[HN Gopher] Life expectancy rise in rich countries slows down: t...
___________________________________________________________________
Life expectancy rise in rich countries slows down: took 30 years to
prove
Author : andsoitis
Score : 192 points
Date : 2024-10-15 13:39 UTC (1 days ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| Mistletoe wrote:
| I wonder how Ozempic will change this? I really do expect we will
| all be on this soon and maybe we can resume the increase in
| lifespan that has been stalled by obesity, lack of exercise, and
| processed food.
| zoklet-enjoyer wrote:
| I'm not fat or diabetic. Why would I take ozempic?
| sidewndr46 wrote:
| Yeah, I'm still kind of confused by this sentiment. There's a
| cohort that claims metformin somehow extends life as well.
| I'm pretty sure if a doctor prescribed me Ozempic that'd be
| grounds for malpractice.
| AstralStorm wrote:
| It does. But not exactly in healthy humans by any sizable
| amount. Works pretty well for diabetics and prediabetics,
| and in cases of PCOS. Otherwise the effect is rather small
| and depends on prevention of diabetes and a few kinds of
| cancer.
|
| It has a side effect of reducing muscle gains from
| exercise.
|
| As for life extension by GLP-1 active drugs, it's much more
| of a guess. Mechanism is relatively similar. Side effects
| might not be...
| jprete wrote:
| Ozempic seems to have a large number of positive effects for
| virtually everyone. It's a little premature to think everyone
| will be on it "soon" and there are plenty of people who won't
| take something even if it's universally beneficial.
| AstralStorm wrote:
| Not that many. Probably less than or similar to metformin.
| For the silly cost, it's not very effective at extending
| life.
|
| And there are potential bad side effects too.
| throwway120385 wrote:
| Yeah why would I take a pill if I can get the same effect
| through discipline and hard work? I understand not everyone
| can do that but if I can it would be absurd for me to take
| a drug for the rest of my life. Especially when I enjoy the
| work involved in changing my weight and body composition.
|
| If a doctor tried to push that on me I would fire that
| doctor.
| rajamaka wrote:
| Because you already take many modern shortcuts and
| conveniences to avoid hard work, why not take this one?
| nradov wrote:
| Taking a medication with potentially severe side effects
| (including perhaps some that we haven't found yet) is
| hardly equivalent to using a machine to wash my clothes.
| Scoundreller wrote:
| Iunno, I don't think the side effects of a washing
| machine have been studied at all.
|
| We're really flying in the dark there.
| throwway120385 wrote:
| Because at its core it changes who I am. I had a really
| bad experience on SSRIs as a teenager, and those were
| also pitched to me as "low to no side effects."
|
| My washing machine isn't going to make me suicidal if I
| start or stop using it.
| nostrademons wrote:
| Assuming you're not on drugs or thinking of killing yourself,
| you're probably not in the cohort that's dragging the life
| expectancy stats down.
|
| Life expectancy is a _weighted average_ (no pun intended),
| and so it 's unusually sensitive to outliers. People who die
| early drag the average down much more than people who live
| close to the mean life expectancy. The biggest premature
| killers of Americans are obesity, drugs, car accidents, and
| suicide. Anything that addresses one of those causes of death
| has an outsize effect on life expectancy. There are 100M+
| obese Americans. There are about 100,000 overdose deaths per
| year. Obesity, while not as lethal as drugs or suicide,
| afflicts 1000x as many patients, and so a treatment for it
| can have a large effect on the numbers.
| drawkward wrote:
| >Life expectancy is a weighted average
|
| Sure, if all the weights are 1. Where i come from, we just
| call that an average.
|
| >People who die early drag the average down much more than
| people who live close to the mean life expectancy.
|
| This is true of all averages where all weights are the
| same.
| nostrademons wrote:
| I should probably have said the _change_ in life
| expectancy is a weighted average, weighted by how far you
| are from the average. If average life expectancy is 80,
| removing a data point where somebody died at 40 has 8x
| the effect of removing a data point where somebody died
| at 75.
| drawkward wrote:
| Ok, that makes a lot more sense in light of your
| argument!
| cscheid wrote:
| In case anyone else is curious about the specific term
| for the concept you are describing, it's
| https://en.wikipedia.org/wiki/Leverage_(statistics)
|
| (To reproduce exactly the scenario being discussed, you
| fit a constant-only model to the data using least
| squares: that gives the average as the best fit. Then,
| you measure the leverage of each point of interest.)
| onlyrealcuzzo wrote:
| > The Oxford University research found that moderate
| obesity, which is now common, reduces life expectancy by
| about 3 years, and that severe obesity, which is still
| uncommon, can shorten a person's life by 10 years. This 10
| year loss is equal to the effects of lifelong smoking.
|
| https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-
| takes-...
|
| > According to the CDC, 9.4% of adults in the United States
| were severely obese between August 2021 and August 2023.
| This is higher for women (12.1%) than men (6.7%). The
| prevalence of severe obesity varies by age group, with the
| highest rates in adults aged 40-59 (12.0%)
|
| Only 9.4% of people are severely obese. Moderately obese
| people have only a ~4% shorter life-span than healthy
| weight individuals - much of which can probably be
| attributed to other lifestyle issues besides simply being
| overweight.
|
| This will move the needle, but I doubt as much as you
| think.
|
| There's a lot more smokers than there are severely obese
| people.
| kbelder wrote:
| >There's a lot more smokers than there are severely obese
| people.
|
| Huh, I was going to argue this, but you're right (in the
| US). 19.5% of the population smokes, so there's about
| twice as many smokers as severely obese people.
|
| I was sure it had dropped to 5-10%. I guess I'm in a
| bubble (of fresh air).
| photonthug wrote:
| Kind of a tangent but I think a big part of the
| explanation for declining life expectancy is hiding here
| in plain sight.
|
| Since everyone knows smoking is bad for a long time now,
| we're going to eventually need to categorize stuff like
| lung-cancer as a death of despair, similar to other
| deaths caused by alcoholism, opioids, or suicide.
|
| A lot of people who otherwise might quit smoking are
| probably looking at impossible dreams of home ownership
| or retirement, and thinking consciously or unconsciously
| that there is more dignity in a death at 50-60ish than
| one at 80ish when you're unemployable and the thin
| promises of social safety nets have fallen through.
|
| Smoking (or other high risk activities) might be a dirty
| habit but it's still more socially acceptable than
| suicide.
| onlyrealcuzzo wrote:
| That's a bleak view. I doubt a substantial percentage of
| smokers are smoking specifically to die sooner.
|
| Most of them are smoking primarily because they're
| addicted.
|
| A few of them actually like smoking.
| photonthug wrote:
| Dying sooner is certainly not why they started.. rather
| the bleakness of outlook is a (fairly rational) reason
| why they don't quit.
|
| If obesity is supposed to be the other main candidate for
| why life expectancy is down, you can do a similar
| analysis there. Is life really _good enough_ to prolong
| or attempt to improve for people that are in at-risk
| categories? That's the question people are looking at
| when they choose to move towards or away from self-care.
| For someone who makes minimum wage and already has to
| choose between paying for a date or paying for rent, it
| makes less sense for them to care much about losing
| weight, because it makes a bad life longer but won't help
| their love life.
|
| This is how practically all population-level analysis of
| health is just economics in disguise, even without
| directly looking at costs of medicine/services
| ck425 wrote:
| I think your hypothesis is correct but your reasoning is
| wrong. Few people are morbid enough to think "Oh my life
| sucks so why bother looking after myself". But if you're
| constantly stressed because you're struggling in life,
| small indulgences like smoking, alcohol and fast
| food/sugar are a lot harder to resist as they provide a
| much needed outlet/release.
| bee_rider wrote:
| It would be really interesting to see a stat that is
| like... "life expectancy without morbidities that can be
| avoided with some effort."
|
| Which, I recognize is a pretty privileged way of putting it
| --people struggle with weight, mental health, and drugs,
| and those are real struggles that shouldn't be ignored. I
| just also want to see where things are developing on the
| upper-bound for reasonably plausible lifespans.
| Mistletoe wrote:
| https://asteriskmag.com/issues/07/how-long-til-were-all-
| on-o...
|
| https://www.wired.com/story/the-benefits-of-ozempic-are-
| mult...
|
| > Known as GLP-1 agonists, these drugs were originally
| developed to help control diabetes. But there's increasing
| evidence that they have other health benefits, beyond
| controlling weight. They seem to boost heart health, protect
| the kidneys, improve sleep apnea, and lower the risk of
| certain obesity-related cancers.
| jvans wrote:
| > I really do expect we will all be on this
|
| When antibiotics were first invented some people thought we'd
| be taking them daily as a vitamin. Turns out that's not such a
| good idea despite them being life saving in some scenarios
| Scoundreller wrote:
| My totally off-the-cuff theory is that we'll only need a
| lifetime of ozempic and its clones every 3-4 generations to
| reset the obesity cycle.
|
| I guess we'll soon be able to measure the impacts on what it
| does to the children of parents that take it.
|
| How have McDonalds Happy Meal sales been looking lately?
| Mistletoe wrote:
| Surprising that you asked. :)
|
| https://www.reuters.com/business/retail-
| consumer/mcdonalds-p...
| taeric wrote:
| This is a thing that always blows my mind.
|
| The accepted view is a lot like the accepted views to mono-
| cultures for crops. In that they are bad. The practiced take,
| though, is quite the opposite? Crops are dominated by mono-
| cultured fields. And though antibiotics are known not to be
| used constantly, farms seem to use them at an amazing rate.
|
| I'd love to see a longer exploration of this. Why is it farms
| seem to be full of practices that we are taught are bad?
| Izkata wrote:
| > The practiced take, though, is quite the opposite? Crops
| are dominated by mono-cultured fields.
|
| Not exactly. We have crop rotation because over time a
| strict mono-culture wasn't very good.
| taeric wrote:
| I'm curious on the numbers on this. Every time the
| general topic comes up, avocados and bananas seem to come
| up and completely spurn the idea. Googling says 80+% of
| crops are rotated on a regular basis. Though, it is noted
| that "cover crops" are sub 10% of rotations. Which seem
| to be required for fruit farms.
|
| At any rate, I'll be reading more on this some. I have
| real work I should be doing, after all. :D
| mr_toad wrote:
| > I wonder how Ozempic will change this?
|
| It wont. This is about maximum lifespans. Weight loss might
| mean more people reach their maximum, but that maximum has
| proved, to quote the article: "resistant to improvements".
| sneed_chucker wrote:
| Did we expect it to grow forever?
| latexr wrote:
| If someone said "my son has stopped wetting the bed", would you
| reply "did you expect them to wet the bed forever"? What if
| someone said "my leg no longer hurts", would you reply "did you
| expect it to hurt forever"? How about "my bag of candy is
| almost empty", would you reply "did you expect it to be full
| forever"?
|
| The information that something stopped or slowed down is still
| useful without having to think it was going to go on eternally.
| It allows you to adjust your plans for the future.
| wesselbindt wrote:
| > my mother died
|
| > did you expect her to live forever?
| Brajeshwar wrote:
| If not forever, but if 200-ish becomes a norm, it would be
| super awesome. Now, it is like, "Awesome, I know this, I know
| that. I need to learn that." "Hold on, time to die."
| JohnMakin wrote:
| I assure you many aspects of a society where 200 years old
| becomes a normal life expectancy would be a hellscape and not
| "awesome." We already currently have a massive societal and
| economic problem with aging populations as things currently
| are.
| geodel wrote:
| Come on wouldn't it be great fun with a dozen diseases,
| broken hip bone, shitting in diapers (if one can afford)
| people celebrating their 177th birthday. Seems people would
| sacrifice their first born if such dream life is
| guaranteed.
| derektank wrote:
| Physical exercise is the most potent life extension
| intervention we have. So it's very unlikely we'll get
| anyone to 200 if they're stuck in bed with a broken hip.
