31 replies to this topic

[timar]

I think Dr. David Katz, head of the Yale Prevention Center is one of the most brilliant commenters on public health issues, and I'm an avid follower of his HuffPost Blog. This recent blog post is so absolutely spot-on, that I have to share it with you here:

http://www.huffingto..._b_4837886.html

[JohnD60]

disjointed rambling, imo

[YOLF]

I disagree John. We need to eat and we have to do it a few times a day. Marketing and habit as well as the simple availability of crap food as part of our culture is pushing at risk individuals into bigger and bigger pants.

If you don't eat junk food, aren't interested in it, and stay healthy, that's great! But you're not a hero and you should be thanking the people who introduced you to the culture that you know. Obesity and the pathology starts off in childhood. Fast easy food from overworked parents who don't manage the development of their children's health and keep bringing home snacks and junk that was marketed to them and their manic shopping habits didn't effect you. But for many it's different and the problem is spreading. McDonalds has reformed it's menu, but some of the most popular items are worst for you and you might not think it. There is a common misconception that whip cream is only 20 calories because that's what it says on the bottle, people just don't care to not the serving size and the fact that there are 20-30 of them on top of the average frappe. So they buy them anyways and think they're healthy. I always order mine without whip cream, though I certainly don't mind the extra 60 calories from the drizzle.

We need a massive mobilized effort here in the US to put an end to these things and all advertising should be held to a standard that prevents obesity. We should no more be able to advertise twinkies that we can advertise cigarettes, yet still we do. Years of not caring about obesity and not treating it like any other disease that needs to be cured has created a customer base that companies are compelled to keep marketing too and whom they depend on. When your customers are addicted to crack, they aren't coming back if you aren't selling it anymore, especially if someone else is! It's all too frequent that a new startup gets it's start selling foods that will make people fatter. The people starting these businesses will easily replace McDonalds under current conditions. We need more Bloombergs or even more executive orders to get us out of this mess. When food companies must adhere to and enforce health standards, even if it means telling the customer "no refills, and only one drink or small fries per meal" they'll be able to remain competitive. When they will be able to maintain their market share, they'll be able to make profits selling healthful foods and we'll be able to catch crack dealers by following people who remain fat to their doorsteps where they deal in illegally imported foods of dubious nutritional content.

Edited by cryonicsculture, 26 February 2014 - 09:02 PM.

[niner]

It does strike me as weird that when tobacco companies engineer an addictive substance that's bad for your health, we crucify them, but when anyone suggests that we should do something about the same stuff going on at food companies, a bunch of people start howling about "The Nanny State" and how no one should "tell people what to eat". They are seriously not getting it.

[YOLF]

The smokers and tobacco companies did the same thing right up until they started regulating them... Though we still don't regulate them enough.

[chemicalambrosia]

I disagree John. We need to eat and we have to do it a few times a day. Marketing and habit as well as the simple availability of crap food as part of our culture is pushing at risk individuals into bigger and bigger pants.

If you don't eat junk food, aren't interested in it, and stay healthy, that's great! But you're not a hero and you should be thanking the people who introduced you to the culture that you know. Obesity and the pathology starts off in childhood. Fast easy food from overworked parents who don't manage the development of their children's health and keep bringing home snacks and junk that was marketed to them and their manic shopping habits didn't effect you. But for many it's different and the problem is spreading. McDonalds has reformed it's menu, but some of the most popular items are worst for you and you might not think it. There is a common misconception that whip cream is only 20 calories because that's what it says on the bottle, people just don't care to not the serving size and the fact that there are 20-30 of them on top of the average frappe. So they buy them anyways and think they're healthy. I always order mine without whip cream, though I certainly don't mind the extra 60 calories from the drizzle.

We need a massive mobilized effort here in the US to put an end to these things and all advertising should be held to a standard that prevents obesity. We should no more be able to advertise twinkies that we can advertise cigarettes, yet still we do. Years of not caring about obesity and not treating it like any other disease that needs to be cured has created a customer base that companies are compelled to keep marketing too and whom they depend on. When your customers are addicted to crack, they aren't coming back if you aren't selling it anymore, especially if someone else is! It's all too frequent that a new startup gets it's start selling foods that will make people fatter. The people starting these businesses will easily replace McDonalds under current conditions. We need more Bloombergs or even more executive orders to get us out of this mess. When food companies must adhere to and enforce health standards, even if it means telling the customer "no refills, and only one drink or small fries per meal" they'll be able to remain competitive. When they will be able to maintain their market share, they'll be able to make profits selling healthful foods and we'll be able to catch crack dealers by following people who remain fat to their doorsteps where they deal in illegally imported foods of dubious nutritional content.

Bloomberg and his ilk would be just as quick to regulate away a lot of the supplements and grey market substances that we take after they regulated away fast food and other junk. I for one, eat a little junk or dessert here and there and don't want someone telling me what to eat.

We can help eradicate a problem like that without the tyrannical regulations of the nanny state. A big problem is that people have no skills to quantify what is good and bad. They don't read labels and don't understand them. Schools should teach nutrition much better than they do in practice. Students should have to keep accurate nutritional logs and learn how to read labels and design healthy diets. They should learn to look at things from a bigger picture point of view, to see choices in perspective. A single sugared soda might increase the calories of a small woman's diet by 10%, as an example, but how many people see it from that perspective?

[YOLF]

People don't want to put that much thought into buying things. Teach them all you want, it won't work and marketing will always win. If I cared to look at the contents of my food I'd probably starve because no food is perfect. Enriching foods can even be bad for you.

The fact of the matter is that I need something to drink, and it will all have calories and all of it has too much or has cancer/tumor sugars. The regular sugar on the other hand is so proliferous that it's what our brains expect, especially if we're being fed snacks and candy for 4 years before schools start teaching us anything. It's shortsighted to think it's all about education. It's all about engineering. Even the food marketing is engineered. The only way to beat engineering is counter engineering and that's what government is for.

The problem is culture. Don't market junk and don't make it available and people won't eat it.

[niner]

Bloomberg and his ilk would be just as quick to regulate away a lot of the supplements and grey market substances that we take after they regulated away fast food and other junk. I for one, eat a little junk or dessert here and there and don't want someone telling me what to eat.

