Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that bad at the time... it didn't to me and it didn't to Jason Scott... just do it.
Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that bad at the time... it didn't to me and it didn't to Jason Scott... just do it.
Sociologist Lisa Wade, interviewed in New York Magazine, says that 'some scholars argue that being male is the single strongest predictor of whether a person will take health risks.'
Men like risk it turns out. Most of them also hate putting lotion on their skin (too girly) and being afraid of things (not manly). They are also more likely to have outdoor jobs and do household tasks that involve being outside the house. Think lawn mowing and BBQ-ing. They also pay less attention to their skin and so don’t catch early warning signs.
Women, generally speaking, don’t mind lotions, do pay attention to changes in our skin, wear sunscreen to avoid premature aging and wrinkles, and often also wear make up year round that contains ingredients that protect skin from the sun."
"[...] part of the reason that married men, or men with female partners anyway, live longer. They’re nagged into healthy habits and visit the doctor more often."
https://fitisafeministissue.com/2014/08/16/men-and-skin-canc...
He said middle-aged guys with no obvious health problems pretty much only come to the doctor for one (or both) of two reasons: Their wife made them, or they want Viagra.
I pretty severely injured an ankle back in September, at MMA, and for the first time in my life (at 38) it doesn't seem to be healing up very well. I keep finding new little movements that cause it to feel pretty wrong ("popping", "pulling", cold sensation, mild short-term pain, weakness).
One of these happened in front of my girlfriend, who ordered me to see a doctor, so I did. I filled out new copies of all the paperwork I filled out a year ago when I was grievously ill, sat around for a bit, got into the doctor's office, his assistant appeared and asked me a couple of questions, then the doctor appeared after a bit and asked me the same questions again. He palpated my ankle for a few seconds, told me to get a brace, and then left the room without another word.
Unless you're wealthy enough to afford a dedicated physician, there's just really no point in seeing a doctor for anything less than "I might be about to die".
...which sucks, because I'm a huge proponent of preventative medical care. It's just not available for most people.
I think it depends on your doctor.
My GP is fantastic. He's always running late because the company he works for slots patients in 30 minute intervals, but he takes as long as is needed for his patients.
I'm not even close to wealthy ($50k/year) I can go to him for anything from the flu to broken bones to high cholesterol without thinking, "this is pointless".
Why would anyone see a doctor unless they had a health problem? (Or wanted health advice?)
Last I knew though they weren't evidence based.
Quite a few deadly things need to be caught before they become obvious problems. As a crude example, prostate cancer is one of diseases causing death for men; and has the "nice" property that if it's detected early in a screening then it's (usually) treatable with minor side effects, but by the time it causes symptoms serious enough to seek a fix for the symptoms, it generally has grown enough to be lethal.
In 2012, the Cochrane Collaboration, an international group of medical researchers who systematically review the world’s biomedical research, analyzed 14 randomized controlled trials with over 182,000 people followed for a median of nine years that sought to evaluate the benefits of routine, general health checkups — that is, visits to the physician for general health and not prompted by any particular symptom or complaint.
The unequivocal conclusion: the appointments are unlikely to be beneficial.
From https://www.nytimes.com/2015/01/09/opinion/skip-your-annual-...
https://sciencebasedmedicine.org/a-skeptical-look-at-screeni...
>Prostate cancer is very common but isn’t always harmful. It is found in 80% of autopsies where the men died of something else. Many more men die with prostate cancer than because of it.
>The screening test for prostate cancer is a blood test for prostate-specific antigen (PSA). This is not a yes-or-no test. It must be interpreted in the context of the patient’s age and risk factors and the rate of rise, and any cut-off level is arbitrary and will miss some small percentage of cancers. If the PSA test is positive, the next step is biopsy. Typically, 12 needle biopsies are done, 6 on each side. They find cancer in 25% of patients. But if you go back and do more biopsies, you’ll find cancer in 25% more patients. Theoretically, if you could see every cell in the prostate, you might be able to find a cancer cell or two in almost everyone, most of which would never progress or kill the patient. So you have to decide how many biopsies are reasonable. If you find cancer on a biopsy, the next step is treatment, and treatments for prostate cancer are not benign.