| ben_w wrote:
| The problems are due to what aging involves and the lack of
| young people inverting the population pyramid; getting us
| to 200 at all means solving every age-related biological
| problem, while also meaning we have longer to start a
| family and have kids to stabilise that population pyramid.
| JohnMakin wrote:
| Lol ok so imagine your dream scenario is everyone,
| magically and with equality, is able to live and
| reproduce to absurdly long time frames - that's also a
| hellscape in so many easily imaginable ways. you'll start
| to see jobs requiring 100+ years experience or with the
| right genetic modifications to make you insurable enough
| to invest a 60 year career into. Since this is all
| science fiction, we can imagine all sorts of things as we
| understand this is fiction. My only real point is this
| isn't a utopian future. we can't deal with the amount of
| humans we already have at the ages they live to. I don't
| see what solving aging does to solve any of these
| problems.
| JohnPrine wrote:
| you'd rather everyone die than to see experience
| requirements for certain jobs go up?
| hackable_sand wrote:
| What a rude comment.
|
| Everyone already dies.
| throaway2112 wrote:
| Kind of ironic that your "hellscape" is created by an
| increased difficulty to get a job.
| JohnMakin wrote:
| Kind of ironic only in that's literally how society works
| ben_w wrote:
| Societies change, and also plainly ours does not work
| that way as we don't have a high proportion of jobs
| requiring even 10 years' experience despite most of us
| spending ~47 years in the workforce.
| ben_w wrote:
| > Since this is all science fiction
|
| Everything is, before it gets invented. 200 years ago,
| radio, cars, skyscrapers, anaesthesia, transplants, space
| travel, plastics, and bioprinting were all scifi.
| Aluminium was almost exactly 200 years ago.
|
| Voice-to-voice translation and cheap synthetic gem
| quality diamonds were too, even when I was a kid.
|
| I'm not saying any of this will be easy -- from what I've
| heard, it's sufficiently hard that one would need to do a
| PhD in the subject just to really understand _how hard_
| and I 've not done that -- but you are made of atoms, and
| the atoms in your body can be rearranged into a younger
| form.
|
| That the only mechanism to do so today is called
| "cannibalism" is an (enormous and repugnant!)
| implementation detail, even though it's also an
| existence-proof of the possibility of such a re-
| arrangement.
|
| Do you know what's _not_ science fiction? People are
| already experimenting with genetically modifying
| themselves, because of things as simple as "they don't
| enjoy lactose intolerance".
|
| > I don't see what solving aging does to solve any of
| these problems.
|
| Then you don't understand the actual problems.
|
| Most of the costs we have today from an aging population
| are that old people are physically weak, get sick a lot,
| have many expensive complications, and 30 years ago they
| collectively didn't have enough kids for the next
| generation to be able to afford to look after them so
| well.
|
| When you write:
|
| > we can't deal with the amount of humans we already have
| at the ages they live to
|
| That's because (1) it's their kids (us) doing the
| "dealing with", and they didn't have so many; and (2) our
| natural aging process is awful.
|
| Anti-aging's biggest promise is that it makes age-related
| degeneration much easier to manage.
|
| (And all that's assuming "you'll start to see jobs
| requiring 100+ years experience" isn't obviated by AI).
| jjk166 wrote:
| > you'll start to see jobs requiring 100+ years
| experience
|
| Do you currently see jobs demanding 50+ years experience?
|
| Even if we ignore the fact that most jobs won't require
| any more experience to do than they take now just because
| we live longer, longer periods of time won't seem as
| costly to us either. Right now 100+ years of experience
| is absurd because the only way they could ever have that
| much experienced is if they worked from the day they were
| born until the day they died, and even then they would
| need to live an exceptionally long life. If we lived to
| 200, you could start your career in your 30s, get those
| 100 years experience, and still have 70 years - an entire
| current lifetime - to reap the rewards afterwards.
|
| Being more realistic, there is some finite amount of
| money you need to put away to live indefinitely off
| interest at any given level of comfort. Right now
| reaching that threshold in the 50ish healthy adult years
| we have is a difficult but achievable goal for most
| people. But with more time you can reach that threshold
| on a less aggressive trajectory and enjoy retirement for
| substantially longer (all while being healthier to boot).
|
| As a thought experiment, if you want to imagine how you
| would feel about your doubled lifespan, consider your
| current lifespan doubled from some previous threshold.
| Would you prefer to live only 35 years on average with 50
| being advanced old age? Sure there might be some
| benefits, perhaps some jobs might lessen their experience
| requirements, but would this be overall a more pleasant
| world with higher quality of life? We did not choose a
| 75-100 year lifespan to optimize human happiness, it is
| just the number we happened to wind up at as a result of
| a process that did not consider human happiness at all.
| Ekaros wrote:
| 200 at what qualitative life point currently? 80? 90? 100?
|
| Spending an other 100 years like say from 80 to 100... Well
| you are alive, but still...
| asoneth wrote:
| My grandfather lived to 104. More impressive was that he
| still played tennis regularly in his 90s.
|
| It's not his lifespan I aspire to, but his healthspan.
| potato3732842 wrote:
| The macroeconomic implications of that large a fraction of
| the population being above working age or such a large
| fraction of one's life not being working years are not
| exactly great.
| ben_w wrote:
| Apart from the fact that "working age" doesn't mean the
| same thing in a world that has anti-aging interventions?
|
| Our economic system is incompatible with the next 200 years
| irregardless of what specifically gets invented.
|
| At 5%/year, that's a factor (not percentage) of 17292
| growth; in energy terms that's not quite boiling the
| oceans, but it is making the poles the only barely livable
| zone.
|
| In any sense besides energy, this kind of growth implies
| automation that makes the meaning of work radically
| different than today. Human or superhuman AI would be an
| example of that, but the successful creation of that has
| other complications that we can currently only guess at
| with less awareness than the Victorians had of climate
| change or biodiversity loss.
| geodel wrote:
| And then some.
|
| I understand some tech billionaire want to live forever by
| eating hundreds of pills a day for nutrition, anti-aging,
| disease control etc. Their life may be "great" for some
| definition of great.
|
| But do billions of people on earth think that their life will
| become great in another 50 years even if it is rather miserable
| right now? I just live under rock to not know the desires of
| modern human.
| nerdponx wrote:
| The actual story here is that it's slowing down because the
| _lower tail is growing_ , not because the upper tail is
| compressing as we hit some kind of upper limit of human
| longevity. That is: more people are actually dying _younger_ ,
| which has been gradually offsetting other people living longer.
| edflsafoiewq wrote:
| I wonder if "life expectancy" is really such a useful metric,
| since it aggregates so many different things together. It's
| kind of like measuring "aggregate years of human life lived".
| nerdponx wrote:
| It's still useful because it provides _some information_.
| Specifically, a change in life expectancy, or a change in
| the rate of change in life expectancy (as here) means
| _something_. We just don 't necessarily know what that
| something is without further study.
| throw4847285 wrote:
| It leads to a lot of misunderstandings. For example, lower
| life expectancy throughout history is far more attributable
| to higher infant mortality than to adults dying young. But
| people think everybody died at 45.
| mr_toad wrote:
| That's the exact opposite conclusion of this paper.
|
| "Our analysis also revealed that resistance to improvements
| in life expectancy increased while lifespan inequality
| declined and mortality compression occurred."
| shirro wrote:
| It seems reasonable to expect it to grow even at a diminished
| rate until everyone enjoys equivalent access to health care,
| nutrition, occupational safety etc but that is subject to the
| political environment, priorities of the electorate and the
| capacity of the economy. Without pandemic, famine, war or
| natural disaster a decline in life expectancy is generally the
| result of public policy for a rich democracy and not an
| inevitability.
|
| I think we need to distinguish between longevity and health
| though. Lots of people live with chronic disease and giving
| them more quality of life counts for more than longer life IMO.
| Vox_Leone wrote:
| In our relentless quest for longevity and a richer life
| experience, one profound consideration emerges: the role of sleep
| in our daily lives. Sleep, which consumes approximately one-third
| of our existence, represents a significant barrier to maximizing
| our time and productivity. If we could find a safe way to
| eliminate the need for sleep, we would theoretically unlock vast
| reservoirs of hours previously devoted to rest, transforming them
| into opportunities for personal and societal advancement.
| kspacewalk2 wrote:
| Enter cocaine
| Scoundreller wrote:
| Micro dosing cocaine _might_ have positive impacts over long
| time periods.
|
| We really don't know and have made it nigh impossible to
| study. Obviously governments are trying to hide something.
| rajamaka wrote:
| For some reason I would feel disappointed if sleep was a solved
| issue. I feel as though perhaps I need that daily break from
| being conscious for my own mental health.
| presidentender wrote:
| One of my favorite science fiction novels deals with this:
| https://en.wikipedia.org/wiki/Beggars_in_Spain
| Loughla wrote:
| What a fascinating book series that I've never heard of. It
| looks like it sort of takes a middle ground between Le Guin
| and Rand?
| presidentender wrote:
| It doesn't preach so much as it explores. The author
| strikes me as being more economically literate than Rand or
| LeGuin, but not as good a writer as the latter.
|
| The real and staggering excellence of the series is the
| speculation - it's not such hard SF that it explains the
| mechanisms by which everything happens, and there are real
| characters who do more than stand as cardboard observers to
| technology, but it's crunchier than most.
| BeetleB wrote:
| Read the novella and skip the novel.
| AlexandrB wrote:
| Hopefully it doesn't go like the X files episode:
| https://en.m.wikipedia.org/wiki/Sleepless_(The_X-Files)
|
| I'm all for getting rid of sleep, but given how society is
| structured I worry that the extra time will just end up being
| used for longer commutes and more zoom calls. Hardly
| advancement.
| arp242 wrote:
| I have a hard time imagining this will ever become a reality;
| the need for sleep is fairly deeply hard-coded in how our
| brains operate, and I believe it's also needed for some more
| basic cellular functions.
|
| It's not binary I guess (sleep "once a week" is less than
| "sleep once a day"), but even some incremental improvements
| seem very far off.
|
| One also has to wonder if it's actually desirable to have less
| sleep and be "on" with fewer or no breaks.
| latexr wrote:
| > If we could find a safe way to eliminate the need for sleep,
| we would theoretically unlock vast reservoirs of hours
| previously devoted to rest, transforming them into
| opportunities for personal and societal advancement.
|
| While in practice, what would happen is that we'd be doing more
| of the same. Bosses would be demanding more time in the office,
| people would be spending more time doomscrolling, nothing would
| change. It's a pipe dream to think that if we had more time in
| the day we'd suddenly start using it more respectfully and
| responsibly.
| jowdones wrote:
| On the plus side, this would solve the housing problem too.
| Without the nuisance of sleep requirements we would move to
| the offices and live, ahem, produce there 24/7. Much like
| cattle.
|
| This is the great future the visionary OP envisions for us.
| anthonypasq wrote:
| we currently spend about half our waking hours during the day
| at work during the week. if we got those 8 hours of sleep
| back then presumably we would get 4 more hours of non-working
| awake time.
|
| seems decent to me. I hate sleeping, the problem is i get
| tired and cant avoid it.
| throw0101d wrote:
| > _Sleep, which consumes approximately one-third of our
| existence, represents a significant barrier to maximizing our
| time and productivity._
|
| "Millions long for immortality who don't know what to do with
| themselves on a rainy Sunday afternoon." -- Susan Ertz, _Anger
| in the Sky_ (1943)
| tuukkah wrote:
| That question was solved by social media.
| psychoslave wrote:
| Have you ever considered that sleep can actually make your life
| richer in interesting experiences?
| rawgabbit wrote:
| The current thinking is that Alzheimers and dementia are caused
| by the brain's waste disposal system malfunctioning and results
| in an accumulation of proteins in the brain that damages a lot
| of important functions. This waste disposal only happens during
| sleep.