We can help eradicate a problem like that without the tyrannical regulations of the nanny state. A big problem is that people have no skills to quantify what is good and bad. They don't read labels and don't understand them. Schools should teach nutrition much better than they do in practice. Students should have to keep accurate nutritional logs and learn how to read labels and design healthy diets. They should learn to look at things from a bigger picture point of view, to see choices in perspective. A single sugared soda might increase the calories of a small woman's diet by 10%, as an example, but how many people see it from that perspective?

chemicalambrosia, are you aware that food companies employ well-paid scientists to make their junk food more addictive? That is their express intent- to get people hooked on their product. What is your opinion of that?

[chemicalambrosia]

Coffee has caffeine(among other psychoactive substances) and causes physical withdrawal symptoms. Coffee gets sold loaded up with cream and sugar and has been sold this way before food ever became a science. I understand a lot of study goes into things like the exact size of salt crystals on snacks, but I don't think unhealthy food as a whole is really more addictive because of all that. Can they beat the addictiveness of coffee with cream and sugar? They are using science to do what chefs and bakers have done for a long time, which is make food taste better. Big companies are just doing it cheaper and on a bigger scale and making it more available, and people have more disposable income. Give someone a choice between a selection of French gourmet desserts or the scientifically engineered junk food, and I think people would choose the gourmet desserts over and over again.

Really, this is something you have to deal with when you have capitalism and free markets. Do you really want people watching over a company's back, and asking if they're trying too hard to make their product appealing? Every company wants repeat customers, and big companies are going to use science to find out what appeals to people's taste buds. A lot of things sold are dangerous or unhealthy in some way. As long as they are sold with transparency(accurate labeling and the like), then it is up to the consumer to decide.

If we want to start with "regulation", how about looking at the massive subsidies that the US government gives to junk food in various forms? 1 in 5 US households get food stamps, what kind of restrictions are there on junk food for them? That is basically a huge junk food subsidy. How about corn subsidies, which have given us high fructose corn syrup everywhere? We can change and eliminate laws without telling businesses what kind of food they can sell or how they can sell it and still make the country considerably healthier. If only the government could make a law that says everyone had to have a little self-discipline...

[niner]

Ok, I guess you're a Libertarian. Here's my problem: I believe in freedom, just like you, but freedom means, among other things, the freedom not to be harmed by others. That means I can't fill your air or water with toxins, and I don't think I should be allowed to create clever trap doors in the sidewalk where your kids walk to school, and charge you money to get them out. By your logic, your kids should just be smart enough to spot my traps and step around them.

I totally agree with you about the subsidies being wrong. If we have to subsidize something, it ought to be food that's healthy, not crap. We shouldn't let people buy junk food with food stamps. I know you can't buy cigarettes and alcohol with food stamps. I don't actually know if there are other restrictions, but I think there should be. There would be a certain amount of people buying junk food with cash and using food stamps for more expensive items, but it would at least be a start.

[chemicalambrosia]

"I believe in freedom, just like you, but freedom means, among other things, the freedom not to be harmed by others."

I agree entirely, but freedom also means being allowed to freely harm yourself. That means IMO, up to and including suicide.

"and I don't think I should be allowed to create clever trap doors in the sidewalk where your kids walk to school, and charge you money to get them out. By your logic, your kids should just be smart enough to spot my traps and step around them."

That is a pretty ridiculous analogy, lol. Foods have labels which indirectly inform people of the risks you take on when eating that food. Foods also have to contain what they say they do on the label. Shopping at the grocery store if I buy only whole foods I can be pretty sure I'm going to eat relatively healthy. A trip to the grocery store certainly doesn't seem like I am hopping over trap doors and dodging boulders while stuck in an Indiana Jones movie.

[niner]

"and I don't think I should be allowed to create clever trap doors in the sidewalk where your kids walk to school, and charge you money to get them out. By your logic, your kids should just be smart enough to spot my traps and step around them."

That is a pretty ridiculous analogy, lol. Foods have labels which indirectly inform people of the risks you take on when eating that food. Foods also have to contain what they say they do on the label. Shopping at the grocery store if I buy only whole foods I can be pretty sure I'm going to eat relatively healthy. A trip to the grocery store certainly doesn't seem like I am hopping over trap doors and dodging boulders while stuck in an Indiana Jones movie.

Yeah, it was a bit of a stretch, but the point was that food companies aren't just making stuff taste good, they're making it addictive. On purpose. They know exactly what they're doing- they want you to "crave" the product, just like a junky craves a fix. They're setting a trap for unsuspecting people. I read labels all the time, and I've never seen one that says "warning, this product is addictive" or "excessive use of this product may cause type 2 diabetes".

BTW, I'm totally with you on the suicide, but freedom to hurt yourself should stipulate that I don't have to pay for it, through higher taxes, higher insurance premiums, or other mechanisms. Freedom is complicated.

Edited by niner, 01 March 2014 - 10:48 PM.

[YOLF]

"and I don't think I should be allowed to create clever trap doors in the sidewalk where your kids walk to school, and charge you money to get them out. By your logic, your kids should just be smart enough to spot my traps and step around them."

That is a pretty ridiculous analogy, lol. Foods have labels which indirectly inform people of the risks you take on when eating that food. Foods also have to contain what they say they do on the label. Shopping at the grocery store if I buy only whole foods I can be pretty sure I'm going to eat relatively healthy. A trip to the grocery store certainly doesn't seem like I am hopping over trap doors and dodging boulders while stuck in an Indiana Jones movie.

Yeah, it was a bit of a stretch, but the point was that food companies aren't just making stuff taste good, they're making it addictive. On purpose. They know exactly what they're doing- they want you to "crave" the product, just like a junky craves a fix. They're setting a trap for unsuspecting people. I read labels all the time, and I've never seen one that says "warning, this product is addictive" or "excessive use of this product may cause type 2 diabetes".

BTW, I'm totally with you on the suicide, but freedom to hurt yourself should stipulate that I don't have to pay for it, through higher taxes, higher insurance premiums, or other mechanisms. Freedom is complicated.

Great post. Don't forget that obesity and diseases from eating unhealthy will have an impact on generations to come.

[nupi]

The fact of the matter is that I need something to drink, and it will all have calories and all of it has too much or has cancer/tumor sugars.

The water that comes out of my tap here does not contain any sugar or other calories. If that is different where you live, then maybe you should move.

