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Comment by ecf | Hacker News Reader

It’s an extremely sad situation and will guarantee every single healthcare system eventually breaks down.

You're saying that it's a guarantee that every single healthcare system (in the world?) will break down because of _sugar consumption_? Seriously?

Diabetes is really rough on the organs. Especially once the kidneys go, you need dialysis 3 times per week and the treatment takes hours. If a substantial fraction of the population needs that treatment, it's going to be rough. Plus the eye surgeries for glaucoma, and other kinds of organ failure.

can't decide if it's good or bad then that we somehow have universal care... but only for kidneys, lol https://www.npr.org/transcripts/131167638

Oh wow, thanks for the link. I had no idea that we covered kidney disease that way.

> Especially once the kidneys go, you need dialysis 3 times per week and the treatment takes hours.

My grandpa went through this in 2020. He was a tough navy guy, and even he said "This is a half-assed way to live", stopped the dialysis, and passed away a few weeks later. Once you're on dialysis, there's not much of a chance of going back to a life without it.

That plus the inverted population pyramid. It's certainly plausible

Yeah if birth rates stay low ( which they have now for a few decades esp in Western countries but true elsewhere), you’ll need either large scale immigration or lots of cash to service the social care system, which now has to service the growing number of the geriatric and chronically il

If sugar consumption is the leading factor in obesity, and if obesity is the leading factor in added pressure to the health care system, then... it's definitely a big preventable factor, I'd say.

But it's not absolutes. Anyway yeah, some lifestyle choices need to be addressed to reduce pressure on the health care system. Like how for two years now we've had certain measures in place like social distancing and facial masks, not to eradicate the virus (that would require extended full stay-at-home mandate lockdowns) but to keep pressure on the health care system manageable.

It is very close to the truth unfortunately. Maybe it won't break down but the vast majority of health care spending is there to undo the effects of a bad diet more than anything else.

Almost every health care system is based on shared payment. Either insurance or socialized medicine, it's similar with a varying amount of pooling. If almost everybody is obese, us few healthy people may end up stuck paying for the fatties. And eventually, there will be too many fatties, they will vote that they can't be pooled separately so we have to pay even more, and there will at some point be too few of us.

IInsurance for me should be very low. I am in great shape by anybody's measure. But all the drunks, junkies, fatties, make my payments so high I've debated dropping medical insurance.

Why was this down voted? You're not wrong. Regardless of whether we have a private or socialized healthcare system, we simply won't be able to afford to continue delivering high quality care to everyone with chronic conditions caused by bad dietary choices and sedentary lifestyle. The resources just aren't there so we will increasingly have to ration care.

Why? Playing the devil's advocate here, 42% of the US population is obese right now. Why is it going to be impossible if that hits 60%, or 80%?

I ask this as someone with a BMI of 23 who puts a reasonable amount of effort into not becoming obese or overweight again. The personal benefits of not dying from cardiac arrest at 55 are very obvious, but I'm not clear on why healthcare systems won't be able to cope.

Healthcare is already about 20% of the US economy. Where do you think the additional money is going to come from to care for a major increase in diabetics? The rest of the economy doesn't produce enough of a surplus to sustain that.

A huge amount of spending goes towards the healthcare needs of the elderly, and obese people die early. Is there data that suggests increasing obesity increases overall healthcare costs, instead of decreasing them?

I can understand the argument that diabetes resources, specifically, will be strained. If overall costs don't rise, that's not a huge problem.

Obese patients on average cost about $2500 per year more than normal weight patients. Even though they die earlier they still increase overall healthcare costs.

https://www.jmcp.org/doi/10.18553/jmcp.2021.20410

All in all, we eat and live in a more healthy way then generations before.

No, we really don't. Just look at the way the obesity rate has steadily increased over the past several generations.

https://www.niddk.nih.gov/health-information/health-statisti...

Doctors are now seeing children come in fatty liver disease. That never used to happen.

> Doctors are now seeing children come in fatty liver disease. That never used to happen.

They used to die of malnutrition of all kinds. Not just because of being poor, but because of us not knowing this or that is necessary in food.

The physical work people used to do was body breaking fairly often. The chemicals people used to be in daily contact with were body damaging too.

Well now you're just making things up. Deaths from nutritional deficiency have always been extremely rare in the USA. Outside of some isolated cases of abuse or neglect or mental illness, only the poorest people ever died of malnutrition. It has never been among the leading causes of death. Knowing this or that is necessary in food is mostly just of academic interest and hasn't actually produced better health outcomes.

This is not true. The malnutrition of some kind is not rare and diseases from it were life. Malnutrition is not famine. It is lack of Iron and anemia. It is Rickets due to lacking calcium. It is missing any of vitamins - like being sickly in winter due to lack of vitamin C.

It is missing Iodine which is now commonly added to salt.

You can be overfed in calories and still suffer from malnutrition. Especially without science we have now. And whole classes of sicknesses caused by malnutrition don't exist anymore.

I think it's safe to say both are true.

In general, we live in a healthier world. We know more about nutrition, cancer-causing chemicals, etc. We continue to make progress automating some of the most body-breaking jobs. Most of us (western world, anyways) have access to clean water.

But, a substantial portion of the US (and world?) population is making bad decisions about their diet which have life-altering side-effects like diabetes. The question then is "why?" We know a lot about nutrition and it's impact on our bodies. Is it advertising? Is it cost (McDonalds is more sometimes more affordable on a time+money basis than home-cooked food)? Is it just our tiny lizard brains REALLY like salt and sugar and Nestle etc know how to manipulate that?

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