|
| https://www.medicalnewstoday.com/articles/how-the-brain-flus...
| pdfernhout wrote:
| Not suggesting anyone try this but some people claim to sleep
| only two hours a day with this approach:
| https://www.sleepfoundation.org/how-sleep-works/polyphasic-s...
| "Uberman Sleep Schedule: Six 20-minute naps are spaced evenly
| throughout the day, totaling two hours of sleep per 24-hour
| period."
|
| A book on sleep and how important it is to learning and health:
| https://en.wikipedia.org/wiki/Why_We_Sleep "Walker spent four
| years writing the book, in which he asserts that sleep
| deprivation is linked to numerous fatal diseases, including
| dementia. ... The values of sleep and the consequences of sleep
| deprivation are also brought up in the book. One particular
| research conducted in the past, where people volunteered
| themselves to sleep for only six hours in a span of 10 nights,
| is brought up by Walker. This resulted in the volunteers being
| "cognitively impaired" along with their brains being heavily
| damaged, regardless of the three week eight-hour sleep schedule
| they received later."
| typeofhuman wrote:
| We're not living longer. We're dying more slowly.
| stefs wrote:
| i don't think that's generally true. quality of life at old age
| could be increasing due to several factors. for example:
| decrease of hard labor and better protections for laborers,
| doctors telling their elderly patients to go to the gym and
| train their strength and people generally being more health
| conscious.
| lovethevoid wrote:
| > The decline in the United States is driven by increasing
| numbers of deaths because of conditions such as diabetes and
| heart disease in people aged roughly 40 to 60.
|
| People are asking if we should be surprised by the headline but
| are missing this. As suggested in the article by the researchers,
| there is something dragging down the average since the 2010s. Not
| even hitting the general expectation of ~75 years. We don't have
| solid answers yet, only theories.
|
| So yes, generally while going up against the process of aging is
| going to create barriers (eg can we get to 130 years old), we are
| also failing to raise the baseline which is the bigger issue that
| people might not grasp when it comes to "life expectancy rates".
| hn_throwaway_99 wrote:
| > We don't have solid answers yet, only theories.
|
| The exact quote you gave had a pretty solid answer, certainly
| not just "theories".
| daveguy wrote:
| I think the distinction there is between immediate cause and
| root cause. Heart disease and diabetes (or complications
| thereof) is the immediate cause of death, but what is causing
| an increase in those diseases is theory at this point.
| orionsbelt wrote:
| Is it not clearly obesity? Why everyone is obese is perhaps
| unclear (although portion sizes, ultra processed foods,
| screen time and sedentary lives, etc, all seem to likely
| play a clear role), but I'd be surprised if the level of
| obesity that exists didn't cause more heart disease and
| diabetes.
| safety1st wrote:
| Yes. Why is everyone tiptoeing around this? The obesity
| rate has increased by something like 50% since the turn
| of the century. It is a major risk factor for all the
| causes of death being discussed here. Sure there are
| probably many factors but this is clearly a big one.
| hu3 wrote:
| Yeah if I try to handwave obesity impact on diabetes and
| cardiovascular diseases to the average cardiologist, they
| are going to tear me a new one within minutes.
|
| I don't know why is this even a question. Do people
| really think being overweight is a net positive?
| pessimizer wrote:
| https://pubmed.ncbi.nlm.nih.gov/23280227/
|
| _Association of all-cause mortality with overweight and
| obesity using standard body mass index categories: a
| systematic review and meta-analysis_
|
| > Conclusions and Relevance: [...]overweight was
| associated with significantly lower all-cause mortality.
| watwut wrote:
| You gotta go higher in BMI for those to kick in.
| Basically, where you are within normal and slightly
| overweight bounds is mostly an aesthetic concern with
| slight lifespan advantage for slightly overweight people.
|
| When you move toward obese or into underweight category,
| health problems kick in.
| lovethevoid wrote:
| Go here https://www.cdc.gov/bmi/adult-
| calculator/index.html and enter your height and weight.
| If you fall above the healthy category, you are part of
| the obesity rate and are what most research points to
| when it comes to increased cardiovascular risk. Also for
| asians the numbers are slightly lower.
|
| I find that when I point this out, people often get mad.
| They feel they aren't obese. But the research doesn't
| support them, if you are anywhere outside of the
| "healthy" categorization you are at the same risk (that
| we know of so far) as "clinically obese" people.
| hu3 wrote:
| My result: 18.5 to 24.9. "Healthy Weight".
|
| I tried adding 10kgs and it said "Overweight".
|
| Seems ok to me.
|
| They even warn that BMI should be used along with other
| indicators.
| pessimizer wrote:
| Mechanick, J. (2013). "What If" Being Overweight was Good
| For You? Endocrine Practice, 19(1), 166-168.
|
| https://doi.org/10.4158/endp.19.1.50042678317gx698
|
| The evidence that being overweight is _healthier_ is a
| bit dubious, but the evidence that having a "normal" BMI
| is healthier than "overweight" is nonexistent.
| orionsbelt wrote:
| Is it not the case that as BMI increases the risk
| increases? My BMI is not healthy - and I don't deny that
| makes me subject to increased risk - but I would still
| think morbidly obese is far worse than obese which is
| worse than overweight, in terms of risk of diabetes,
| cardiovascular disease, etc.
| throwway120385 wrote:
| That's essentially what "morbidly" means.
| Izkata wrote:
| Not strictly. Over the past few decades I've occasionally
| but regularly seen evidence that "overweight but not
| obese" (BMI 25-30) might actually be healthier than a
| normal weight (BMI 18.5-25). In those studies obese did
| have a worse outcome than both.
|
| IIRC mostly they had to do with seasonal sicknesses like
| the flu, the theory being that your body can burn the
| extra fat during periods you aren't able to eat well.
| JumpCrisscross wrote:
| > _when I point this out, people often get mad. They feel
| they aren 't obese_
|
| We've normalised being fat.
| sundvor wrote:
| Still remember my first time ever setting afoot in USA,
| Newark airport coming from Norway, in 1999, going to a
| tech conference.
|
| I saw more grossly obese people at that airport in the
| first ten minutes than I had back home in probably the
| previous year. It really stood out to me.
|
| It must be your general dietary makeup and lifestyle. All
| that corn syrup. Also, I don't see any reason why it
| would have gotten better since then.
|
| Just calling a spade a spade from an outsider's
| perspective..
| JumpCrisscross wrote:
| > _must be your general dietary makeup and lifestyle. All
| that corn syrup_
|
| It's not just America [1].
|
| Norway's obesity rate runs at roughly half America's [2].
| But the trend across the world is increasing rates of
| overweightness, obesity and--most worryingly--child
| obesity.
|
| [1] https://news.ycombinator.com/item?id=41634611
|
| [2] https://en.m.wikipedia.org/wiki/List_of_countries_by_
| obesity...
| sundvor wrote:
| It's been a minute since then, I've been in Australia for
| the past two decades as well - and yup, the trend is bad
| almost everywhere.
|
| Having read (well, listened to) Attia's excellent
| OUTLIVE, I've reversed my own (slowly turned bad)
| trajectory by switching my diet to the basics - all home
| made meals, making my own breads, lots of milk and eggs,
| meats (not in excess), exclusively extra virgin oil and
| pure butter in my cooking (zero blends/veg oil etc), and
| not buying any (sugar) snacks - combined with exercise.
| Oh and no alcohol for the past few years either -
| sacrifices had to be made. :-)
|
| Luckily my own kids are showing zero signs of obesity,
| they are very healthy.
| watwut wrote:
| People hate fat people. Everywhere I look, everyone is
| obsessing with diets and weight. People go to unhealthy
| extremes to try to loose weight, then predictably fail
| and cycle.
|
| Disordered eating is a norm and being ashamed is a norm.
| KittenInABox wrote:
| I find obesity a weird problem societally because
| literature to get people to stop being obese on a
| _population_ level just kind of sucks. All we know is
| stuff that doesn 't really work. Shaming fat people,
| pointing out their fatness, or other public pressure
| doesn't do anything. Strict diets like keto or OMAD don't
| work on a population level (individuals can get great
| results but I'm talking enough to statistically move the
| needle as a population). Ozempic and other injectables
| seem like the best widespread treatment, but that doesn't
| tell us any causes.
| fwip wrote:
| To the best of my knowledge, there's actually no diet
| that has been proven to yield long-term weight loss.
| (There are of course individual success cases.)
| Enginerrrd wrote:
| There are tons of diets that have been proven to work.
| Getting people to adhere to them long-term is the
| problem.
| watwut wrote:
| The issue is that people able to keep doing them long
| term end up in hospitals diagnozed with eating disorders.
|
| As in, inability to keep them long term is biological
| defense of organism that does not have genetic
| predisposition toward anorexia.
| Teever wrote:
| We're not making movement on this because we're not
| calling it what it is -- an addiction.
|
| We dance around it and call it 'obesity' but the real
| medical cause of obesity is an addiction to unhealthy
| food.
|
| This is compounded by the fact that it is completely
| legal for people to make their food more addictive and
| therefore unhealthy and advertise it to addicted people
| with underhanded marketing techniques that take advantage
| of their addiction.
|
| Until we recognize this as an addiction issue that is
| compounded by dealers being able to operate with impunity
| we won't make any headway -- short of technological
| advancements like Ozempic that allow people to side step
| their addiction.
| a-french-anon wrote:
| > Shaming fat people, pointing out their fatness, or
| other public pressure doesn't do anything.
|
| Says who? Are you implying that true societal shame is
| still being enforced right now, without hundreds of
| refuges in the form of safe spaces and social justice
| advocacy groups? I'm pretty sure that such shame worked
| pretty well in the past, and still does in countries like
| Japan.
|
| In the end, you'll just have to realize that the root
| issue you're facing is decadence, and that's there's no
| fighting it.
| ckemere wrote:
| Please correct me if I'm wrong, I believe that for aged
| women, being slightly overweight predicts longevity?
| watwut wrote:
| In anyone afaik. The healthiest weight is to be slightly
| overweight. The worst results are for underweight people
| and for obese people. The curve makes nosedive in its
| ends.
| cogman10 wrote:
| I mostly get mad not because obesity isn't a problem, but
| because BMI is a bad way to measure it. It may work in
| the general, but it can give bad information in specific
| cases.
|
| I'm a good example of how it fails. I have long arms and
| legs which causes my BMI to be fairly low. However, my
| body fat is fairly high. I need to lose fat but were I to
| rely solely on BMI I'd think I'm fine.
|
| What I'd want instead of BMI is body fat percentage. I
| think that gives a much better measure of health
| problems.
| pessimizer wrote:
| > I find that when I point this out, people often get
| mad. They feel they aren't obese. But the research
| doesn't support them, if you are anywhere outside of the
| "healthy" categorization you are at the same risk (that
| we know of so far) as "clinically obese" people.
|
| "Overweight" is longer-lived than "Normal," and "Grade I
| Obesity" isn't significantly less longer lived than
| "Normal." So what you're pointing out is misinformation,
| which is why people are annoyed by it. There is a case
| that "Normal" includes more sick and dying people because
| sick people often lose weight, but the difference still
| can't be as stark as _reddit knowledge_ makes it out to
| be.
|
| https://pubmed.ncbi.nlm.nih.gov/23280227/
|
| _Conclusions and relevance: Relative to normal weight,
| both obesity (all grades) and grades 2 and 3 obesity were
| associated with significantly higher all-cause mortality.
| Grade 1 obesity overall was not associated with higher
| mortality, and overweight was associated with
| significantly lower all-cause mortality. The use of
| predefined standard BMI groupings can facilitate between-
| study comparisons._
| BeetleB wrote:
| > If you fall above the healthy category, you are part of
| the obesity rate
|
| No. If you fall above healthy, you are "overweight". You
| need a higher BMI to be classified as obese.