BTW, I'm totally with you on the suicide, but freedom to hurt yourself should stipulate that I don't have to pay for it, through higher taxes, higher insurance premiums, or other mechanisms. Freedom is complicated.

Which is why socialized health care (IF we are going to have it at all) should have strong limits on coverage for life style diseases.

Edited by nupi, 02 March 2014 - 10:09 AM.

[username]

What's a lifestyle disease and how do you know it's a lifestyle disease? There are no clear boundaries.
Maybe the fat guy won't get cancer because he doesn't smoke and exercises and lowers his chance of getting cancer (let's ignore the weight for the sake of the argument). But instead of saying 'hey, not bad' people will just say: You're fat, lose weight, you lazy idiot. That's society for ya.

Maybe the skinny guy is someone seeking risk and hurts himself badly and ends up in a wheel chair. Is that lifestyle?

Type 2 diabetes and many other diseases aren't only 'lifestyle'. Infections and genetics play a role as well in many diseases - including Type 2 diabetes.

When someone isolates himself and becomes depressed. Is that lifestyle? Was he already depressed and that's why he withdrew himself from society? Did he make that choice himself because he's pissed at society and that led to him becoming depressed?

People who want a health police should always consider this: What if it's you or your mom or your brother or your best friend? They don't get treatment because it's not covered and they die. It's an incredibly narcisstic point of view and only when you or a loved one is affected, you realize how flawed your logic is. Furthermore, not covering these diseases will cost quite a bit as well: Very sick people DON'T WORK. They aren't able to. Sooo... no social safety net -> street -> death? Or welfare -> cost? Great choice.

Libertarianism sounds really nice and especially Americans love this. "Freedom". "Self-responsibility". Problem is: It's unrealistic and oversimplified. There's a good reason why scandinavian societies are safer than American societies. Their libertarian, narcissistic, naive viewpoint inevitably leads to disaster. It teaches society that empathy and love is bullshit. Just let 'em die. Let the poor die. Let the sick die. Because they brought it upon themselves.

I respect skinny and fat people, healthy and sick people, good-looking and ugly people unless they don't respect me. Instead of blaming people, we should empathize. Instead of following ideology blindly, we should evaluate the facts. Not helping people has consequences for society and also financially. Not helping saves money. But libertarians love to ignore the costs of not helping.

Sorry for the rant, but the Ron Paul attitude gets tiring after a while. It sounds nice. But it doesn't work and we know that it doesn't work. People who are helpless need help.

[nupi]

Look, ultimately there will always be rationing. Either implicit or explicit. Good luck getting a liver if you need a transplant if you are an alcoholic, FWIW. I would much rather have a system where the rationing is explicit so that people know what they are up against (incentives DO matter, a lot). If that means death panels (in some edge cases it will), so be it. For all the brokenness inherent with the NHS, their concept of paying at most X for one quality life year is exactly the discussion that we should be having except that it should also include an element of personal responsibility for cases where the causation is clear (e.g., if you smoke for more than X years, no lung cancer treatment beyond pain relief or some such, got badly injured doing extreme sports? Well you could have gotten that additional insurance to cover it.). In most of the western world, what is called health insurance would more appropriately be called health insulation because it pretty much insulates people from the monetary consequences of their actions.

As for putting my money where my mouth is, while I do pay (a borderline insane amount) out of my own pocket for one of the most comprehensive health insurance packages available [1], I also just signed what amounts to a DNR in case I crash my motorbike badly enough (the legal framework to do so only became recently available).

As for Ron Paul, the guy is a nut case doing more damage than good to the libertarian movement, world wide...

[1] It even includes known to be useless treatments but I cannot exclude them, sadly.

Edited by nupi, 02 March 2014 - 03:02 PM.

[username]

I just see too many problems with this approach:

Let's say someone wanted to get that insurance for his motorbike 2 days after he bought it. But just one day later he has an accident. What now?

People who don't smoke can get lung cancer. What if someone smoked for 30 years, but only 2 cigarettes a day. And he gets lung cancer. Probably not from the cigs. What now? Check if the cancer was actually caused by smoking? -> $$$

There's a difference between organ transplantation and other treatments: Spending money on something can save money in the future. You cannot use the organ analogy for this. There are few organs and many people who need them. Not treating people also affects moral standards of a society.

When you try to establish in which cases people shouldn't be treated, you will have to make more and more exceptions to the rule because the world is really complicated. What if a woman was raped, became depressed and started drinking and drinking and drinking -> liver cirrhosis -> do you want to tell that person to go home and die? The doctor will probably never hear of her terrible past. He only sees facts. She doesn't qualify for treatment.

I do understand the wish to create some kind of 'fairness'. Be good to those who try their best to stay healthy while punishing those who didn't in order to save money. But, again, the world is way too complicated. I don't want to live in that kind of society. I don't know what people experienced in their past and why they made bad choices. But denying them treatment even though you could offer it is morally wrong and it will just be a matter of time until the 'health people' realize that they were wrong: When a loved one is affected, people change their views from one second to the other. Just look at republicans who suddenly support gay marriage because their son/daughter is gay. That's how people are.

Edited by longschi, 02 March 2014 - 08:00 PM.

[niner]

I just see too many problems with this approach:

Let's say someone wanted to get that insurance for his motorbike 2 days after he bought it. But just one day later he has an accident. What now?

People who don't smoke can get lung cancer. What if someone smoked for 30 years, but only 2 cigarettes a day. And he gets lung cancer. Probably not from the cigs. What now? Check if the cancer was actually caused by smoking? -> $$$

There are a ton of problems with a hard-core version of making everyone responsible for their irresponsible behavior, which is a major reason why we don't do it. We have a softer approach to the problem- like charging people higher insurance premiums if they smoke. We charge older people more for health insurance because they are more expensive than young people, as a group. Younger people pay higher auto premiums, even if they're great drivers. Cigarettes cost a lot more than the cost of production would warrant. There's a reason for that. I don't have a problem with erecting some mild barriers to the consumption of massive amounts of sugar, but obviously, a lot of people do have a problem with that, as we've seen in this thread.

[YOLF]

The fact of the matter is that I need something to drink, and it will all have calories and all of it has too much or has cancer/tumor sugars.

The water that comes out of my tap here does not contain any sugar or other calories. If that is different where you live, then maybe you should move.