>In a large European study, screening resulted in an absolute reduction in deaths from prostate cancer of 7 per 10,000 men screened. We can look at this in terms of number needed to screen (NNS) and number needed to treat (NNT). To prevent one death from prostate cancer, 1,068 men would have to be screened and 48 treated. But here’s the kicker: there was no reduction in all-cause mortality. The overall death rate was the same in the screened group as in the unscreened group.
>If a prostate cancer is localized and low grade, it is reasonable to observe the patient and not treat unless he develops signs of progression. A recent study compared surgery to watchful waiting and found no reduction in deaths. Within 30 days of surgery, 1/5 of the patients had complications including deaths. 2 years after surgery, these long term complications were present:
17% were incontinent
81% had erectile dysfunction
12% had bowel dysfunction
>Popular advice has been “Get tested; it could save your life” but current expert advice is “Don’t get tested; it does more harm than good.” (Mainly from impotence and incontinence.) Emotional anecdotes abound. One doctor wrote an article titled “The New York Times Killed My Patient.” His patient refused PSA testing because he had read that it was not recommended; he developed invasive prostate cancer and died. Another doctor wrote about the opposite experience: his patient had insisted on testing. He was diagnosed with low-grade localized cancer, the kind that can be observed without treating. But he couldn’t face living with the knowledge that he was harboring an untreated cancer. He was afraid of surgery and opted for radiation treatment. He developed radiation proctitis and had rectal pain and bleeding for years. He became impotent and lost bladder control. He told his doctor he would rather be dead than live wearing adult diapers.>The American Urological Association initially disagreed with the recommendation not to screen, but they have re-considered and issued these new recommendations:
Don’t screen men under 40 or over 70
Don’t screen men with a life expectancy of less than 10-15 years
Don’t screen men age 40-50 who are at average risk
Consider screening men age 55-69 who are at average risk
Consider screening high risk men of any age
Before any screening, doctor should discuss risks and benefits with patient
The U.S. Preventive Services Task Force concludes:https://www.uspreventiveservicestaskforce.org/Page/Document/...
>Although the precise, long-term effect of PSA screening on prostate cancer–specific mortality remains uncertain, existing studies adequately demonstrate that the reduction in prostate cancer mortality after 10 to 14 years is, at most, very small, even for men in what seems to be the optimal age range of 55 to 69 years. There is no apparent reduction in all-cause mortality. In contrast, the harms associated with the diagnosis and treatment of screen-detected cancer are common, occur early, often persist, and include a small but real risk for premature death. Many more men in a screened population will experience the harms of screening and treatment of screen-detected disease than will experience the benefit. The inevitability of overdiagnosis and overtreatment of prostate cancer as a result of screening means that many men will experience the adverse effects of diagnosis and treatment of a disease that would have remained asymptomatic throughout their lives. Assessing the balance of benefits and harms requires weighing a moderate to high probability of early and persistent harm from treatment against the very low probability of preventing a death from prostate cancer in the long term. The USPSTF concludes that there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
We are slowly learning to do much less asymptomatic screening, though charities and celebrities are fighting against it. Joe Torre still comes on my TV saying "get screened early and often." The generic advice about "always catching cancer early" being an unequivocal good thing is false. Over-diagnosis and over-treatment are huge problems. For another example, thyroid cancer screening in South Korea has resulted in a massive increase in thyroid cancer diagnosis and treatment but not any decrease in thyroid cancer mortality.
I can go on about this topic, but I won't. I suggest reading that blog I linked to, its fantastic.
Because "sedentary middle-aged American eating a typical American diet" (possibly including "fat" as well) might as well be considered a preexisting condition all by itself, and a simple checkup may catch something that can be addressed before it becomes a hospital visit. Most notable as things to watch out for are high blood pressure, high/poorly balanced cholesterol and diabetes or early signs of it. Two of those you can do some checking for at home fairly inexpensively, but cholesterol not so much.
Despite having health insurance (Thanks Obama! while it lasts) I haven't actually had a checkup in probably 5+ years, but after this I'm going to see about getting in and at the least getting bloodwork, etc. which I've been thinking about anyway. Clearly Jason Scott can't be called all that sedentary given all the walking he did during his heart attack, which is why this is a bit of a wakeup call.
Edit:
I'll throw in a surgeon's commentary from when my wife had her gallbladder out: "Men are stupid."