| thaumasiotes wrote:
| > I find that when I point this out, people often get
| mad. They feel they aren't obese. But the research
| doesn't support them, if you are anywhere outside of the
| "healthy" categorization you are at the same risk (that
| we know of so far) as "clinically obese" people.
|
| Depends. All cause mortality is notoriously lower for
| "overweight" people than "normal weight" people.
| vundercind wrote:
| Really smells like one of those " _some_ alcohol is
| healthier than none" things where there's a subset of the
| otherwise-healthiest group that's in the otherwise-
| healthiest group _because_ they're very sick.
| thaumasiotes wrote:
| Why? "Overweight" and "normal weight" weren't determined
| by reference to what's better.
| vundercind wrote:
| A big 30-year Danish study that seems to be one of the
| main ones referenced for this purpose _sure appears to
| be_ doing exactly what I worried it was: measuring the
| predictive power of BMI for mortality, _not_ the
| healthiest weight for someone to maintain, which are
| different things. I see nothing in the abstract &
| methods about correcting for sick people tending to lose
| weight, and the healthiest BMI creeping up over time as
| mean population BMI increased, plus the U-shaped
| mortality curve, really do look like what you'd expect to
| see if they're not accounting for that.
| watwut wrote:
| Normal weight and overweight were determined by
| percentage of population at some point. The boundaries
| are not about lifespan, they never were.
| lovethevoid wrote:
| Kind of. The tricky thing here is that most people have a
| rigid view of "obesity" in their minds as it's easier to
| shift blame to, but the only thing research has shown is
| that abnormal BMI leads to increased cardiovascular
| issues. Which includes slightly overweight people.
| derektank wrote:
| Higher levels of body fat (which is almost always the
| cause of a high BMI unless you are an active athlete) is
| pretty directly tied to inflammation and pre-diabetic
| insulin resistance. This subsequently results in the
| liver producing more triglycerides and lipoproteins that
| clog the circulatory system and the inflammation itself
| promotes hypertension. All of this together results in
| more heart attacks and strokes. There's a pretty clear
| mechanistic link between obesity and cardiovascular
| disease.
|
| That doesn't mean obese people are "to blame" for any
| medical complications they might suffer from obesity. It
| also doesn't mean that obesity is a death sentence;
| people's bodies function differently and we've all heard
| stories of pack a day smokers that lived into their 90s.
| But there is absolutely a connection between the two.
| shadowmanifold wrote:
| I am on track to lose about 40lbs in 2024 and I suspect
| the main variable is really as simple as we have mastered
| the art of making really incredible tasting food.
|
| It is so pervasive though it is hard to tell until you go
| on a really boring and restrictive diet. It is just hard
| to not gain weight on average when the food tastes this
| good with such incredible variety.
|
| That is even if you buy something at the store. With our
| "foodie" culture, restaurants are an entire other level
| of choice and taste on top of that.
| throwaway2037 wrote:
| I hope this isn't a throwaway account(!). This is a good
| post. Can you share what/why it is working for you? The
| best stories always share small experiments that people
| tried where they learned what _didn 't_ work.
| zeroonetwothree wrote:
| I don't think the taste itself is an issue, it's the
| availability. If I have to cook a delicious steak every
| time I want to eat I'm not going to randomly snack all
| day since it's quite a process. My food consumption will
| remain at a reasonable amount. Whereas if I just pull out
| a bag of $chips from the pantry I could eat the whole bag
| without feeling sated.
| bluedino wrote:
| >> we have mastered the art of making really incredible
| tasting food.
|
| Corporations have intentionally created incredibly
| _addicting_ food.
| llamaimperative wrote:
| All those things you mention are almost certainly
| contributors. Another one for you to investigate if you'd
| like to get pissed off: endocrine-disrupting chemicals.
| They are _everywhere_ and many of them are strongly tied
| to metabolic disorders including obesity.
| lovethevoid wrote:
| That's not what I meant. A solid answer as to why those
| conditions are happening, not the fact that they are
| happening at all.
|
| We have research on what can affect heart health, like what
| things might be linked to it, such as smoking and alcohol. We
| also know genetics plays a huge role.
|
| So we don't actually have solid answers, actionable answers
| as to the rise of heart health issues. Look at this
| analysis[1] regarding how dietary guidelines specifically for
| fats (saturated, trans) have very little substantial evidence
| supporting it. Yet this gets repeated by the average person,
| that fats are the ultimate evil you must avoid. In another
| study[2] we find that reducing your fat intake still resulted
| in the same rates of mortality as those who ate more. This is
| also why more in the space are shifting away from these sort
| of claims ("only eat x amount of saturated fat per day") and
| more to general food composition (eg who cares if a fish has
| saturated fats, eat the fish with vegetables).
|
| It's quite challenging to figure out, everyone has their
| theories. All I'm saying is we don't actually have the
| answers yet.
|
| [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/
| [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/
| hu3 wrote:
| I recommend studies about stain medication in increasing
| life expectancy.
|
| We're talking years of increased life expectancy.
|
| Sadly statin is not without its downsides.
| joe_the_user wrote:
| _We 're talking years of increased life expectancy._
|
| Huh? Statins are a medication type in which increases in
| life expectancy are extremely hard to point to all. I
| think they're almost a "poster child" for medications
| that correct a problem to an extent but whose overall
| benefit is quite dubious.
|
| (and given that these medications were highly prescribed
| before any long term studies were finish - creating
| considerable incentive for people to find benefit - I'd
| personally wager they are overall harmful but that's me
| guessing - the main point is they definitely aren't
| boost-life-expectancy-by-years drugs but probably aren't
| reduce-life-expectancy-by-years drugs either, given the
| studies)
|
| Link from google:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/
| pessimizer wrote:
| Every few years, the lobby inserts op-eds insisting that
| statins are of such indisputable benefit and zero side
| effects that they should go into the water supply. I
| understand this from the companies themselves, but I have
| no idea which studies are convincing normal people that
| this is sane.
|
| There is no lobbying like the lobbying for massively
| selling classes of drugs of dubious effect.
| hulitu wrote:
| > That's not what I meant. A solid answer as to why those
| conditions are happening, not the fact that they are
| happening at all.
|
| Nestle ? McDonalds ? Burger King ?
| pessimizer wrote:
| Insane prices for insulin?
|
| edit: you really think insulin prices don't have an
| effect on the lifespans of diabetics?
| doubled112 wrote:
| People putting off healthcare because it costs money?
| ponector wrote:
| Are they insane, though? How many hours average man
| should work to pay for average monthly dose of the
| average quality insulin? May be even more affordable than
| in other countries.
| Riseed wrote:
| I don't think the average man should have to work any
| hours to pay for an average monthly dose of average
| quality anything that they require to stay alive. Perhaps
| I'm insane.
| sokoloff wrote:
| Who then _will work_ to provide these average monthly
| doses of things they require to stay alive?
| Riseed wrote:
| I don't believe being _able_ to work is an ethical
| prerequisite to survival. I don 't believe being willing
| to work is an ethical prerequisite to survival.
|
| The government can work to provide the medication that
| its citizens require to stay alive. Under such a system,
| those who are able and willing to work can, via taxes or
| other contributions, provide medications that some
| citizens require to stay alive. Many such systems seem to
| cost less overall than the system currently existing in
| the United States, so the average man who will work will
| have to work fewer hours to pay for an average dose of
| average quality anything required to stay alive.
|
| Alternatively or in tandem, the pharmaceutical companies
| can sell such medications at cost, with rebates and
| coupons for no/low-income patients, while still making
| plenty of profit on reasonably priced pharmaceuticals
| that patients do not technically require to survive.
|
| https://www.mayoclinicproceedings.org/article/S0025-6196(
| 19)...
|
| https://www.house.mn.gov/Caucus/View/DFL/31433
| sokoloff wrote:
| People also require food and water (and arguably shelter
| and clothing). Should those also be provided by society
| in average doses and at average quality?
|
| That does not seem likely to result in a stable and
| productive society, particularly when many working people
| would have below average housing in order that government
| beneficiaries could have average housing provided to
| them.
| Riseed wrote:
| As I said, I don't believe being _able_ to work is an
| ethical prerequisite to survival. I don 't believe being
| willing to work is an ethical prerequisite to survival.
|
| Yes, I believe people should have food and water
| sufficient for survival regardless of their ability to
| work.
| sokoloff wrote:
| In the system, as proposed, it seems like some will
| choose to work and pay taxes in order that someone who is
| able but unwilling to work can have better housing and
| food than they do.
|
| That doesn't seem like it will have broadly popular
| support.
| Riseed wrote:
| > it seems like some will choose to work and pay taxes in
| order that someone who is able but unwilling to work can
| have better housing and food than they do
|
| This is certainly possible because it already happens now
| with the current setup.
| watwut wrote:
| Insulin is cheap elsewhere.
|
| > U.S. manufacturer gross prices per 100 international
| units of insulin were on average 9.71 times those in OECD
| comparison countries combined.
|
| It is 10 times more expensive in USA.
| ponector wrote:
| According to ceicdata, annual household income per capita
| in USA is 10.6 times more than in Mexico. Even with
| prices 10 times higher it is slightly more affordable in
| USA.
| watwut wrote:
| Yeah, but my claim was not for Mexico. It was for OECD.
| BeetleB wrote:
| Portion sizes. The average plate is larger than it was,
| say, in the 60's.
| mjevans wrote:
| Portion Sizes and the No/Low Fat craze from the 90s
| mentioned in another post are related.
|
| This is all my THEORY, a speculation that I would like
| someone to study or to find a study about.
|
| Theory / speculation:
|
| Humans evolved with natural sugars, fats, proteins/meats;
| primitive cooking, probably some grains (more recently).
| That's what our bodies know how to process, to react to.
|
| All the fake sugars, modified foods that lack the
| components our bodies use to regulate internal processes;
| highly processed foods which also lack those components
| we need to feel satiated and to produce the messengers to
| digest correctly: those are likely the causes of obesity
| (not feeling full, so more eating) and bodies behaving
| poorly.
|
| 'Food Deserts' and corporations that are geared around
| selling large portions of tasty but unsatisfying food, or
| only offering huge sizes rather than also offering adults
| a tasty portion that's not intended for take home
| leftovers also contribute.
|
| Also: my main vice for this topic. Can I _please_ have
| lightly caffeinated + carbonated water that isn't
| outrageously expensive?
| asdff wrote:
| Caffeine addiction gets cheap when you stop beating
| around the bush and start just buying the caffeine pills
| that are like a cent a pop.
| BeetleB wrote:
| > Yet this gets repeated by the average person, that fats
| are the ultimate evil you must avoid.
|
| I've been hearing this complaint (that the guidelines claim
| fat are the worst) for way too long, when in (my) reality,
| all the guidelines I've seen in the last 25 years has put
| more emphasis on carbs than on fats (i.e. too many carbs is
| evil).
|
| I know "low fat" diets were the craze a long time ago. And
| sure, advertisers still like to slap "low/no fat" labels.
| But I believe the actual recommendation has been to lower
| carbs since around the 90's.
|
| This is ultimately a strawman.
| DoughnutHole wrote:
| To be fair the framing of "carbs are evil" is also lazy.
| The root cause of most cardiovascular disease and type 2
| diabetes is obesity due to excess calories of any sort
| (although once you're diabetic or prediabetic carbs are a
| HUGE problem no matter what).
|
| The modern lifestyle is incredibly sedentary and every
| civilisation is built on staple foods that can feed hours
| of manual labour (with modern snacks thrown on top).
|
| Calling a major food group evil is just a good scapegoat
| because it's much more palatable than telling people that
| they don't move enough and eat too much food.
| throwaway2037 wrote:
| One thing I think that we can be very specific about:
| Diets high in saturated fat surely increase your chances
| for cardiovascular disease.
|
| Also, I agree with your general sentiment: Framing carbs
| are evil is lazy. First, calories matter. Second, if your
| calories are general under control, most people need
| fewer calories as they age. Many choose to restrict carbs
| to maintain weight.