BTW, I'm totally with you on the suicide, but freedom to hurt yourself should stipulate that I don't have to pay for it, through higher taxes, higher insurance premiums, or other mechanisms. Freedom is complicated.

Which is why socialized health care (IF we are going to have it at all) should have strong limits on coverage for life style diseases.

That's true, I could drink water. But I don't because it's tasteless and I've been used to taste my entire life and I'm surrounded by taste. If you give a foreigner from a country where they don't have such things a sweet drink, they will tell you that it's too sweet and refuse it. They are able too because their brains aren't looking for it because it was never available to them.

I see socialized medicine a little bit differently, I'm of the opinion that we should be required to meet a standard age adjusted (at least for the time being while we work on defeating aging) health criteria for the duration of our lives. If we don't meet those criteria as kids, we get held back. If we don't meet them as adults, we are required to attend a gym. If that doesn't work, we get sent away to a boot camp style adult fat camp where our health and lifestyle is re-engineered by medical professionals and we can't leave until we reach the optimal criteria. This includes the use of medical intervention to add muscle mass, brown fat, and things like that. After that, it's 3 years probation and mandatory gym attendance with checks from a probation officer.

The idea of just cutting off someone with a problem and leaving them to their own devices is ethically wrong.

Oh and while I'm posting...

I went to the store to look for iced tea mix yesterday. I usually buy one of two brands. Either Lipton or 4C and prefer Lipton. I usually don't read labels for things like this but decided to see what the difference is. The 4C gives me a weird feeling I don't get with Lipton and has a slightly sweeter taste due to its ingredient list. There were three more brands there that I hadn't seen before including a well known generic company, a white box company and a store brand. All of which had the same ingredients. The Lipton however had a completely different list of ingredients. The most noteable of which was the lack of caramel coloring. It doesn't give an amount on it, but I drink several glasses of tea a day, often exceeding two quarts and didn't know until recently that caramel coloring could be a problem if we consumed too much. I don't care for the added colors and I could do with less sugar, but I can't deal with less caffeine. It's just not going to happen.

Now let's examine the historical pathology of my tea drinking habits. For many years I was a straight pepsi drinker and when it was available, I would preferred crystal clear pepsi (I think that's what it was called) or coke or pepsi from the fast food tap. I briefly started drinking Snapple, but for some reason or another... despite it being made from the best stuff on Earth gave me headaches if I drank too much of it, especially kiwi strawberry. I also drink the occasional bottled water depending on what I'm eating. At some point, I decide to start drinking healthier substances and Tea has half-quarter the calories. However it also has half-quarter the caffeine, so I now have to drink more of it to satiate my crack-like caffeine addiction and it results in very high intake of caramel coloring which isn't healthy. With normal drinks, light sugaring is good, tea can get away with having an eighth or less of the amount of sugar that a softdrink has. So why add so much? Why is there still so much sugar in tea? It's expected by the customer. Comparing the brands might make you think the Lipton has less taste. But the fact of the matter is that the flavor of the caramel coloring has to be masked by extra sugar. That's why sweet teas at subway and MCD taste ridiculously sweet. Why is there so much caramel color? Because customers associate the darkness of the tea with more tea content. But the associate is a lie. There isn't more healthy tea stuff in it, there is more unhealthy additive stuff in it and if you drink too much it can be toxic.

This is a circumstance that creates an out of control situation that leads to harm and higher sugar content and it's not going to stop and unsuspecting people are going to get hurt because of it. It needs regulation. Some government agency or another needs to ban putting the stuff into our food. I want to live a healthy life and have the benefits of caffeine. Why do I have to eat all this sugar and these coloring agents? That's not what a rational person wants to do, but we can't very well make our own food with an American lifestyle. It just won't work. I've tried boiling tea concentrate in gallons, it doesn't work, the tea winds up over boiled, and the concentrate grows moldy.

So for the purpose of selling more food and being more competitive, I'm being poisoned.

I'll link to this article where the spokesperson from pepsi states that most people drink less than a can a day, so it's okay and the CDC states that the average US consumption per capita is 1.3 with some people not drinking it at all... The average among the general consumer is bound to be much higher... something around 4-5 day. If we drank that many beers we'd be alcoholics. FWIW, though the report says that pepsi was the culprit, I would have assumed that it was coke as it is a much darker drink and tends to give me heartburn unless it's the classic formulation that comes in glass... It wouldn't surprise me if something else was wrong with it.

[PWAIN]

The correct approach is not to ban or punish, it is to educate. When people know the real level of risk they take, they are more inclined to not do harmful things to themselves. No one banned sitting in the sun to get a suntan and suntan lotions are not compulsory and yet we have responded positivly to the education programs. Yes, some people will ignore this but the vast majority listen and take action.

[YOLF]

Look, ultimately there will always be rationing. Either implicit or explicit. Good luck getting a liver if you need a transplant if you are an alcoholic, FWIW. I would much rather have a system where the rationing is explicit so that people know what they are up against (incentives DO matter, a lot). If that means death panels (in some edge cases it will), so be it. For all the brokenness inherent with the NHS, their concept of paying at most X for one quality life year is exactly the discussion that we should be having except that it should also include an element of personal responsibility for cases where the causation is clear (e.g., if you smoke for more than X years, no lung cancer treatment beyond pain relief or some such, got badly injured doing extreme sports? Well you could have gotten that additional insurance to cover it.). In most of the western world, what is called health insurance would more appropriately be called health insulation because it pretty much insulates people from the monetary consequences of their actions.

As for putting my money where my mouth is, while I do pay (a borderline insane amount) out of my own pocket for one of the most comprehensive health insurance packages available [1], I also just signed what amounts to a DNR in case I crash my motorbike badly enough (the legal framework to do so only became recently available).

As for Ron Paul, the guy is a nut case doing more damage than good to the libertarian movement, world wide...

[1] It even includes known to be useless treatments but I cannot exclude them, sadly.

The fact of the matter is that if you keep those people healthy and prevent them from developing problems, you'll have more organs for transplantation and need less of them. Enforce health and keep health standards on the rise the way we do with carbon emissions and energy efficiency requirements. We don't have to have the problems we do, but there are consequences to letting people live unhealthy lifestyles.