Context: He was noting that most gallbladder problems are in women, that 90% of gallbladders are removed laparoscopically as outpatient procedures, and that of the other 10% where people end up hospitalized most are men because "Men are stupid." Men will try to tough it out and won't go see a doctor until they're in so much pain that they end up in the ER, and the ER isn't going to dink around with a laparoscope for investigation - if things are that bad, they may well slice you open so they can see what's going on and yank it right then and there leaving a nice scar, at least one overnight in the hospital, and some significant movement restrictions while you're healing.
And how many of those women needed surgery?
From a quick read before I dash out the door, it looks like at most ~21% had surgery based on indefinite or vague symptoms. I'd say that there's a good chance that many or most of those cases should have received at the least other treatment before surgery and that some physicians started resorting to surgery too soon once that surgery became easier, cheaper and safer.
That still leaves the other 79%.
I did spend two nights in the hospital (one before the surgery, one after), but I'm surprised that surgery would be considered outpatient under any circumstances. Do they really send people home immediately after putting them under and rooting around in their chest cavities?
I was very sickly as a child. Every doctor's visit did nothing to change this (it wasn't even "Hmm, you have a trend", it was "oh, you have a cold/bonchitis/etc.) It wasn't until I was 30 that I learned I was allergic to pollen, molds, dustmites, cats, dogs, and rats - basically everything that won't kill you (no food allergies I've nailed down) - and that discovery was made when my symptoms suddenly got dramatically worse for months, and I pinned down the only three things that had changed in that time and went to an allergist myself.
Each winter for several years since then I would get bronchitis, and the coughing and shortness of breath would last for months. Every doctor told me to take some Delsym and wait 4-8 weeks. I eventually pieced together that this is my allergies (which, while treated, aren't gone) draining into lungs overnight and slowly being coughed up during the day. Some anti-inflammatory treatment that is now legal in Washington turns out to have stopped that for the last few winters.
I've had two rounds of kidney stones in the last 5 years (each involving at least two stones, because apparently the inflammation from a kidney stone tends to "shake more loose") - Doctors couldn't do much beyond painmeds and flowmax. (First time though, I had a $1000 CT scan (I think it was CT - I get CT and MRI mixed up) because the doc suggested it.)
I had pneumonia once - didn't realize it, it was just a bad cold/cough that got dramatically worse. Calling my doctor for an appt gave me something in 3 days. Day of, I wasn't sure I would be breathing by the time of the appt, so I was going to go to the ER. (which would have been ridiculously expensive). My wife took me to a local urgent care clinic (PatientFirst in VA) because she was worried about the wait time at the ER. They were awesome, saw me immediately as I walked in (they could hear me breathing), did in-house xray of my lungs and o2 sensor. Now that I'm in Seattle, the local clinics work differently - they REALLY want you to have a primary care physician. I recall a doctor there once saying that's because they want someone to coordinate your care, maintain a big picture view, and proactively look into potential issues. I told her I'd never had a PCP do any of those things)
I'm not knocking medical science - it's a near impossible job: "Debug this program to which you don't have the source code, can't control or even know all the environment and inputs, and if you crash it someone dies". It's amazing they can do what they can, and in certain circumstances they are responsible for saving and improving a lot of lives (see above having pneumonia).
But the reality is that if I went to the doctor every time some part of me hurt (and now that I'm 40, that's a lot of parts) based on my past experiences, I'd just spend a lot of time and money and be not much better off. So I'm all for being cautious on big things like chest pains. I'm all for knowing the warning signs of stroke, heart attack, and the like. But going to the doctor for every little thing? Seems a waste.
Still, if I walked into a doctor and said "is anything wrong with me?" with no symptoms or obvious indication that this might be so, they would probably take blood pressure, do a breathing test, ask me if anything was actually wrong, and then wonder why I was wasting their time (or maybe ask if I was looking for a medical certificate cos I didn't feel like going to work, heh).
Like, all those dietary restrictions they give to people who've had heart attacks? Why not give them to me before I have a heart attack, so I won't ever get one? Make my life more of a hassle, so that I live longer!
I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health.
You better not expect doctors to be that. Most of them still believe cholesterol causes heart disease, for example, or that you need 50% carbs in your diet.
I have to think hard to recall otherwise. Usually it would be in context of a specific argument. Maybe I just don't know any hard core feminists.
For example, I know lots of people that want women to be able to be in combat roles in the military. I've not heard anyone suggest that any qualification standard that actually applies to fitness to do so be lowered. Given the biological range of the genders, this would mean that:
* there would be women who physically qualify * that number would be less than men that physically qualify
...and everyone seems okay with this.