| nonameiguess wrote:
| All of this shit is stupid. Research has pretty
| conclusively shown at this point that a high proportion
| of calories coming from saturated fat specifically will
| raise LDL cholesterol levels, in people who have neither
| genetic predisposition toward low or high LDL. If you
| have one of those, it won't make a difference either way.
|
| Whether that leads to actual heart disease is iffier, but
| not terribly controversial among cardiologists as far as
| I can tell. It's only doubted on the Internet where
| everyone wants to be a galaxy brain with some answer the
| doctors don't want you to know.
|
| But nobody ever demonized fat in general, and demonizing
| carbs is just as stupid. Eating enormous amounts of carbs
| is fine as long as you actually use them. My daily
| calories right now are around 3,900 with carbs at 650
| grams a day, a fair amount being syrups I eat early in
| the morning while running. If you listened to the
| Internet, you'd believe I was diabetic already, yet
| basically every remotely serious endurance athlete eats
| like this and is fine. Glucose that is continuously and
| immediately shuttled into muscle cells to power
| mitochondria and provide energy for movement does no harm
| whatsoever. It's roughly the entire point of animal
| metabolism. Glucose that sits around in your blood
| forever because you're sitting around staring at a screen
| for 16 hours a day while stuffing your face is what
| causes problems because of all the oxidizing effects of
| glucose when it isn't taken apart quickly and turned into
| ATP.
|
| My BMI is 21.6 for what it's worth. As far as I can tell,
| the whole "mystery" behind why no diets work is because
| no diet can magically make people eat less when they
| spend the overwhelming majority of their time not moving
| and hunger decouples from energy expenditure. If you're
| sufficiently active as a lifelong athlete, every diet
| works. I ate super sized McFlurries, entire boxes of
| Entenmann's donuts, and Little Debbie's treats as a
| teenager as staples of my diet. As an adult, I've tried
| paleo, zone, mediterranean. Right now, I pretty much just
| eat the standard American food pyramid. None of these has
| managed to magically poison my brain or destroy my
| metabolism because metabolic function can be trained just
| like any other bodily function and it is trained by doing
| regular athletic activity with a high energy demand. Just
| like your muscles atrophy if you never do any resistance
| training, your metabolism atrophies if you never do any
| aerobic exercise.
|
| I can't claim to know the secret to weight loss but I
| know how to never get fat in the first place. On every
| team I was ever on from middle school to college to my
| time in the Army, whether that be cross country, track,
| volleyball, basketball, tennis, or general outdoor
| adventurism and long-haul hiking with a weighted pack,
| the overweight rate was never 0 but it sure as shit
| wasn't 70%. And we were all eating the same "poisons" and
| manufactured foods from evil Nestle that the rest of you
| were eating.
| janalsncm wrote:
| Perhaps there are many causes of heart disease and
| diabetes. It is likely that actionable information would
| require a case-by-case assessment. That is exactly what
| doctors do, so getting people time with doctors seems
| pretty useful.
|
| Regarding other factors, American culture is fairly similar
| to Canadian culture. However Canadians have free
| healthcare, meaning more Canadians see doctors than
| Americans. So I wonder if they have lower levels of
| obesity, heart disease and diabetes, and if their lifespans
| have also been decreasing.
| throwaway2037 wrote:
| > However Canadians have free healthcare
|
| I don't like this use of "free". It is paid for by taxes.
| That is no where near free. It is extremely hard in a
| highly advanced economy to provide quality healthcare at
| less than 10% of GDP. That is a _huge_ number for any
| wealthy country.
|
| Also, Canadians are pretty fat. It looks like 65% are
| overweight, which includes obese. Ref:
| https://www.statista.com/statistics/1317268/overweight-
| obesi...
| janalsncm wrote:
| Fair point, it isn't "free" of course. But it is
| accessible to everyone. No copay/deductible/coinsurance
| bs.
|
| > It is extremely hard in a highly advanced economy to
| provide quality healthcare at less than 10% of GDP.
|
| In the US we pay 17% of GDP towards healthcare and tons
| of people still can't afford it.
| defrost wrote:
| The general view of US healthcare is that not much of the
| money paid _toward_ better health outcomes reaches the
| target.
|
| A quote from another comment here is:
| Australia's health system far outperforms the .. US
| healthcare system, which spends nearly twice as much per
| capita as Australia to deliver far worse outcomes --
| including Americans dying five years younger than us.
| throwaway2037 wrote:
| > No copay/deductible/coinsurance bs.
|
| Many highly developed countries have copays in their
| national health insurance programme.
| briandear wrote:
| What has been the role in demographic shifts?
| dyauspitr wrote:
| Wow so ozempic is going to cause expectancy to jump by 10 years
| over the next decade or so.
| neffy wrote:
| Isn't this also an issue with World War's 1 and 2? They both
| dented life expectancy fairly significantly, and that cohort is
| now aging out of the figures. If the rate of increase is being
| measured, then that would presumably play a small part?
| GuB-42 wrote:
| The way life expectancy is usually calculated, it shouldn't
| have an effect. It is calculated is by looking at the mortality
| rate for each age group, which gives a probability of death for
| each age, and by simulating people growing up in such
| conditions, and then taking the average age of death.
|
| By doing so, historical events outside of the study period
| don't have a major effect. In this study, they deliberately
| avoided the covid pandemic as it would have caused a
| significant drop in life expectancy that is not representative
| of a general trend. Of course, the future is not taken into
| account either. Despite what the name may suggest, life
| expectancy is like a snapshot of the studied period (1990-2019
| here), not a prediction.
| cdrini wrote:
| Frustrating that an article with a title like this doesn't
| include a single graph.
| Mathnerd314 wrote:
| Actual study:
| https://www.nature.com/articles/s43587-024-00702-3#Sec2
| lynx23 wrote:
| I always wondered why I personally know almost nobody who has
| managed to exceed average age. With the only exception of my
| previous landlady, she became 95. In my family, the average age
| is roughly 60, with three siblings on my fathers side dying
| before 50. Both my grandpas died around 50. My best friend died
| with 18. Many of the fellow blind people I know died below 50.
| And I am from a relatively rich country, with classical western
| standards. It is almost as if I was thrown into a local minimum
| while the simulation was set up. I would understand if the
| phenomenon was largely limited to my family, call it genes then.
| But it doesn't end there. I guess the personal statistics becomes
| only meaningful after your own death and beyond. But really,
| looking at how many people had to pass away early, I am beginning
| to get spooked.
| asoneth wrote:
| > I would understand if the phenomenon was largely limited to
| my family, call it genes then
|
| Perhaps there are other shared variables besides genes? For one
| thing, blindness is associated with higher mortality [1]. And
| even within a country, life expectancy can vary dramatically by
| region, city, and even neighborhood. Or perhaps the people you
| know happen to be more likely to share certain occupations,
| mindsets, levels of physical activity, or diets?
|
| Or maybe it's just coincidence.
|
| [1]
| https://www.thelancet.com/journals/langlo/article/PIIS2214-1...
| foobiekr wrote:
| I wonder how much impact there will be on average life expectancy
| uncovering that a lot of the super-long-lived population examples
| have been pension fraud.
| potato3732842 wrote:
| Those people are statistically irrelevant. Not enough of them
| to drag the average much one way or the other.
| dustyventure wrote:
| For every pension fraud that went on that long and took such
| an obvious risk with continuing to a notable age, I imagine
| there were hundreds or thousands of shorter frauds.
| tired-turtle wrote:
| In this case, the "shorter frauds" involve dying near the
| reported date of death? By your definition, the postulated
| (unreported) deviation is statistically insignificant.
| jandrewrogers wrote:
| Probably not much because you can find long-lived populations
| that don't follow the administrative boundaries of pensions.
|
| King County in Washington State, which contains the Seattle
| metro area, has a life expectancy of 86.3 years. This is higher
| than any country in the world. If you move one county south
| (Pierce), it is 75.7 years, slightly worse than the US average
| currently. Not surprisingly, there are many obvious factors
| that may contribute to this e.g. the obesity rate in Pierce
| County is 50% higher and the obesity rate in King County is
| roughly _half_ the US obesity rate. The Seattle metro is a
| relatively walkable city and people do, Pierce County is not.
| As a matter of demographics, King County is significantly more
| Asian than Pierce County. And so on.
|
| Both counties are geographically large and contain many
| municipalities. It is difficult to come up with a theory where
| pension fraud in King County is so high relative to Pierce
| County that it explains a >10 year difference in life
| expectancy.
| zeroonetwothree wrote:
| This source gives King County as 81 years:
| https://www.communitiescount.org/life-expectancy
| jandrewrogers wrote:
| There is quite a lot of disagreement but I think you are
| correct. My source appears to be bad AI generated content;
| I did not dig in too much.
|
| The underlying source of 86.3 matches San Juan county from
| other sources. Seattle metro areas are a bit over 83, and
| King County is somewhere between 81-82 from sources that
| seem more primary.
|
| Internet search is straight garbage these days.
| lazerpants wrote:
| Our organization (the American Federation for Aging Research) is
| hosting a webinar with Jay Olshansky (author of the paper) and
| Andrew Scott, a leading economist in longevity to discuss Jay's
| results on 10/22.
|
| The gist is that this isn't quite as cut and dry as it may seem.
|
| We also paid to make the Nature Aging paper open access.
|
| Event: https://www.afar.org/events/webinar-lifeexpectancy-1
| throwup238 wrote:
| _> We also paid to make the Nature Aging paper open access._
|
| That's awesome! Did you make a deal with the authors to pay for
| the fee during publication or is this something anyone can do
| by approaching the journal itself?
| lazerpants wrote:
| Thanks! I wasn't directly involved in that discussion, but I
| imagine anyone can do it. It is a requirement for some grants
| and for some research funders.
|
| Edit: if you need to know I would just ask the editor if it's
| an option
| seydor wrote:
| $12290
| llm_trw wrote:
| >We also paid to make the Nature Aging paper open access.
|
| What a world to live in.
| A_D_E_P_T wrote:
| > _We also paid to make the Nature Aging paper open access._
|
| Why not just use a preprint server like Medrxiv?
|
| Arxiv is now the default place to publish papers in physics --
| and, with that established, it seems to me that it would be for
| the best if more institutions, researchers, and organizations
| in biology, medicine, chemistry, and other areas also use
| preprint servers.
| switch007 wrote:
| They're going to need new excuses for phasing out state pensions
| oops sorry I mean "raising the pension age".
| readthenotes1 wrote:
| Talking about the number of people who live over 100 along with
| the average life expectancy seems to be mixing two unrelated
| things.
|
| To show that we are hitting a limit on our ability to extend
| lifetime, we really should look at having reached 95, how many
| people reach 105 or something like that.
|
| To say that the average life expectancy is dropping and therefore
| we have reached our limit on their ability to extend the
| lifetimes ignores the fact that much of the reason for a stage
| life expectancy drop in my country is lifelong maltreatment,
| often self-inflicted--death-oriented decisions on drugs,
| nutrition, and activity.
| aucisson_masque wrote:
| > Can we overcome ageing?
|
| 75% American are overweight..
|
| Just let it sink a second, they speak about how many baby born
| after 2000 will reach 100 years old, how we are reaching the
| absolute limit of human survival.
|
| 75% overweight... Everyone know fat people don't live long. I bet
| all the studies done in the 90's that predicted we would easily
| be able to reach 100 years old didn't take that into account.
| Zenzero wrote:
| There is probably a distinction to be made between
|
| "here is the theoretical limit given adherence to modern
| recommendations on cardiovascular health, exercise, etc."
|
| and
|
| "you all didn't listen and got fat instead"
| Barrin92 wrote:
| > Everyone know fat people don't live long.
|
| studies estimate that moderate obesity takes about 2-3 years of
| life expectancy (defined as having a BMI of 30-35), only people
| with severe obesity (BMI of 40-45+) lose on average 6-13 years,
| comparable to smoking.
