiation therapy, the results were striking. The treatment, [Jack] Hoopes [a veterinary radiation specialist at Dartmouth College] felt, had the potential to be a breakthrough that could save lives, both human and canine.

“If a treatment works in dog cancer, it has a very good chance of working, at some level, in human patients,” says Hoopes.

The new cancer therapy is based on the cowpea mosaic virus, or CPMV, a pathogen that takes its name from the mottled pattern it creates on the leaves of infected cowpea plants, which are perhaps best known as the source of black-eyed peas. The virus doesn’t replicate in mammals like it does in plants, but as the researchers behind the therapy discovered, it still triggers an immune response that could be the key to more effective treatments for a wide variety of cancers.