Frankly, I've heard far more people get angry about some theoretical upset person than I've ever seen actual upset persons.
There's a difference between taking risks (if you take risks, and bad things happen as a result, that's often outside of your control; e.g. sharks when swimming in the ocean, there's always a risk) and self-neglect, which is within your control. Self-neglect is a consequence of low self-esteem, and has nothing to do with masculinity. This may be uncouth, but: think of the men who you think are least masculine, and ask yourself if they nurture themselves more, go more to the gym, and eat better. If anything, the opposite is true.
The real problem is self-neglect, whose root cause is low self-esteem.
I don't think women's average self-esteem is any higher or lower than men's, but theirs manifests itself in different ways, which explains why women would be more conscientious of their physical health, and push men to do the same. Still doesn't change the nature of the problem, or its real solution.
I'm not sure if I disagree with you, or if my perspective is this same perspective from a different angle, but: I would say that it's more that men tend to (expect to) derive their self-esteem from things they do, rather than things they are—so they invest much more time in doing things, and much less time in being things.
In order to "be" beautiful or to "be" athletic, it's usually a pre-requisite to be healthy—to take care of your body. In order to do things like building a successful business or finding cures for diseases, you don't have to be anything in particular, other than, perhaps, stubborn. So you tend to see things like your own physical health as distractions from "doing."
It's in the "Western man" role-script to "do" things—and to be expected to "do" things by others; it's in the "Western woman" role-script to "be" things—and to be expected to "be" things by others. As long as you "put on the mask", the people around you will generally push you toward playing your part. (This is what a large part of gender dysphoria is about: being pushed by society to play a part you don't identify with, because of what you present as.)
If you don't strongly identify with either of the roles of "Western man" or "Western woman", then the likelihood of you taking care of yourself isn't predictable. But if you do (and a lot of people do), it generally is.
I agree, but that seems tangential to the point. It's a gender difference that has been constant throughout history, and seems arbitrary to want to change. It also doesn't fix the main problem. Making men more feminine will not make them more self-nurturing.
To illustrate, putting on makeup isn't self-nurturing, anymore than getting a haircut. It's not something that depends on your self-esteem, everyone does it. Binge-dieting is self-neglectful (the opposite of nurturing), and so obviously doesn't come from a position of high self-esteem. Being more obsessed about your appearance doesn't make you more nurturing of yourself physically. Again, women don't nurture themselves more than men. You could chalk up wives' willingness to go to the doctor as higher fear of potential negative consequences, rather than self-nourishment.
The question is how do you get men to care more about their health, remember. And changing society or "gender roles" isn't the solution.
> In order to "be" beautiful or to "be" athletic, it's usually a pre-requisite to be healthy
The assumption here is that women nurture themselves because they want to look good, I don't believe that at all. You'll nurture yourself because you'll want to do it, instinctively, without needing any willpower. A necessary condition for that is high self-esteem.
Put another way: if you want to learn better eye contact, you have two ways. 1st: practice better eye contact. 2nd: increase your self-respect. The 1st won't work. The 2nd, will, because it addresses the actual cause. I'm arguing that the same is true for men's health.
That wasn't what I was trying to communicate at all. My intended meaning was that women—by wanting to look good, or to seem happy, or to put on one of the numerous other faces people expect women to present to the world—are forced to pay attention to their own bodies. At which point they will notice if-and-when they're bodily unhealthy. (And in many of the other major roles women play, they're expected to be caregivers: people who pay attention to others, and are paid attention to in turn. Women in such roles have support networks who will notice if-and-when they are unhealthy.)
Men, meanwhile, usually are expected to strive toward goals that involve paying solely external attention—and often abstract attention, to things or systems or concepts more than to people. Their attention will almost never need to be on their own bodies to achieve their goals; and nor will anyone around them (in a professional capacity) pay attention to their state of being, as long as their work is getting done.
The stereotype is at its strongest in war narratives: "valor" is ignoring the bullet in your calf and the stab-wound in your left side and marching on to finish the battle. Because, relative to winning the battle, the state of your body is immaterial. All other stories of "heroism" tend to have some form of this—the mathematician who abuses drugs to find the answer, the entrepreneur who gives a thousand sleepless nights to their cause, etc.