[chemicalambrosia]

Cryonicsculture, you really want someone to take care of you from cradle to grave. Good luck with that. The government keeps people nice and skinny in North Korea, but their nutrition and exercise programs won't be trendy in any Western countries any time soon. Be careful what you wish for.

Look, ultimately there will always be rationing. Either implicit or explicit. Good luck getting a liver if you need a transplant if you are an alcoholic, FWIW. I would much rather have a system where the rationing is explicit so that people know what they are up against (incentives DO matter, a lot). If that means death panels (in some edge cases it will), so be it. For all the brokenness inherent with the NHS, their concept of paying at most X for one quality life year is exactly the discussion that we should be having except that it should also include an element of personal responsibility for cases where the causation is clear (e.g., if you smoke for more than X years, no lung cancer treatment beyond pain relief or some such, got badly injured doing extreme sports? Well you could have gotten that additional insurance to cover it.). In most of the western world, what is called health insurance would more appropriately be called health insulation because it pretty much insulates people from the monetary consequences of their actions.

As for putting my money where my mouth is, while I do pay (a borderline insane amount) out of my own pocket for one of the most comprehensive health insurance packages available [1], I also just signed what amounts to a DNR in case I crash my motorbike badly enough (the legal framework to do so only became recently available).

As for Ron Paul, the guy is a nut case doing more damage than good to the libertarian movement, world wide...

[1] It even includes known to be useless treatments but I cannot exclude them, sadly.

Really good post until you took a shot at Ron Paul. Incentives and penalties to encourage people towards good behavior are mostly good things, especially when they use market based pricing instead of having the baskets of distortions we have now. Fixing systems with distorted penalties is much better than banning food or telling companies how delicious their food can be.

I don't want to get crazy far off topic, but Ron Paul has probably boosted the numbers of the libertarian movement several fold. A lot of people had never even heard the word libertarian before him. He is far from perfect and has made plenty of mistakes and has an unhealthy obsession with gold and the gold standard, but IMO he has done a lot for the libertarian movement. Because of him(and his supporters) libertarians get mentioned as a swing vote, they can't be ignored, and his son has a decent shot at the presidential nomination in the next election.

I just see too many problems with this approach:

Let's say someone wanted to get that insurance for his motorbike 2 days after he bought it. But just one day later he has an accident. What now?

People who don't smoke can get lung cancer. What if someone smoked for 30 years, but only 2 cigarettes a day. And he gets lung cancer. Probably not from the cigs. What now? Check if the cancer was actually caused by smoking? -> $$$

There are a ton of problems with a hard-core version of making everyone responsible for their irresponsible behavior, which is a major reason why we don't do it. We have a softer approach to the problem- like charging people higher insurance premiums if they smoke. We charge older people more for health insurance because they are more expensive than young people, as a group. Younger people pay higher auto premiums, even if they're great drivers. Cigarettes cost a lot more than the cost of production would warrant. There's a reason for that. I don't have a problem with erecting some mild barriers to the consumption of massive amounts of sugar, but obviously, a lot of people do have a problem with that, as we've seen in this thread.

I don't really have much of a problem with well designed and fair taxes on processed junk food. Bloomberg and his type go way beyond that, and you were hinting at what are IMO much more onerous and meddling regulations when you were asking if making food addictive or not was all right. However, as far as taxing junk food, it is pretty ridiculous IMO to do so while still subsidizing it at the same time. That is basically giving handouts to the manufacturers and then taxing it at the retail level. It is at best a wash, but in reality it is just a wealth transfer from low level consumers/the poor to the rich. Actually, you would probably have to have a ridiculously high tax to offset the damage of food stamps, to the point people would be rioting in the streets over the price of Twinkies and Mountain Dew. It would be better to make sure that tax payer's dollars are being used for the good of tax payers.

[YOLF]

Chem,

I want everyone to be taken care of. Give me one good reason why we should abandon anyone? And if we are going to abandon someone, why? Do we have to manage what we do in such a way that we have the results that we do today? The world may be a better place than it has been in years past, but it's not as good a place as it can be and if we don't work towards that end, to the future we are no more than those of years past who sit in their graves.

[niner]

Not to speak for chem, but some people are egregiously irresponsible and bring their problems upon themselves. If we had infinite money, then I guess we could afford to take care of everyone, but when health care is ridiculously expensive, if you have to choose between a liver transplant for a 90 year old alcoholic who's still drinking versus primary care for 5000 children, ignoring the kids would be morally wrong, and is simply a better investment. I'm not sure what you mean by "taking care of". Are you talking about just health care, or also providing free food, housing, clothing, and cable TV? I think it's better psychologically for people to earn what they get, if possible.

[YOLF]

That's one way of looking at it. The way I see it, if you create a person you have a responsibility to ensure that they will live a good life. The problem is complex and I just can't imagine that a person could be wholly responsible for their own bad health. Obviously I agree with you that we shouldn't give a 90 year old a liver at the expense of primary care for 5000 kids and the system we are living with today makes that an imperative where it doesn't have to.

I'm a proponent of a Health/Life Care centric global economy. The more diseases you cure and the more vaccines you produce, the more money there is. The Health/Life Care Administration or HLCA would entirely replace the Fed. Therefore, the better the health and lives of your people, the more wealthy your country. Countries would compete for economic dominance by improving the health, lives, and lifespans of their people. Thus (for argument's sake) if the UN or other international body determines that 1% of people are living with a disease at any given time in the US and 2% in the UK, the value of the USD would exceed the value of the GBP on the disease portion of the currency valuation. If the average lifespan of someone in the UK is 3% higher than in the US, the lifespan portion of the currency valuation would reflect this. Significant differentials in any given portion of the currency valuation would result in a penalty. Under a system like this people would be motivated to improve health, well being and lifespan. Existence of poverty would also reduce a currency's value and in order to create more relative wealth, you'd have to work harder to ensure that the HLC index was on top. Countries would train people to

A country that didn't participate in raising HLC standards would drive itself to ruin and would quickly be replaced with the assistance of the more developed world. A low standard of HLC would essentially be a crime against humanity. Let's face it. We created the system we live in now and we can create a better one. What we have now was designed to have problems and with each generation the effects of the problems grow. It simply isn't sustainable and by design, it can only be attenuated by death and moral compromise. The possibilities and prosperity is limited only by our imaginations and the amount of effort we put into something. If part of the population is lazy, it's because they aren't motivated, and allowing people to become unmotivated would result in decreased HLC output and more drag on the economy. Countries who could keep more of their population motivated without eugenics could accomplish more.

