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Comment by sethg | Hacker News Reader

It wouldn't surprise me if the health of the average person is not significantly affected by the amount spent on medical care. So what? The whole point of insurance is to protect the policy-holder from the risk of outcomes that are much worse than average.

My seven-year-old son has a friend with hemophilia; if he didn't get regular infusions of clotting factor and similar treatments, he might live for another ten years--fifteen, tops. The quality of his health coverage certainly has an effect on his health. And he is exactly the sort of patient that the insurance companies will drop like a hot rock at the earliest excuse.

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You are arguing against a point the article isn't making. There are two types of treatments:

1. Marginal treatments, or treatments you will not pay for out of pocket, but will consume if they are free. These comprise 30% or more of treatments.

2. Non-marginal treatments, which you will buy regardless of whether insurance pays for them.

Your son's friend's hemophilia treatments sound like they fall into category 2. The article argues that category 1 treatments are useless (equally likely to harm or help you).

This strikes me as a false dichotomy, especially since I believe the hemophilia treatments fall into the first of two additional categories:

3. Treatments you will pay as much as possible for. This category may not be distinct from category 2 for a single adult with no family.

4. Treatments which have a high enough out-of-pocket cost, that it is a factor in the consumption decision.

A personal example falls into category 4. Two migraine aborting treatments work for me, rizatriptan in tablet form and sumatriptan in injection form. The first requires about 3 hours for full effect, whereas the second takes under an hour. The differences in cost between insurance an no insuranceare around $25 and $100, respectively.

In the context of missing a full day of work, even the $100 falls into category 2. However, during unemployment, on a weekend or an evening, even $25 is enough that it's not "free," but even the $100 isn't so much that I wouldn't pay for it out of pocket, depending on the circumstances.

These treatments may well reduce my "health" by any objective measure, including lifespan, but they certainly improve my productivity and quality of life, something the article seems to ignore.

For every patient like him, there's probably 10 or more being treated for conditions they could have avoided entirely through better diet and exercise. Nearly all cases of diabetes, heart disease, osteoporosis, and most cancers are preventable, just to name a few.

I think the point is that if we focused more on health (i.e. long term preventative health) instead of on medicine alone, there would be far more available resources to handle the genuine medical needs.

Most cancers preventable? Lung cancers maybe (and only maybe), but on the whole (and as far as we know) cancer isn't affected all that strongly by lifestyle factors.

it's affected by dietary factor: cancers are caused by animal-based protein such as meat, fish, milk, and egg

cancers are not only preventable, but also reversible -- see ch3 turning off cancer, especially starting from the indian report on rat studies given aflatoxin in 'the china study' by collin campbels, hosted on google books for reference: http://books.google.com/books?id=FIRLLcLjyC8C&lpg=PA74&#...

solution? whole-plant-based diet, no, not vegetarian nor vegan diet. basically non-processed food (marketing does play trick saying, correctly, sugar/hfcs is natural plant-based because it's made from cane/corn -- but we know it's harmful)

why whole-plant and not vegan? because one can eat fried potatoe, chewing candies, drinking sodas, sipping alcohol, smoking cigarretes ... and still claim (validly) to be vegan, but s/he probably isn't healthy

Some sources:

http://wholehealthsource.blogspot.com/2008/07/cancer-among-i... http://wholehealthsource.blogspot.com/2008/07/cancer-in-othe...

"Dr. Albert Schweitzer examined over 10,000 traditionally-living natives in Gabon (West Africa) in 1913 and did not find cancer. Later, it became common in the same population as they began "living more and more after the manner of the whites." "

Well, there's your problem. They didn't find a lot of things back in 1913, and the ability to detect cancer back then was about as advanced as their ability to detect neutrinos. All of the studies cited are more than 40 years old, with questionable methods or tools used.

Cancer was given its current name by Hippocrates and first described in the surviving medical literature over a millennium before him. Neutrinos were first detected in the 1950s.

I'd love to see newer studies on the few surviving traditionally-living populations. Here's one: http://www.medsci.org/v04p0053.htm

While I'm a layman and would like to be enlightened (how should they have done these studies? What evidence would make you think there's something to look into?), I don't think you're fair to the linked sources. Like, "One of these physicians was captain George B. Leavitt. He actively searched for cancer among the traditionally-living Inuit from 1885 to 1907. Along with his staff, he performed 50,000 examinations a year for the first 15 years, and 25,000 a year thereafter. He did not find a single case of cancer. At the same time, he was regularly diagnosing cancers among the crews of whaling ships and other Westernized populations. It's important to note two relevant facts about Inuit culture: first, their habit of going shirtless indoors. This would make visual inspection for external cancers very easy. Second, the Inuit generally had great faith in Western doctors and would consult them even for minor problems. Therefore, doctors in the arctic had ample opportunity to inspect them for cancer."

Cancer types and rates have varied dramatically over time in populations and between populations. Ergo cancer is driven by lifestyle factors.

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