Put women in those roles, and the immediate evaluation (in our culture) changes from "heroism" to "self-neglect." Which tells you a lot more about how our culture thinks of men, than how it thinks of women, since the evaluation for women is clearly factual.
I misunderstood that, you're right.
About your wider point: you seem to put a lot of importance on societal roles ("expected to", "narratives"), and I don't think much of this (if at all) is caused by society rather than self-directed. You're arguing that women are more physically nurturing than men (which could well be true), I'm arguing that it's inconsequential as to how to make men more self-nurturing.
Why do you think so?
Yeah, but where do you draw the line? I guess that will sound silly, but I'm always afraid that people think of me as a hypochondriac if I ran to the doctor for every little pain, most of them probably being some sprained muscle or indigestion.
If it could be a heart attack, or similar life threatening thing, you go to emergency.
In the first case, I'm pretty sure I had a panic attack. At least they served me bacon and eggs, probably hoping for a repeat customer with a real heart attack.
In the second case, I'm pretty sure I pinched a nerve in my back. I got shoulder pain associated with movement. I then got pain in the front -- but remember that a nerve pinched in one spot can cause pain to be felt elsewhere. Other back-related issues in the days afterward lead me to my conclusion.
I'm now way less inclined to go in to the emergency room. I don't want to spend 12 hours with an IV hurting my arm, no privacy, no sleep, and not being able to work on anything. One of the times the doctor even cleared me to go home, but the nurses didn't bother to remove the IV for hours afterward. Being in the emergency room isn't harmless; it is a place where diseases spread.
It's a valid diagnosis: https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion
I once waited four hours to see a doctor because of a sharp pain in the left side of my chest when I breathed more than shallow. The doctor told me it was probably a muscle spasm and to take some Advil. I thought "what an asshole" as I left.
About 20 minutes later, someone told me a joke, I laughed, and was cured. Turns out the doctor was right.
If you had ECG, x-ray, CT scan, echo, and everything looks fine, then the treatment is the same regardless. If you think you had a panic attack or hurt your back, then communicate that to your doctor. It's important.
Edit: thought I'd mention: my wife is currently diagnosed with pleurisy. She went to the ER due to shortness of breath and chest pain a month ago. We've done all the tests possible. She's still in quite a bit of pain. Pleurisy usually takes months to resolve. If you were diagnosed and it disappeared within a day or a week, then you were likely misdiagnosed. However, it does not necessarily mean the prescribed treatment was erroneous.
TLDR: It's probably not a heart attack if you can pinpoint the pain, if the pain gets worse on a deep breath, the pain is related to movement of your shoulder or arm, or if it only lasts a few second.
You should call a doctor if the pain is mild but consistent and is untreatable by pain killers, and remains regardless of if you're resting or not.
You should call 911 or get to a hospital immediately if your chest pain is "crushing" or "squeezing," and especially if it is accompanied by ANY ONE of the following: sweating, shortness of breath, nausea/vomiting, pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms, dizziness or lightheadedness, fast or irregular pulse, severe weakness, inability to walk.
So yea you don't go to the hospital for every pulled muscle, but do your best to memorize the above symptoms of escalating seriousness, and you should be ok.
If you've had symptoms for weeks/months, well, I guess that's probably not a heart attack, good job? Still should have gone in within the first day.
(this is not medical advice!)
https://www.heart.org/HEARTORG/Conditions/HeartAttack/Warnin...
You can search the English NHS Choices website.
That gives calm mostly evidence based advice and lets you know when you should self care, or when you should see a doctor.
For example, here's "chest pain": http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.a...
It says there are a variety of causes, but it says you must never ignore it, and gives some criteria for when you should dial 911.
In England we also have NHS 111, which is a free telephone advice line. It's not as good as it could be because fo obvious reasons they're risk averse.
I say this as someone who has survived PE. In my case, I had pain that was a vague persistent discomfort combined with an evolving sense of panic. I hesitated for a day but then drove myself to the hospital just in time because it had progressed in the emergency room to searing pain where I "saw stars" upon each breath. Literally the most painful experience I ever had.
When you walk into an emergency room and indicate you have chest pains, they will immediately try to assess whether or not you're having a heart attack. After that there are checks to rule out PE and you may have a CAT scan w/contrast fluid.
There are other much less dangerous things that cause chest pain... stress-induced muscle pain is one. The problem is you can't be sure until its too late. Carry health insurance and don't try to second-guess chest pain.