|
| Given that severe obesity is still uncommon even in the rich
| world it only has a small impact on life expectancy overall.
| bamboozled wrote:
| Combined with getting in your car and driving absolutely
| everywhere (most Americans)?
| asdff wrote:
| This is what people also don't realize. When these sorts of
| people get old they become immobile as they lose what
| precious little of actual muscle mass they had and
| unsupported joints start failing left and right. Sure your
| life expectancy might only be 2-3 years shy. What about
| your health span? That's what most people are actually
| interested in extending when they talk about living longer.
| bamboozled wrote:
| Yeah, this is why I lift everyday and I plan too until I
| can no longer do it. Lifting is also good for mobility if
| done correctly. Especially deep squats.
|
| Hunched over old people do not have the muscle mass to
| help keep them upright, I guess amongst other things.
| lovethevoid wrote:
| Lifting does very little for mobility.
| andsoitis wrote:
| > Lifting does very little for mobility.
|
| Weightlifting can improve mobility by:
|
| - strengthening muscles around joints allowing for more
| controlled movement.
|
| - increasing flexibility: Dynamic movements in
| weightlifting, like squats, lunges, and overhead presses,
| can stretch and strengthen muscles simultaneously,
| improving flexibility over time.
|
| - improving joint health because loading the joints with
| resistance can increase the production of synovial fluid,
| which helps lubricate joints and promote better movement.
|
| - promoting balance and coordination because exercises
| often challenge stability and coordination, which can
| help improve motor control and range of motion in
| everyday movements.
| theshackleford wrote:
| My neurosurgeon and my rehabilitation program would both
| disagree with you.
| aucisson_masque wrote:
| Lifting is universally recommended to keep you healthy as
| you age, that and 30 min of moderate to intense cardio
| per day.
| throwaway2037 wrote:
| Why do people on HN think the US is special about (quantity
| of) driving? All wealthy non-microstate nations are driving
| nations. And, they drive _a lot_. That includes Australia.
| aucisson_masque wrote:
| Bicycle are pretty common in Europe, infrastructures are
| designed around it and pedestrian since the middle 90's.
|
| Most people still have a car but you wouldn't think about
| taking the car to go buy bread for instance.
| bequanna wrote:
| > ...studies estimate that moderate obesity takes about 2-3
| years of life expectancy
|
| This is really hard to believe. Moderate obesity has to shave
| at least 10 years off life expectancy.
|
| A 70 year old man 6' tall with a BMI of ~35 weighs 260 lbs.
| That is pretty overweight.
|
| Anecdotally, I just don't see many people that overweight or
| heavier making it into their 80s.
| mercutio2 wrote:
| On the contrary. Conditional on living to your 60s, being
| moderately overweight is _positively_ correlated with
| lifespan, not negatively.
|
| When you're old, setbacks that cause you to lose your
| appetite are much more common and much bigger threats to
| the health of skinny people.
|
| I don't know where you live, but I've met tons of
| moderately fat people in their 70s and 80s.
| scarby2 wrote:
| I'm thinking that ozempic and zepbound will have something to
| say about this. When ozempic becomes available as a generic
| (2032) it's going to be available for $10 a dose and a huge
| amount of people will be taking it.
| Muromec wrote:
| Wait, doing amphetamines for weight loss is cool again and
| has no drawbacks of it's own?
| llm_trw wrote:
| Welcome to the 80s part 2. Hope you enjoy the ride.
| llamaimperative wrote:
| Ozempic et al are nothing like amphetamines. They
| definitely have side-effects but we have far, far more
| evidence that the benefits are outweighed than we did for
| stimulants in the 80s.
| llm_trw wrote:
| Every decade or two I hear this about some wonder drug
| only for them to turn out just as bad as what they were
| replacing. The opioid epidemic being the latest one.
| ywvcbk wrote:
| Do you pay more attention to those and ignore the actual
| success stories?
|
| The opioids thing is hardly comparable. Everybody clearly
| knew the risks (for the past 100+ years) and chose to
| ignore them. This is an almost entirely new type of
| drugs.
| llm_trw wrote:
| Do you pay attention to the people who win at Russian
| roulette more than those who lose?
|
| OxyContin was marketed to be the safe alternative to all
| opioids that came before it, impossible to become
| addicted to and extremely difficult to overdose from.
| This was a lie.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/
| ywvcbk wrote:
| > Do you pay attention to the people who win at Russian
| roulette more than those who lose?
|
| Well.. no since you cant really win anything. With
| pharmaceuticals on the other I hand I think 1
| Oxycontin/etc. like "situation" would be a reasonable
| price to pay for let's say 4 major successes.
|
| You were talking about decades. Surely you noticed the
| advancements in treating cancer, HIV and a multitude of
| other conditions since the 90s?
|
| > This was a lie.
|
| Sure. But it's on the same level as saying that filtered
| cigarettes don't cause cancer. If a doctor actually
| believes that he's just too dumb to be a doctor...
| (although I assume most safety claims were relative to
| other opioids and not in absolute terms?)
|
| Are there any signs that the situation with Semaglutides
| is that similar? Yes they are new and not well understood
| drugs (well not really but sort of..) and it's not
| inconceivable that their longterm cost might end up
| outweighing the benefits but I don't really see any signs
| of an actual conspiracy yet.
| NemoNobody wrote:
| I don't think ozempic is amphetamines.
| EasyMark wrote:
| Ozempic isn't anywhere near the amphetamine class of weight
| control prescriptions, where are you getting your
| misinformation from?
| tuatoru wrote:
| Honest puzzlement: how is it possible to be so
| underinformed when google, duckduckgo and wikipedia are
| _right there_? Are they blocked some places where hacker
| news isn 't?
| NoMoreNicksLeft wrote:
| You live in a world where willful stupidity is far from
| rare. Yes, I know that we should assume incompetence
| before malevolence, but that was an earlier era. A
| mixture of the two is the new norm.
| MichaelZuo wrote:
| How do you know they don't have side effects that would
| reduce max life expectancy?
| generalizations wrote:
| Entirely possible they do - but those effects would
| probably manifest in some fashion earlier than actual
| death. We'll have at least 7 years to see if we can spot
| them. But, even if they do exist, they will probably be
| small (given we haven't found them so far), and the
| positive effect on life expectancy via weight loss is huge.
|
| i.e. the benefits of the weight loss almost certainly
| outweigh any side effects that are likely to manifest.
| positr0n wrote:
| People have been taking them for decades for other reasons,
| so if they had side effects reducing max life expectancy
| worse than being overweight surely we'd know by now.
| hackernewds wrote:
| have they? why are they only gaining prominence now?
| ben_w wrote:
| Because they have been made available for weight loss.
|
| Viagra's original purpose was for heart conditions, that
| purpose didn't make the headlines (or spam folders)
| either.
| tuatoru wrote:
| Almost. Pulmonary hypertension, high blood pressure in
| the arteries of the lungs. Pretty close to the heart.
| ben_w wrote:
| Oh? I stand corrected. I thought it was for angina.
| renewiltord wrote:
| We don't know if MMR doesn't but we still give kids[0] the
| vaccine in infancy. The vaccine is too young (<60 y old).
| So I suppose ask yourself what proof you need and why.
|
| 0: most kids, I just got the disease instead and the vax
| later
| izend wrote:
| We do know MMRV causes more seizures in kids than MMR and
| countries (like Canada) still choose to administer the
| vaccine with riskier outcomes due to costs and the fact
| parents don't like to come back for more shots.
| sph wrote:
| A vaccine is _very_ different than a hormone taken daily.
| aucisson_masque wrote:
| A study by researchers from the University of British
| Columbia (Canada) shows a link between drugs intended for
| diabetics and severe gastrointestinal diseases:
| pancreatitis, intestinal obstruction, biliary pathologies
| and gastroparesis.
|
| Only fools would convince themselves a drug has no
| sideeffect.
|
| The worst is that these drugs were created for legitimate
| use but are now being abused by what I would call lazy fat
| who can't get their finger out of their arse and start
| eating healthy.
|
| When there is a natural, effective and no side effects
| alternative, why go the medication way.
| ben_w wrote:
| When I was at university, I made a game of spending as
| little as possible on food. 50p/day. Didn't realise until
| someone here refused to believe me, that my diet then was
| about 1100 kcal/day during term time. Didn't feel bad at
| all.
|
| A few years after graduation, for unrelated reasons, I
| was on antidepressants. I massively over-ate, became
| obese, gained stretch marks that will likely remain for
| life.
|
| There was no voice in my head telling me I was even over-
| eating, there was no awareness of what I was doing to
| myself even when I felt the weird tingle in my belly that
| in retrospect was the tearing flesh that has the outward
| sign of a stretch mark -- I ate without thought.
|
| There is no "natural, effective" solution, because our
| natural instincts are at odds with our unnatural world.
| sph wrote:
| So the solution is to take a hormone so we can still eat
| all the junk food we massively produce?
|
| Ozempic is exactly the type of drug Unilevel/Nestle would
| create if they were tasked with reducing obesity. I
| wonder if they'll include a free 7 day dose of it with
| Mars bars.
| ben_w wrote:
| It reduces food intake by lowering appetite.
|
| That's pretty much the exact opposite of what you seem to
| think it does, and is exactly the kind of thing that will
| hurt Nestle's junk food line. (Though probably not their
| bottled tap water line).
| Elinvynia wrote:
| There really is no natural solution if you are taking
| medication that increases your weight. Kinda disproving
| your own example there.
| ben_w wrote:
| Is this "nature" in the room with us right now?
|
| Seriously -- the US and Europe have not been in a
| remotely "natural" condition since over a century before
| I was born. Even the air we breathe is significantly
| different from its natural condition.
|
| Why do you think I gave that example?
| arkh wrote:
| I wish people with your worldview could try some drug
| enhancing appetite for like a month. See how easy it is
| to get their fingers out of their arse and keep eating
| healthy when their body is craving food all day long.
|
| Would you also tell people suffering from depression to
| just cheer the fuck up instead of going the medication
| way?
| Pikamander2 wrote:
| We don't, but there's also no particular reason to believe
| it will unless some evidence for it appears.
|
| Similar to zero-calorie sugar substitutes, "too good to be
| true" isn't always the case. Sometimes new inventions
| really are just better.
| yodsanklai wrote:
| I'm not quite sure this will address the root issues. Obesity
| is linked with very unhealthy diet. Ozempic isn't going to
| address that.
| aetherson wrote:
| It does at least potentially address that.
|
| Ozempic's mechanism of action is not "ramp up your
| metabolism" or "make you absorb fewer calories from food."
| It's "make the desire to eat less intense, making it easier
| to remain on a diet plan." That diet plan could be, "eat
| exactly the same things but less of them," but it will
| often be, "cut out unhealthy snacks" or whatever.
| gruez wrote:
| >It's "make the desire to eat less intense, making it
| easier to remain on a diet plan." That diet plan could
| be, "eat exactly the same things but less of them," but
| it will often be, "cut out unhealthy snacks" or whatever.
|
| If people can't be convinced to eat carrots over chips,
| what makes you think they're going to suddenly eat
| carrots over chips after eating medication that makes
| them want to eat less?
| hoseja wrote:
| Because that's literally what Ozempic does.
| gruez wrote:
| I'm not sure how making someone less hungry magically
| makes them want to eat carrots over chips. Is the reason
| why they're eating chips because they're so hungry and so
| pressed for time that they're reaching for the highest
| calorie food? Or do they eat whatever's the most
| delicious? If it's the latter, I doubt being less hungry
| is going to make them choose healthier options over more
| delicious ones.
| siver_john wrote:
| From my friends who are on ozempic, yes it has literally
| done just that. Along with the fact because they are
| driven to eat less they, in general are less snacky (and
| thus eat less chips) and tend to avoid greasy/fried foods
| because combined with the medicine it leaves them feeling
| worse afterwards than eating a similar "healthier meal".