As too great a differential between rich and poor would result in valuation penalties, there wouldn't be any wages that aren't liveable and everyone would be able to own their own on their income or yes, why not give people the stability of home ownership and the basic necessities? I know that it's what North Korea does, but doing it doesn't mean having the same level of poverty that North Korea does. Having that level of poverty is a complex matter, but not the result of ensuring that everyone has basic necessities such as their own home, food, and clothing.

Again, I resolve everything to pathology. The people that make up the world will be whatever their life experience produces. Life produces the person IMO. Those who have the highest level of motivation are those who enjoyed the system the most and receive the best rewards in their development. They want the system to persist and work hard for it. On the other hand, those that suffer under the system want nothing to do with it and their life has produced a person with limited job prospects. For them, working hard would either mean harming those around them as is the case in civil wars or supporting those around them and the system that allowed for the possibility of such disparity. Being lazy in this case is more a form of civil disobedience.

Under the system I propose, the government would have to ensure that everyone has a motivating life. I also add provisions for universal language and the freedom of independent naturalization to the country of their choice. This would allow anyone to find a country that fits and be able to live a motivated life working for what they believe in. At such a point where we leave the Earth in favor of orbitals and the like, I could see people independently choosing to build new countries of like minded people gathered from all of human kind.

So how do you think I can improve this vision?

[username]

I see socialized medicine a little bit differently, I'm of the opinion that we should be required to meet a standard age adjusted (at least for the time being while we work on defeating aging) health criteria for the duration of our lives. If we don't meet those criteria as kids, we get held back. If we don't meet them as adults, we are required to attend a gym. If that doesn't work, we get sent away to a boot camp style adult fat camp where our health and lifestyle is re-engineered by medical professionals and we can't leave until we reach the optimal criteria. This includes the use of medical intervention to add muscle mass, brown fat, and things like that. After that, it's 3 years probation and mandatory gym attendance with checks from a probation officer.

The idea of just cutting off someone with a problem and leaving them to their own devices is ethically wrong.

And this isn't? You can't just ignore the consequences this will have on society. Ideas are a nice thing to have, but when they are not applicable in reality, they are worthless. People would riot...

This is a circumstance that creates an out of control situation that leads to harm and higher sugar content and it's not going to stop and unsuspecting people are going to get hurt because of it. It needs regulation. Some government agency or another needs to ban putting the stuff into our food. I want to live a healthy life and have the benefits of caffeine. Why do I have to eat all this sugar and these coloring agents? That's not what a rational person wants to do, but we can't very well make our own food with an American lifestyle. It just won't work. I've tried boiling tea concentrate in gallons, it doesn't work, the tea winds up over boiled, and the concentrate grows moldy.

So for the purpose of selling more food and being more competitive, I'm being poisoned.

I agree with the additive/sugar situation. However, I prefer different labeling, ad campaigns, and prevention in schools to prohibiting things.
And why don't you just brew tea, put some sugar in it and let it cool?

[YOLF]

I see socialized medicine a little bit differently, I'm of the opinion that we should be required to meet a standard age adjusted (at least for the time being while we work on defeating aging) health criteria for the duration of our lives. If we don't meet those criteria as kids, we get held back. If we don't meet them as adults, we are required to attend a gym. If that doesn't work, we get sent away to a boot camp style adult fat camp where our health and lifestyle is re-engineered by medical professionals and we can't leave until we reach the optimal criteria. This includes the use of medical intervention to add muscle mass, brown fat, and things like that. After that, it's 3 years probation and mandatory gym attendance with checks from a probation officer.

The idea of just cutting off someone with a problem and leaving them to their own devices is ethically wrong.

And this isn't? You can't just ignore the consequences this will have on society. Ideas are a nice thing to have, but when they are not applicable in reality, they are worthless. People would riot...

This is a circumstance that creates an out of control situation that leads to harm and higher sugar content and it's not going to stop and unsuspecting people are going to get hurt because of it. It needs regulation. Some government agency or another needs to ban putting the stuff into our food. I want to live a healthy life and have the benefits of caffeine. Why do I have to eat all this sugar and these coloring agents? That's not what a rational person wants to do, but we can't very well make our own food with an American lifestyle. It just won't work. I've tried boiling tea concentrate in gallons, it doesn't work, the tea winds up over boiled, and the concentrate grows moldy.

So for the purpose of selling more food and being more competitive, I'm being poisoned.

I agree with the additive/sugar situation. However, I prefer different labeling, ad campaigns, and prevention in schools to prohibiting things.
And why don't you just brew tea, put some sugar in it and let it cool?

I can't imagine that there is an overweight person who wants to be overweight. Plucking someone out of their unhealthy habits wouldn't lead to riots, it would lead to better health. Everyone who is fat wants to lose weight. It's a fact, they just haven't been able to do it yet. There is no such thing as a person who wants to be fat. There are people who have been told that it is ok to be fat and have been reassured to the point where they feel comfortable being fat, but remove the illusion and start letting them face the facts in a regulated environment, and most if not all will want to get on with fat camp and get healthy. Every overweight person I know wants to lose weight. Give them a serious opportunity, compel them to do so, and go all the way (reaching a point where their muscle fat ratio has been normalized or more and their bad habits have been broken and new habits have been reinforced) and it will be the most positive life affirming experience people have.

Consider this:
Michelle Obama has gone around promoting fitter kids and we now have a much lower rate of obesity among them. We also have the first steps of socialized single payer medicine. So we've stopped harming future generations to some extent and admitted that our system has a problem that produces unhealthy people. So what do we do about the problems we've caused? We abandon them. We let them live until the death panel gets them and they live decades less than they might have if they had achieved permanent weight loss. We made a mistake, now instead of fixing it and helping the injured, we just throw them away? What's the more ethical solution? Is it ok to reassure ourselves that it's ok to let the fat people die because the biochemistry of obesity makes them lethargic and apathetic to their condition? Their disease makes them feel ok with being fat and happy, so we can just let them be fat and happy until we let them keel over. This pathology is inaction. Will good men do nothing?