Definitely not worth going to the ER for.
People drop dead too frequently because they wait too long to get help when they have unexplained chest pains that [they think] couldn't possibly be a heart attack.
almost lost a buddy once to a brain tumor around 25. he was light headed with slight pain for a 3 days. checked himself in on day 4 for slight but persistent pain. rushed into surgery immediately. wouldn't have lasted another day.
don't take a chance. would rather be a hypochondriac than dead. a good doctor will respect that.
This was a bit over two weeks after a delayed Transatlantic flight with turbulence bad enough that we barely left our seats.
The main reason I freaked out and took him to the hospital immediately instead of just saying, "that's weird," was that a close friend had had a pulmonary embolism a few weeks after flying back to the US after tearing up her knee skiing (and having to wear a stiff brace on the plane).
Yeah, there are some stereotypes I'm repeating, but they're accurate somewhat often.
I still make sure to get up and walk around frequently on flights now! (As well as the usual anticoagulant libation... Bloody Mary)
My wife did this last year. Out of an abundance of caution they checked in her into the hospital for 8 hours and ran a battery of tests. A full work day and $30k in medical bills later they didn't find anything. By then she felt fine and went home. I'm not faulting the original advice, but medical intervention can be expensive and frustrating.
The USA tells us their model of capitalism is the best. They apply their system to healthcare. It utterly fails to deliver versus "socialist" solutions.
At what point are you guys going to join the dots on this contradiction?
GP didn't say this, though. They said applying the model of American capitalism to healthcare fails to deliver (a reasonable standard of care, I assume). Your assessment seems to largely agree.
Perhaps we interpreted these paragraphs differently because I read it as saying "when are we going to connect the dots and see that capitalism is not the best because it utterly fails in healthcare and thus by extension elsewhere too"
The unrealistic fantasy later capitalists developed as a propaganda to sell capitalism doesn't have those features, but then it also has nothing to do with anything that is, has, or ever could be, realized in the real world.
I'd say, go with what works.
One dispute seems to be over the meaning of the word "access". Some people, like my Libertarian friend, feel that "access" is satisfied if you have the freedom to choose your provider (or none at all) -- but god help you if you don't have any money, because no one should be taxed to pay for others' health care. For many, taxation is viewed as state-enforced theft. (I'm not sure how to argue against that viewpoint.)
Others (like Senator Sanders) believe that "access" means "you can get it" -- and include the ability to afford it in that metric. This is why some people in our country argue that we Should Be making sure that people _get_ their medical costs subsidized by taxes. While it's a tax on all of us, the costs end up being lower, and you don't end up people forgoing routine preventative care because they feel they can't afford it, simply because the chance of them having something catastrophically bad is low.
Many that oppose this point to anecdotes of people who needed Serious Help and could not get to it in time, or flew to the US to get it, rather than in their home country.
The last time I participated in a discussion about this, the best system seemed to be Australian. I'm likely oversimplifying, but basically everyone paid into a national system that covered basic things and normal socialized care, and you also had the freedom to have additional insurance that would cover the things that the national system might not be inclined to give you for various reasons. I liked this idea because it meant that poor people and children all had basic care, and anyone who cared about their freedom to choose their doctors / treatments could do so (at a price). The net price still sounded like it was less than what I pay for my family here in the US for medical care.
The US is a crazy cult for "capitalism" and "free" markets. The problem I have is the absolutism about it. Markets can solve everything. This is the USA position. They force other countries to change to it via the IMF, not content with messing up their own country.
Yet even on a very simple system to model, sports, they have a socialist model. You finish bottom you get the first draft pick. Because when reasoning about a small group of teams it's patently obvious that if you give all the TV rights to the top team, all the draft picks to the top team, you end up with a total mess.
They will probably argue back, "in both cases you're taking something by force," but there are lots of pairs of things that share some traits but not others.
Sharing a trait does not make the two things the same thing (i.e. prison vs kidnapping, again, one is legal and one is not).
> the best system seemed to be Australian
Insurance-wise, sure. The single-payer guaranteed basic medical care + private top-ups for faster access/non-medicare-covered procedures offers a lot of flexibility! But I think single-payer only is better (singe the single payer has a gigantic position to use when negotiating prices with pharma companies, medical associations, & hospital administrations). The French system is single-payer guaranteed (up to a percentage) + optional insurance to cover the remainder. > An important element of the French insurance system is solidarity: the more ill a person becomes, the less they pay.
niceWe all die. The more healthcare technology we invent, the more we can spend. If you are willing to spend unlimited money to save a life, then you will... except that every system finds a way to stop you.