|
| Yes N=2, small sample sizes, but I could also see how
| being less snacky makes one less likely to eat chips.
| (Why I almost pathologically don't keep easy to eat food
| in my pantry, granted this can also backfire too).
| leetnewb wrote:
| Sometimes the dose (portion) makes the poison.
| aetherson wrote:
| People aren't idiots. They know what foods are healthy.
|
| A lot of people struggle with intense cravings for foods
| that they know to be unhealthy. These cravings stack up
| against their willpower and sometimes overcome that
| willpower and they eat in ways that they know are
| unhealthy.
|
| If the cravings are less intense, willpower wins more
| often, cravings win less often.
|
| I think that you will indeed see that some people on
| ozempic eat much the same mix of foods as before, but
| less so. But others will in fact change their dietary
| mix. And I'm pretty sure that the empirical evidence
| supports me on this.
| kaibee wrote:
| Oh I can answer this one. I've never liked chips but was
| still ~230lb before Ozempic. I tried various diets, but
| the willpower to maintain one was pretty overwhelming if
| anything else was going on in my life. I tried eating
| carrots to get full. And let me tell you, it feels very
| strange to eat half a pound of carrots, feel your stomach
| be full, almost painfully full, and still be just as
| hungry. Same with salads. I would still feel hungry, even
| though the stomach is full. Even though I liked the taste
| of the carrots or the salad. It felt like I hadn't
| actually eaten, and that I was still hungry for an actual
| meal. With Ozempic? I can just eat a salad, feel good
| about it, and feel satiated for hours. It just works?
| s1artibartfast wrote:
| It reduces your interest in food. If you eat chips, you
| will do it less often.
|
| I'm not sure what angle you are getting at. There is tons
| of data that shows that yes, people lose weight on it.
| EasyMark wrote:
| That's a bizarre hill to die on, I see all kinds of larger
| people survive into their 90s when I was living near and
| volunteering at a nursing home as a teenager
| WillPostForFood wrote:
| _I see all kinds of larger people survive into their 90s_
|
| So dangerous to extrapolate from anecdotal observation like
| this. If I see old people smoking, doesn't mean smoking is
| safe. It just means it doesn't kill at 100% effectiveness.
| koolba wrote:
| > It just means it doesn't kill at 100% effectiveness.
|
| If you wait long enough, everything has a 100%
| effectiveness.
| rKarpinski wrote:
| if you wait long enough, obesity actually becomes a
| protective factor for serious issues; like Falling &
| Sarcopenia.
| dyauspitr wrote:
| I see "plenty" of life long smokers making it to their 80s
| and 90s too, that doesn't mean it didn't take out 90% of them
| along the way.
| s1artibartfast wrote:
| Good example of how people overestimate the impact of these
| things. Closer to 10% of smokers get lung cancer.
| dyauspitr wrote:
| But COPD, Emphysema and cardio vascular issues also
| affect smokers, it's not just lung cancer.
| renewiltord wrote:
| That's the funny thing: at homes and nursing homes all around
| America you will find WW2 veterans. One could conclude that
| WW2 wasn't dangerous from that, I suppose.
| kaibee wrote:
| https://en.wikipedia.org/wiki/Survivorship_bias
| throwaway2037 wrote:
| To be clear, it looks like the health stat term "overweight"
| means anything greater than "normal", which includes obese.
|
| Quick Google search: > what percent of
| australians are overweight?
|
| First hit: > Over the last decade, the
| proportion of adults who were overweight or obese has increased
| from 62.8% in 2011-12 to 65.8% in 2022.
|
| Source: https://www.abs.gov.au/statistics/health/health-
| conditions-a....
|
| US NIH says: 73.1% are overweight (includes obese). Ref:
| https://www.niddk.nih.gov/health-information/health-statisti...
|
| Sure, 73.1% > 65.8%, but Australia is still plenty overweight.
| Both are appalling.
| ywvcbk wrote:
| To be fair BMI is based on Belgians from the 1850s with all
| the implications it has. Modern people are much taller (+15
| cm for males) and eat a lot more protein.
|
| So the line between normal and overweight is somewhat blurry.
| e.g. someone who is 6'3" and weighs 200 pounds is overweight.
| Which might or might not be the case (but you certainly don't
| need to a body builder or invest a lot of time to maintain at
| least reasonably healthy 18-20% body fat ratio).
| gruez wrote:
| >To be fair BMI is based on Belgians from the 1850s with
| all the implications it has.
|
| It's a pretty straightforward formula, and even though the
| cutoffs might be arbitrary, there's undoubtedly a u shaped
| mortality curve centered somewhere around 20-25. At a
| population level I don't think any of that is a relevant
| factor. No one thinks that your risk of death hinges on
| crossing an arbitrary line, but being fatter definitely
| isn't good for your health.
| lolinder wrote:
| But the question here is whether you can compare the BMI
| curves of two countries and come to any conclusions, and
| the answer is pretty solidly "no".
|
| Bone density, muscle mass, torso height relative to leg
| height--none of these things are factored into BMI and
| all of these vary wildly depending on genes.
| Retric wrote:
| Veins have a 2D cross section where body's are 3D. That's
| one reason why using height ^2 not height ^3 may better
| correlate with health.
|
| Similarly, cancer risks may scale with the amount of tissue
| or the surface area for things like skin / colon cancer but
| it's hard to see how being taller is beneficial.
| lolinder wrote:
| > Both are appalling.
|
| Both are also largely meaningless because they're based on
| BMI, which is literally just mass/height^2. No measure of
| percent body fat, no measure of any other aspect of health,
| just mass by the square of height.
|
| If you're comparing the BMI of two countries with very
| similar gene pools it's not a bad point of comparison (though
| the raw number still doesn't tell you much without more
| context about build types), but when you're comparing
| Australia to the US the gene pools of the non-European
| minority groups are sufficiently different to make BMI pretty
| worthless as a point of comparison for public health.
| pwillia7 wrote:
| How do they even pretend that works when some South Asians
| are shorter and the Danes are so large? Are the Danish just
| 100% obese?
|
| This says it's <20% there[1][2]
|
| 1: https://en.wikipedia.org/wiki/Average_human_height_by_co
| untr...
|
| 2: https://academic.oup.com/eurpub/article/33/3/463/7058153
| s1artibartfast wrote:
| Height is factored in, albeit in a very simple way
| lolinder wrote:
| Yeah, it's not height itself that's the problem, it's
| body shape. As just one example: some people have long
| torsos and short legs, others long legs and short torsos.
| Those two groups will have wildly different BMI curves
| even at similar health levels.
| s1artibartfast wrote:
| BMI is a very crude measure. It is only useful in the
| extreme, and not particularly relevant for an individual.
| If you have a BMI of 40 you should think about losing
| weight, but exactly nobody need a composite number to
| know they are that fat. Similarly, you might have a
| normal BMI but an LDL of 300 or a strange lump on your
| thyroid. These things are vastly more important than your
| BMI
| watwut wrote:
| Being slightly overweight is associated with longer lifespan.
| Really look it up, the longest lifespan is slightly overweight
| and top of normal bmi. Lifespan gets down when you move toward
| obese, somewhere in the middle of overweight segment.
|
| The worst life expectations are in underweight category.
| geysersam wrote:
| Haha people really don't want to hear your message
|
| It's hard to take seriously the aversion especially Americans
| seem to have against overweight and obesity
|
| Funny the land of the free is so incredibly intolerant on
| this one point
| taeric wrote:
| I'm actually a little surprised at the framing here. I didn't
| realize anyone thought we could overcome aging. I thought the
| goal was to live longer, but not to completely overcome aging.
| That sounds somewhat foreign to me. Is that a commonly reasonable
| goal for folks?
|
| That is to say, I'm not clear that "beating aging" is what is
| required for "long life." Is that definitionally required and I'm
| just being dense?
|
| I'm assuming this is a tiered discussion? In that nobody thinks
| we should freeze aging at baby stages for someone. Such that we
| would still want some aging, but would then try and fix a point
| where all aging can be stopped?
| Loughla wrote:
| I honestly thought the whole point was beating aging. Whether
| that's longer life or cancer or whatever. The point is to stay
| 20-40 forever, from what I can tell.
| taeric wrote:
| But, by the time you hit 20-40, you have already done a ton
| of aging?
|
| Fair that I don't expect to be as strong in my 60s as I am
| now. Or when I hit 70+. If I get that far. Light weight
| training is plenty to get to be in good physical shape,
| though? Get to where you can do 10-30 pushups and run a
| continuous mile, and you are probably doing fine?
| throaway2112 wrote:
| But why would you not want to beat aging in a medical
| sense? I don't really understand your logic here.
| taeric wrote:
| But this gets to my question, essentially? Is "aging for
| the elderly" different than "aging for the middle aged?"
|
| So, what does it mean to "beat aging in a medical sense?"
| If it is just definitionally to not have any of the bad
| effects of aging, then sure. Of course I would want that.
| What are the names for the good things that are generally
| along for the ride with aging?
|
| Going back to my earlier quip, if you could turn off
| aging for babies/toddlers, how would that be a good
| thing?
| throaway2112 wrote:
| It wouldn't. So you wouldn't do that. It would be like
| giving an insulin pump to someone who wasn't diabetic.
| Why would you?
| taeric wrote:
| This may somewhat surprise you, but I would ask the same
| for people in the 30s. 40s even, at this point. Freezing
| someone at that age doesn't sound appealing to me. At
| all.
|
| So the heart of my question is why do we view "defeating
| aging" as the same as "living longer?" Or is this
| something where the target age that people would want to
| be generally coalesces on a common number?
| Dalewyn wrote:
| "Aging" in the context of "defeating aging" refers to the
| phenomena of declining metabolism and deteriorating
| genetic data.
|
| Wrinkling skin, graying hair, loss of muscle mass and
| bone density, loss of mental acuity, decline of libido,
| late-life diseases (eg: cancer, Alzheimer's, type-2
| diabetes), and so on.
|
| It's scientifically proven that our bodies spend enormous
| amounts of energy up into our 20s when we reach sexual
| maturity and then glide through on momentum through our
| 30s into our 40s when we are raising our children.
|
| Once we're in our late 40s to early 50s we're done
| spawning new life and our bodies throw in the towel,
| starting the slow but inevitable deterioration
| culminating in death.
|
| It's that whole physical process that we as a species
| want to overcome, we want to defy being just machines for
| spawning more machines. Life is fucking evil.
|
| Growing wiser from more and more life experiences is also
| part of aging, but it's not what we refer to when we say
| "defeat aging".
| taeric wrote:
| This makes sense, though I still find the framing odd. I
| don't mind that I look older now that I'm, you know,
| older. Defeating aging feels like it would be to find a
| way to be forever young. Extending life doesn't feel like
| it would need that.
|
| Obviously, we need some way to not completely lose
| genetic data and such. If there is a "throwing in the
| towel" moment, as it were, find a way to prevent that.
| But living forever doesn't equal forever young, to me.
| Mayhap I'm just too old for that to have meaning anymore?
| :D
| science4sail wrote:
| > Is that a commonly reasonable goal for folks?
|
| Why not? Humans have been pursuing immortality for time
| immemorial. "The Epic of Gilgamesh", one of the first known
| stories, features such a pursuit.
| taeric wrote:
| I think it is just a difference in how you view it? I'd
| expect ancient person to be noticeably ancient. Not
| necessarily frail, but just as an old tree has signs of aging
| that younger trees don't necessarily have. Not that they
| stopped aging entirely.
|
| So, if you limit aging to "getting frail," I am fully there.
| But there are other things that happen as you age.
| michaelt wrote:
| It's the bit of life where you can dress yourself and control
| your bowels that most people would like to extend. I think
| nobody gets into longevity research hoping they'll be able to
| dodder around a nursing home with a walker for 25 years instead
| of 15.