Poor health is inherently limiting to freedom. A fat person is not free to experience and live life like a healthy one.

As for boiling and brewing tea, they are all the same thing to me. It won't end well. I cook once or twice a week all at once and reheat stuff in the microwave. It takes more energy to make a single cup than it does to make it in gallons and alot more effort.

If a company has a choice to add a potentially toxic chemical to their food to make it more competitive and they know that a certain subset of their population will consume it in excess and potentially injure themselves, I see an ethical problem and companies that are rampantly disregarding public health for profits. This is corruption and Big(All) Tobacco by another name.

[nupi]

Chem,

I want everyone to be taken care of. Give me one good reason why we should abandon anyone? And if we are going to abandon someone, why? Do we have to manage what we do in such a way that we have the results that we do today? The world may be a better place than it has been in years past, but it's not as good a place as it can be and if we don't work towards that end, to the future we are no more than those of years past who sit in their graves.

Clearly you live in fantasy land then. As niner nicely pointed out, resources are finite and we will have to allocate them somehow. And that is irrespective of the thorny discussion of how much resources we will take from group A to support group B. Personally, I do support a safety net. But one that maintains incentives to help oneself, not the current safety cushion (living in a net would be decidedly uncomfortable).

That's one way of looking at it. The way I see it, if you create a person you have a responsibility to ensure that they will live a good life.

Agreed. So the PARENTS are responsible that their children will have a good life. Not strangers in the form of tax payers.

The problem is complex and I just can't imagine that a person could be wholly responsible for their own bad health.

It's obviously a continuum but people on average are more responsible for their own illnesses (with the notable exception of some highly infectious diseases) than most believe.

Obviously I agree with you that we shouldn't give a 90 year old a liver at the expense of primary care for 5000 kids and the system we are living with today makes that an imperative where it doesn't have to.
I'm a proponent of a Health/Life Care centric global economy. The more diseases you cure and the more vaccines you produce, the more money there is.

Initially, the more money will be SPENT. Whether that can ever be recouped is quite a different question.

The Health/Life Care Administration or HLCA would entirely replace the Fed. Therefore, the better the health and lives of your people, the more wealthy your country. Countries would compete for economic dominance by improving the health, lives, and lifespans of their people. Thus (for argument's sake) if the UN or other international body determines that 1% of people are living with a disease at any given time in the US and 2% in the UK, the value of the USD would exceed the value of the GBP on the disease portion of the currency valuation. If the average lifespan of someone in the UK is 3% higher than in the US, the lifespan portion of the currency valuation would reflect this. Significant differentials in any given portion of the currency valuation would result in a penalty. Under a system like this people would be motivated to improve health, well being and lifespan. Existence of poverty would also reduce a currency's value and in order to create more relative wealth, you'd have to work harder to ensure that the HLC index was on top.

[....]

Ok, you don't just live in fantasy land. This is whole different level of craziness - quite likely exceeding that of your garden variety communist, even.

So how do you think I can improve this vision?

By reading about basic human psychology. And then figuring out why this will never ever work.

I can't imagine that there is an overweight person who wants to be overweight.

Far and by large (some genetic disorders notwithstanding) they simply like eating whatever they want more than they like to be thin.

Poor health is inherently limiting to freedom. A fat person is not free to experience and live life like a healthy one.

Most fat people have but themselves to blame for choosing to exercise a different freedom, that of eating too much. Now, I could be convinced that taxes on junk food would be a workable way to address some of the issues but what you seem to envision sounds like fascism to me, more than anything else.

As for boiling and brewing tea, they are all the same thing to me. It won't end well. I cook once or twice a week all at once and reheat stuff in the microwave. It takes more energy to make a single cup than it does to make it in gallons and alot more effort.

Hardly. Packaging and shipping the finished tea uses large amounts of energy. As for you wanting to have taste in your beverages, welcome to the world of trade-offs (they are real, even if you don't seem to believe so). I will stick to drinking water (which I basically started at age 18 or so, so not from some imagine destitute upbringing devoid of access to sugar [1]) and coffee.

[1] I will maintain that your garden variety sugared drinks DO disgust me these days, though. It gets worse in some countries were the sugar added is even higher (Philippines comes to mind) where it is basically impossible to drink store bought beverages (except water and beer).

[nupi]

Really good post until you took a shot at Ron Paul. Incentives and penalties to encourage people towards good behavior are mostly good things, especially when they use market based pricing instead of having the baskets of distortions we have now. Fixing systems with distorted penalties is much better than banning food or telling companies how delicious their food can be.

I don't want to get crazy far off topic, but Ron Paul has probably boosted the numbers of the libertarian movement several fold. A lot of people had never even heard the word libertarian before him. He is far from perfect and has made plenty of mistakes and has an unhealthy obsession with gold and the gold standard, but IMO he has done a lot for the libertarian movement. Because of him(and his supporters) libertarians get mentioned as a swing vote, they can't be ignored, and his son has a decent shot at the presidential nomination in the next election.

His unhealthy obsession with the gold standard would quite likely do much worse for the economy than all the severely misguided programs of the Bush's and Obama's. I also have philosophical issue with him being a religious nut but at least he does not try to impose that on others (naming his son after a clearly out of her mind writer does not inspire too much confidence, either).

Although I will concede that he on balance probably would do more good than bad if elected (mostly because the gold standard certainly would not be adopted).

Let's say someone wanted to get that insurance for his motorbike 2 days after he bought it. But just one day later he has an accident. What now?

In Switzerland I am not allowed to drive of the dealer's lot until the vehicle has liability insurance. Not too hard to imagine a similar rule for the accompanying health insurance (or we just roll that part into the insurance or even tax on the motorbike, that would work, too, though insurance is probably the better option as insurance is already trying to price relative risks).

There are a ton of problems with a hard-core version of making everyone responsible for their irresponsible behavior, which is a major reason why we don't do it. We have a softer approach to the problem- like charging people higher insurance premiums if they smoke. We charge older people more for health insurance because they are more expensive than young people, as a group. Younger people pay higher auto premiums, even if they're great drivers. Cigarettes cost a lot more than the cost of production would warrant. There's a reason for that. I don't have a problem with erecting some mild barriers to the consumption of massive amounts of sugar, but obviously, a lot of people do have a problem with that, as we've seen in this thread.

