I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 billion in healthcare spending, or $1,429 per person (with obesity).
* Bigger homes means you feel more comfortable being lazy and spending all your time indoors
* Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one
* Bigger TVs means you spend all day "watching the game" instead of going out and playing a sport.
Once again, these are grossly oversimplified, but should drive home the central point that spending on some things can actually worsen outcomes of others.
For many (most?) people in the US, the idea of walking anywhere of consequence from their home is simply ludicrous. Restaurant, convenience store, grocery store, all are completely inaccessible except by car.
Suburb planning has explicitly disallowed that sort of living for most people. It has also made it nearly impossible to serve neighborhoods with any sort of reasonable public transit.
This particular aspect of USA struck me as quite bizarre whenever I visited on business trips. More so as I’m from India where it’s almost a given that things that you need on a day to day basis (grocery, bakery, pharmacy, convenience store etc.,) are available within walking distance. Apart from an opportunity to get some fresh air it’s also a good way to interact with my neighborhood community.
I assumed this is how it’d be in any developed country until I moved to Netherlands. It’s not too different from India at all in that respect here.
So now I wonder, what factors lead to that kind of city planning in US. It was a real ordeal for me to get a meal outside in US, had to either walk for an hour or order taxi service (those were pre-Uber days).
A car requirement (and hence minimum fuel purchasing requirement) helps keep lower socioeconomic classes out of higher socioeconomic classes’ neighborhoods. This results in marked improvements in economic performance of children in school, as the public school students are determined by the area they are in, and spacing things out results in a populace with a minimum level of financial security who can afford to travel further.
The original impetus may not have been exactly that, as people generally like their space anyway, but it’s affects are well known. Historically, I’m sure there was also a racial component to it, with white people moving to more expensive areas that non white people couldn’t afford.
What other countries? The US is very much an outlier. The only one I can think of is maybe Australia?
I call BS on that. Accordingly to this logic homeless must be the healthiest people. That aside, rich people (who also happen to have bigger houses) actually exercise more than the poor.
* Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one
You telling that person with the smaller car would rather walk to the store (often VERY long walk in the US)? I call another BS here.
* Bigger TVs means you spend all day "watching the game" instead of going out and playing a sport.
Same argument as for size of the houses. I think you pulled these arguments right out of the place where the sun does not shine.
Not to put too fine a point on it, but maybe "bigger $things" and "worse outcome" are on the same side of the graph.
Do you have a source for that?
In my experience living and working in a slew of countries around the world, the USA has the cheapest alcohol, cigarettes, cars, electricity, clothing, electronics, gas (and diesel), food at the supermarket, food at the restaurant and many other things of any developed country.
Because taxes are so low, stuff in America is extremely cheap compared to countries with tax-funded healthcare, higher education, etc.
But mostly they're buying the stuff I talked about above. Consumerism.
1. https://milkeninstitute.org/reports/costs-chronic-disease-us....
McDonalds is not cheap, but it’s easy. It astounds me how many people eat out almost every meal.
It was tried and rolled back in chicago because it was deemed as unfairly targeting the poor.
[0] https://truthinitiative.org/research-resources/targeted-comm...
There's no reason why you couldn't pair taxing sugar with price-subsidies on non-sugary foods. The US already knows how to subsidize food production. Just stop subsidizing corn syrup and shift the subsidies to something less clearly destructive.
That makes a big assumption that people aren't buying more spinach because of price of spinach.
beans and rice are already super cheap. Much healthier and cheaper option than mcdonalds.
Why are you slyly shifting from "sugar" to "mcdonalds"? Minus drinks and desserts, McDonalds' offerings are not high in sugar.
> That makes a big assumption that people aren't buying more spinach because of price of spinach.
The price per calorie of spinach is extremely high. Micronutrients are great and all, but you can't live off micronutrients alone.
Aren't carbohydrates sugar though?
Why is the distinction between sugar in drinks and sugar is burger buns relevant to the discussion.
> Micronutrients are great and all, but you can't live off micronutrients alone.
Why did you slyly ignore 'beans and rice' in my comment. I wasn't suggesting people get their calories from spinach, what a weird interpretation.
my mexican family of 5 ate this combo every single day ,growing up. spinach + rice+ beans and occasional meat was afforable on one gardner's salary.
My general point is that the incentives today are all wrong. Many things need to be fixed and subsidies of corn syrup is one egregious thing.
I doubt obesity makes a very large difference because even though it increases morbidity I think it has a larger effect on mortality. If you're obese you might have to retire a few years early, but you'll also die even earlier missing out on years of being taken care of in a nursing home while you suffer from Alzheimer's.
What's odd is that the concept of comorbidies has been abandoned in the C19 era. There is little transparency when it comes to C19's co-conspirators.
Editorial: It troubles me when article after article about the high price is insulin fails to mention demand; and that close to all the demand created by Type 2 is avoidable.
Might there be manufacturer price gouging? Perhaps. But it's universally agreed that demand will increase price.
The fact that hospital/physicians charge as much and insurance accepts to pay is not due to some unhealthy habits or chronic diseases in the US.
Edit: of course your point stands and the higher rate of chronic diseases makes it worse.
Maybe I'm misremembering, but we had a ridiculous high deductible ($10k?) when we had our first kid, and I don't think we met it.
That said, I complain about the price of healthcare and insurance to anyone who will listen, and I hope someday it gets sorted out. So far the only solution I've found is to get a better paying job, which isn't a solution for most people.
No idea how you can make it lower than $10k :) Where was that?
I know, couldn't believe it either
How?
Bariatric surgery is currently the only real effective treatment. With GLP agonists like semaglutide having similar effects at least in the near term.
This baseless assertion is simply outright wrong, and utterly absurd on so many levels.
* https://www.acpjournals.org/doi/abs/10.7326/0003-4819-133-2-...
* https://www.nature.com/articles/0800499
Please don't spread misinformation.
Weight loss from diet/exercise will definitely persist for a year or even a couple.
Also specifically about exercise your study says "[Weight] did not change in the exercise without weight loss [group]"
That only happens if the patient relapses into his previous unhealthy lifestyle.
You can't simply follow a poor high calory diet and a sedentary lifestyle and still expect zero consequences from your actions. If your problem is behavioral then you fix it by fixing the problems in your behavior.