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Comment by RobertRoberts | Hacker News Reader

I really like the idea of encouraging health in any form.

But it seems that when the health care systems feed you green jello, white bread and skippy peanut butter sandwiches when you are sick isn't a system worth solely relying upon to guide us.

Also, it seems percentage wise, the best results for the investment should be on extreme health risk areas. (like help people quit smoking)

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I thought the whole justification for the U.S.' ridiculous health care costs was that it provided a "better quality of care"? The last couple of times I've encountered hospital food (in Australia, a knee reconstruction which cost $500 and having a baby which cost $2k or so) it was a very well balanced meal.

I've heard some people justify it that way, but I keep seeing report after report about the US ratio of dollars to positive outcomes being very bad and getting worse.

https://www.commonwealthfund.org/publications/issue-briefs/2...

https://interactives.commonwealthfund.org/2017/july/mirror-m...

https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more...

etc

> Higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions.

From your first link. It gloms all spending together without accounting for the lifestyle of our population- obesity rates, exercise, etc. Treatments are available to everyone- that means expensive care for even the elderly, who would otherwise me deemed "not worth the cost" to government budgets.

https://www.bma.org.uk/connecting-doctors/b/the-bma-blog/pos...

https://www.google.com/amp/s/amp.smh.com.au/business/workpla...

No, not everything over here is perfect. The takeaway is that there is much more to care than spending / "outcome".

There is no justification for US healthcare costs. There is a culture that requires everyone to have private insurance but there doesn't appear to be legislation that caps the cost of treatment.

In countries like Australia, because the government collects taxes for healthcare and does most of the spending, it caps how much its willing to spend (per doctor visit, or per medication) and the market responds appropriately.

The Australian federal government controls the pricing of medication in the community (i.e from a chemist) and Australian states control the pricing of medication within hospitals.

I feel like this is outdated, at least in respectable facilities.

I stayed in a hospital for a week over a very bad accident. The food wasn't great but I had a lot of healthy choices.

This was in NoVA which is a wealthy place and the hospital is very nice. The issue would be more substandard care nationwide than what the worst of hospitals have to offer.

It's likely location specific. West coast tends to have a lot of health conscience people, but the south east it's a lot of fried food and junk.

I'm also not sure hospitals serving cheap calories when better options are available ought to disqualify the entire medical system. The people who make the decision to do that are corporate types and nurses, whereas the people who do medical research are doctors and those who do things of the sort mentioned in the article may be data scientists. It's not fair to disqualify the entire system based on one bad choice, and were it the greatest flaw of the medical system, we ought to thank God.

It definitely feels to me that the medical system is not really about "health" but about fixing things. A lot of doctors don't live particularly healthy lifestyles, hospitals feed junk food and so on. I am not saying they can't do their job but generally I think it would be better if part of working in the medical profession were to have a healthy lifestyle. For example a doctor who doesn't exercise himself or doesn't eat healthy food or is sleep deprived can sort of give advice to people but somebody who has first hand experience with a wholesome lifestyle can give much better, realistic advice.

A while ago we had a nutritionist in the company lobby giving nutrition advice but the fact that she was quite overweight herself definitely didn't help her credibility.

Not sure where “and nurses” is coming from in your comment. Nursing research is predominately on long-term patient outcome, whereas MD education is predominately on the disease / underlying cause. The nurses I know are more focused on and better educated on how holistic care serves the long-term outcomes of the patients, while docs are better educated to attend to the acute problems.

I would expect a change to quality of calories provided in a hospital to originate from a DNP before a MD.

It is coming from exactly what you said, I would also expect a change to nutrition to originate from a DNP. My point is they have more control over day-to-day intake.

Most hospitals now employ Registered Dieticians for meal planning. Nurses usually have little or no input.

Is that what you were getting? I was in the Kaiser hospitals for 2 weeks and they gave me lots of good options. They had a tablet where you pick one item and it narrows down the remaining items to match your overall nutritional needs (calories, protein, etc.)

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