(I hope I got the quote right) Personally, I consider myself libertarian leaning but I am all for internalizing damage done by products - unfortunately, the dose response curve is rarely linear. But sure, tax sugar (or at the very least, you know, quit subsidizing it) and other stuff where a decent causality exists. I DO have an issue with outright banning of stuff and that goes for all recreational drugs, too.

Edited by nupi, 04 March 2014 - 10:27 AM.

[YOLF]

Chem,

I want everyone to be taken care of. Give me one good reason why we should abandon anyone? And if we are going to abandon someone, why? Do we have to manage what we do in such a way that we have the results that we do today? The world may be a better place than it has been in years past, but it's not as good a place as it can be and if we don't work towards that end, to the future we are no more than those of years past who sit in their graves.

Clearly you live in fantasy land then. As niner nicely pointed out, resources are finite and we will have to allocate them somehow. And that is irrespective of the thorny discussion of how much resources we will take from group A to support group B. Personally, I do support a safety net. But one that maintains incentives to help oneself, not the current safety cushion (living in a net would be decidedly uncomfortable).

That's one way of looking at it. The way I see it, if you create a person you have a responsibility to ensure that they will live a good life.

Agreed. So the PARENTS are responsible that their children will have a good life. Not strangers in the form of tax payers.

The problem is complex and I just can't imagine that a person could be wholly responsible for their own bad health.

It's obviously a continuum but people on average are more responsible for their own illnesses (with the notable exception of some highly infectious diseases) than most believe.

Obviously I agree with you that we shouldn't give a 90 year old a liver at the expense of primary care for 5000 kids and the system we are living with today makes that an imperative where it doesn't have to.
I'm a proponent of a Health/Life Care centric global economy. The more diseases you cure and the more vaccines you produce, the more money there is.

Initially, the more money will be SPENT. Whether that can ever be recouped is quite a different question.

The Health/Life Care Administration or HLCA would entirely replace the Fed. Therefore, the better the health and lives of your people, the more wealthy your country. Countries would compete for economic dominance by improving the health, lives, and lifespans of their people. Thus (for argument's sake) if the UN or other international body determines that 1% of people are living with a disease at any given time in the US and 2% in the UK, the value of the USD would exceed the value of the GBP on the disease portion of the currency valuation. If the average lifespan of someone in the UK is 3% higher than in the US, the lifespan portion of the currency valuation would reflect this. Significant differentials in any given portion of the currency valuation would result in a penalty. Under a system like this people would be motivated to improve health, well being and lifespan. Existence of poverty would also reduce a currency's value and in order to create more relative wealth, you'd have to work harder to ensure that the HLC index was on top.

[....]

Ok, you don't just live in fantasy land. This is whole different level of craziness - quite likely exceeding that of your garden variety communist, even.

So how do you think I can improve this vision?

By reading about basic human psychology. And then figuring out why this will never ever work.

I can't imagine that there is an overweight person who wants to be overweight.

Far and by large (some genetic disorders notwithstanding) they simply like eating whatever they want more than they like to be thin.

Poor health is inherently limiting to freedom. A fat person is not free to experience and live life like a healthy one.

Most fat people have but themselves to blame for choosing to exercise a different freedom, that of eating too much. Now, I could be convinced that taxes on junk food would be a workable way to address some of the issues but what you seem to envision sounds like fascism to me, more than anything else.

As for boiling and brewing tea, they are all the same thing to me. It won't end well. I cook once or twice a week all at once and reheat stuff in the microwave. It takes more energy to make a single cup than it does to make it in gallons and alot more effort.

Hardly. Packaging and shipping the finished tea uses large amounts of energy. As for you wanting to have taste in your beverages, welcome to the world of trade-offs (they are real, even if you don't seem to believe so). I will stick to drinking water (which I basically started at age 18 or so, so not from some imagine destitute upbringing devoid of access to sugar [1]) and coffee.

[1] I will maintain that your garden variety sugared drinks DO disgust me these days, though. It gets worse in some countries were the sugar added is even higher (Philippines comes to mind) where it is basically impossible to drink store bought beverages (except water and beer).

From the beginning you're not seeing the merits of the system. The technology is there, we just haven't built enough medical machines. Drugs are cheap and the process would be the mechanism that creates wealth. More wealth, more jobs. More jobs, more resources. We just haven't trained enough people to operate the technologies. The idea that there are only a finite amount or resources is mostly fallacy. At present we know that there is a finite amount of matter on Earth and physics tells us similar about the universe. But there are plenty of resources that can be obtained for an insanely long period of time. We just need to dig them out of the ground and put more effort into making them something. The only thing slowing us down is not putting the proverbial shovel to the ground. Machines could do much more work than is currently being done and produce more for everyone leaving more resources for the future as modern processes recycle everything but nuclear waste.

On responsibility of condition - if you've never experienced hopelessness, I suggest giving it a try. If you are taught hopelessness, as is largely the case in many hard to beat conditions, then yeah, you aren't going to beat it and you choose to manage it as best as you can. It really is difficult to understand until you experience it. Take a fat kid for example. They were taught to eat crap food and that it was ok to do so and ok to be fat. It's just the way they are. Fast forward to adulthood where their brain has been built by the development process to eat crap and the physiology of their body was built to store fat. Developmental processes which we can't currently restore have determined that they will be able to burn a smaller number of calories each day and they have brain that demands higher intake fueled by a collusion of brain targeted hormones of impulse released by fat cells so they can keep filling up. Everyday is struggle for them. All because society, not just parents reinforced the idea that it was ok to be fat. How many new shows and kids shows have popular fat kids in them and argue that it's ok to be fat? This is as much a social problem as it is a family problem and it will be a problem either until people die or until we do something about it. The society who caused this problem is responsible for fixing it are they not?

Because this money is spent, someone has it. It's better that it isn't recouped and it stays in the hands of people who use it for private industry which may feedback into available resources for HLC. Not everyone is going to be a medical professional or medical engineer. But as long as we keep working to improve people's lives and health, we'll be wealthy. That's the merit of fiat currencies fulfilled.

Now as for brewing tea, Lipton has efficiencies of scale and heat recycling processes I will never have at home. If you run a factory 24/7, it runs more efficiently. When I boil a gallon or so of tea, I don't get their efficiency and I'm wasting time that would be better spent on life extension.