Traditional all-out capitalism stops you when you can't pay. (people also don't WANT to pay with their own money, so costs go down) Some government systems will say "no" to some people, but that isn't too popular. Most common is to say "yes" to everybody, but underfunding means you go on a waiting list and might not make it to the other end of the waiting list. These approaches can be mixed: some procedures for pay, some favored people being able to jump ahead on the waiting list, etc.
Underfunding is a given, because full funding for all the care that people want is impossible. The amount of care desired exceeds the GDP.
In the first case, a clot dislodged and traveled through my heart about an hour after I arrived at the hospital. I had debated waiting until morning as I wasn't sure an ER visit was necessary, but if I had waited any longer I likely would not have survived.
Also, the vast majority of people with PE survive. Depending on the size of the bastard, you can get heart dysfunction and pulmonary hypertension (which can be very severe) down the road.
Basically, unless your blood pressure tanked, your chance of dying from it was probably close to zero.
Not to say it's not a scary thing or that you shouldn't go to the hospital immediately, but we over-diagnose and over-treat PE's all the time. The latter is because we over-estimate their severity.
Also, if you have any unusual shortness of breath. Pulmonary embolisms are no joke, and depending on how much of the lung has been affected, every minute can count.
I almost learned this the hard way a few years ago. I was in my late 30s, and handled going to the doctor the way I always had since reaching adulthood -- which is to say, I didn't bother with it unless I was feeling out of sorts. Routine doctor visits seemed like a waste of time. Why sit an hour in an office to have somebody tell me I was doing OK, which I already knew?
Then my glasses broke, so I went to my local optician's to get a new pair. They did a routine eye exam to make sure my prescription hadn't changed, and in the process noticed something odd about the little blood vessels in my eyes. That led them to take my blood pressure, which turned out to be high. Like, really high. The kind of high where the person giving you the test looks you in the eye afterwards and asks you, entirely seriously, how you are still alive.
I was a stroke victim waiting to happen. (See http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/W...) And I had no idea. And would have continued to have no idea, right up to the moment when my circulatory system strangled my brain to death, if my glasses hadn't broken.
I went to the doctor, they gave me some pills to handle the immediate crisis, we changed my exercise routine and diet a little to bring my blood pressure down for the long term, and now I'm fine. But I don't skip out on routine doctor visits anymore! And neither should you.
But I am moving back to Europe this year so I will go to a doctor there and get all checked up etc.
I'm no doctor, so I'm the wrong person to ask about how often you should see one. But if it's been five years, it's probably time.
https://www.usnews.com/news/articles/2015/12/10/confusion-su...
I personally have my heart rate and blood pressure explode whenever anyone tries to measure them. So I was referred to a cardiologist who did some basic checks like an echo, found nothing wrong and wired me up to a device that measures BP continuously for 24h. My BP was perfectly normal.
High blood pressure will not always be accompanied by easily detectable symptoms like audible thumping. There's a reason why it's called "the silent killer." (See: https://www.cdc.gov/bloodpressure/index.htm).
Also, people who have excellent vision can still benefit from optometrist exams because they can catch early stages of eye problems, and even other kinds of medical problems.
I laugh inside at how consistent she is, so I guess it still works on me.
There is no evidence that routine checkups lead to better outcomes.
http://www.health.harvard.edu/blog/a-checkup-for-the-checkup...
"But what are the true benefits of this practice? Careful reviews of several large studies have shown that these annual visits don’t make any difference in health outcomes. In other words, being seen by your doctor once a year won’t necessarily keep you from getting sick, or even help you live longer."
If your blood pressure spikes a lot when you are stressed that's good to know too. For example I've found that when I drink coffee my blood pressure reacts to stress a lot stronger than when I don't drink coffee.
It's impossible to tell. Thus it would be wise to get checked up just in case.
And I guess they are right. They say our public health care system is excellent.
I don't do annual checkups. They say such checkups are not needed. My employer paid for one at a private doctor when I turned 50. I've heard that if we were more like Canada, that would be illegal.
Hooray NHS free "healthcare"...