| taeric wrote:
| But you could do that by extending the bit of your life where
| you can do those things. Not necessarily turning off aging?
|
| As I said down thread, this could just be a potato/potahto
| thing? If this is just definitionally beating getting frail,
| then that makes sense. But I don't know that I could pin down
| an age that I would want to freeze progress at. Nor do I
| think I expected that there would be a general age to freeze
| aging at. Let me keep my strength longer, but I expect I will
| be/look/appear older and older the older I get.
|
| Now, granted, I'd be delighted if I have the same strength my
| 90 year old grandfather in law did. In his 70s, I'm pretty
| sure the only thing I could beat him at was a race. Lifting
| things or doing manual work outside, and he was far beyond
| what I was in my 30s.
| krisoft wrote:
| > but I expect I will be/look/appear older and older the
| older I get.
|
| I have a suspicion that something is being miscommunicated
| between you and many others here. (I admit that I might be
| wrong. But hear me out.)
|
| It sounds like you are thinking about the visual signs of
| aging. Like wrinkling of the face, or salt-and-pepper hair.
| That kind of thing. And sure, there is a lot of vain people
| who would like to stop that from happening.
|
| But in general the aging people want to defeat is not the
| wrinkled face. It is things like our immune system
| demonstrably going to crap as we turn older. Or losing
| muscle mass. Or becoming senile. Or our bones becoming more
| fragile.
|
| For young people the flue is basically an inconvenience (by
| and large). But as we age things like seasonal flue becomes
| huge issues. People's immune system used to work for
| decades without a hitch, and then suddenly it decides to
| crap out. Why?
|
| I can also put it into a more mathematical framework. If
| maybe that helps? Imagine plotting the probability of a
| human dying in their x'th year assuming that they have
| survived before x-1 years. If you plot this now you would
| see a sort of bath-tub like curve. There is some chance a
| newborn dies in their first few years of life due to birth
| defects. Because of that the first few years have a higher
| probability of death. Then the plot plateaus, and the
| probability remains basically constant low number for
| multiple decades. People can still die due to violence, or
| accidents, or random health issues, but the chance of that
| doesn't really change much from year to year. And as you
| approach the other "side" of the bath-tub you see that the
| probability starts climbing again. And this climb is quite
| rapid. By the time you are 100ish (plus minus a few years)
| you have fairly good chances of dying in any given year.
| And then around 105ish you have about even chances of dying
| or staying alive in each year. And then we don't have
| anyone who ever lived to 130.
|
| On this kind of plot if we were to defeat aging what you
| would see is that the plateau remains constant. That is the
| chances of a 35 year old dying in the next year where the
| same as the 135 year old dying in the next year.
| taeric wrote:
| Right, this is what I meant with the potato/potahto
| thing. To me, wrinkled face, graying hair, more hair,
| etc. are all things that are part of aging.
|
| Which is why I balk at the framing of "defeating aging."
| We want to defeat the decline that comes with advanced
| age. But this doesn't necessarily mean we have to freeze
| the clock at some age, as it were. May be that that is
| the way it happens.
| mr_toad wrote:
| > That is to say, I'm not clear that "beating aging" is what is
| required for "long life."
|
| Ageing is not a perfectly understood process, so what it would
| mean to overcome aging wasn't clear, and there was some hope
| decades ago that maximum human lifespans would just keep going
| up indefinitely as medicine slowly eliminated the various
| causes of death.
|
| But now this research concludes what has been suspected for a
| while - that even under perfect conditions the average human
| lifespan isn't going to hit 100. Even if you eat and exercise
| well and have the best medical treatment, and avoid all the
| other things that might kill you, ageing _will_ get you.
|
| The medical term for this is "mortality compression", the idea
| that as we remove all the ways people die early, the ages of
| death for everyone end up being squashed up against a limit.
|
| It will take significant breakthroughs in technology (probably
| some combination of gene therapy, cancer treatments and
| nanotechnology) to actually stop, or reverse aging.
| taeric wrote:
| I think this somewhat makes sense. Just going on the
| discussion, I was missing that this is using "aging" as
| shorthand for "the degenerate effects of aging." I'm assuming
| the growth effects of aging would be more "maturing" or some
| such.
|
| I still think calling this "defeating aging" is an odd
| framing. But it makes sense in the standard context here.
| rawgabbit wrote:
| > _"It tells you that something pretty negative is happening
| among some subgroups of the population to drag the average down,
| because the wealthier, more highly educated subgroups are
| actually doing better," Olshansky says."_
|
| It is expensive to live a healthy lifestyle in the US.
| karim79 wrote:
| Cutting out sugar and useless carbs, and trying to replace those
| things with nuts and quality proteins - more nourishing and
| filling substitutes, can help a bit, I think. Mostly, try to stay
| away from refined sugar and products containing sugar or corn
| syrup. And for the love of God, lots more vegetables. Less dairy
| perhaps?
|
| Get an apartment on at least the third floor, in a building
| without a lift.
|
| Get a pet dog which needs to be walked several times a day.
|
| Eat lots of chili peppers[0]:
|
| "The analysis included data from more than a half a million
| people in multiple countries. When compared with people who never
| or rarely ate chili pepper, those who ate it regularly had lower
| rates of death due to cardiovascular disease (by 26%), cancer (by
| 23%), or any cause (by 25%)."
|
| [0] https://www.health.harvard.edu/blog/will-eating-more-
| chilis-....
|
| A little bit of high-intensity workout each week?
|
| I know people who are incapable of eating lunch or any meal
| without a large can/bottle of full-strengh coca cola or such,
| ever single day. Most of whom complain about not being able to
| lose weight.
|
| The science is pretty clear. Breaking out of old habits is much
| more challenging.
|
| EDIT: Typos: whole -> whom, mean -> meal
| bottom999mottob wrote:
| The health effects of nuts are fairly overstated especially
| since many of them are high in PUFAs.
| karim79 wrote:
| I think my main point was about reducing all sugar, and
| reducing the intake of garbage carbs.
|
| "Although nuts are high in fat, it's mainly healthier
| unsaturated fat. They contain protein, B vitamins, vitamin E
| and minerals, including iron, potassium, selenium, magnesium,
| zinc and copper."[0]
|
| [0] https://www.bhf.org.uk/informationsupport/heart-matters-
| maga....
| bottom999mottob wrote:
| I get your main point. My main point is that unsaturated
| fats, specifically poly-unsaturated fats, are definitely
| not better than saturated fats and we shouldn't be telling
| people to eat more nuts. The evidence linking saturated fat
| to heart disease has been weak, and organizations like the
| American Heart Association have promoted this claim while
| also promoting crap products like Crisco while taking money
| from Proctor & Gamble.
|
| "The idea that saturated fats cause heart disease, called
| the diet-heart hypothesis, was introduced in the 1950s,
| based on weak, associational evidence"[0]
|
| [0]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/
| rawgabbit wrote:
| https://www.health.harvard.edu/staying-healthy/new-
| thinking-...
|
| > _These studies have two main messages: When you eat
| saturated fat in moderation (contributing 10% or fewer of
| your daily calories), it has little effect on
| cardiovascular disease. When you cut back on saturated
| fat, replacing it with unsaturated fats or whole grains
| is good for your heart and arteries, while replacing it
| with easily digested carbohydrates isn 't._
| hombre_fatal wrote:
| That is not a study. It's science denying storytelling
| from Nina Teicholz, a frequently debunked charlatan.
| Every time you replace saturated fat with unsaturated
| fat, health markers improve.
| throwaway2037 wrote:
| Google tells me that PUFAs == Polyunsaturated fatty acids
|
| Since when are polyunsaturated fatty acids considered
| unhealthy? As I recall, the real enemy is saturated fats.
| dyauspitr wrote:
| Polyunsaturated fats like omega-3 and omega-6 are beneficial.
| patrickhogan1 wrote:
| This will not age well.
| defrost wrote:
| For an interesting side piece: Curiously,
| however, for a system apparently stultified by the dead hand of
| government, Australia's health system far outperforms the free
| market-based US healthcare system, which spends nearly twice as
| much per capita as Australia to deliver far worse outcomes --
| including Americans dying five years younger than us.
|
| _The shocking truth: Australia has a world-leading health system
| -- because of governments_
|
| Source: https://www.crikey.com.au/2024/10/16/pubic-private-
| healthcar...
|
| Bypass:
| https://clearthis.page/?u=https%3A%2F%2Fwww.crikey.com.au%2F...
| Overall, we now have the fourth-highest life expectancy in the
| world. This is contrary to the narrative that
| pervades the media about our health system -- one in which our
| "frontline" health workers heroically battle to overcome
| government neglect and inadequate spending, while the population
| is beset by various "epidemics" -- obesity, alcohol, illicit
| drugs. In fact, Australian longevity is so
| remarkable that in August The Economist published a piece simply
| titled "Why do Australians live so long?"
|
| Other references:
|
| _The Economist_ : https://www.economist.com/graphic-
| detail/2024/08/23/why-do-a...
|
| AU Gov Report: _Advances in measuring healthcare productivity_
| https://www.pc.gov.au/research/completed/measuring-healthcar...
| alwayslikethis wrote:
| > the free market-based US healthcare system
|
| market, maybe, "free" market? I doubt it.
|
| It's not a very free market when there is such a large power
| differential between the buyer and the seller. You can't
| exactly shop around for the ambulance or the hospital when you
| need it, nor can you realistically circumvent the artificially
| constrained supply [1] of doctors to get cheaper healthcare
| (unless you live next to the border).
|
| When the alternative is a one-sided market like this,
| government becomes rather more appealing.
|
| 1.
| https://en.wikipedia.org/wiki/American_Medical_Association#R...
| WalterBright wrote:
| > You can't exactly shop around
|
| The vast bulk of health care is by appointment, not a dash in
| the ambulance.
| globular-toast wrote:
| Even so, when was the last time someone needed cancer
| treatment but said "ooh, that's pricey, nah, I'd rather buy
| a new car instead".
|
| This is my main argument against private healthcare:
| there's no real choice involved. Without even getting into
| what a free market is and perfect information etc, the main
| advantage of a capitalist society is you get to choose what
| you like. Nobody chooses healthcare (at least, not the
| super expensive part).
| tastyfreeze wrote:
| A large portion of healthcare could be free market.
| Insurance should be for unlikely events not every single
| thing deemed "medical". My home and auto insurance don't
| cover regular costs for maintenance. Why must health
| insurance cover a checkup with the doctor?
| SoftTalker wrote:
| > This is my main argument against private healthcare:
| there's no real choice involved.
|
| Is your argument that there _is_ choice involved in
| public healthcare? Or simply that it 's not even a
| question?
| WalterBright wrote:
| There are many options for cancer treatment, with
| different prices, efficacy, misery, etc.
|
| > Nobody chooses healthcare
|
| Yeah, they do. Root canal vs implant vs dentures, for
| example. Ozempic vs diet+exercise, for another.
| davkan wrote:
| You're still significantly limited by your insurance
| carrier's network and also the consolidation of the
| healthcare industry. I used to live in a city of 1 million
| that had essentially two hospital networks that bought
| everything. You could not find a specialist not associated
| with those two companies. Pre-natal, allergy, cardiac, two
| choices. When my seventy year old doctor who ran a practice
| out of his house retired he sold the practice to one of the
| two.
|
| It's not shopping for a tv. You can't choose not to buy.
| It's often time sensitive even if by appointment. Pricing
| is incredibly complex as are the details of the product.
| Your average person does not have the information necessary
| to navigate the market.
| Pikamander2 wrote:
| Even more fun is when your doctor refers you to a
| specialist that's in-network, but your insurance comes up
| with a bunch of reasons to deny it.
|
| How did we collectively decide that it's okay for
| insurance companies to overrule medical professionals?
| gruez wrote:
| AFAIK the overruling is done by a "medical professional"
| as well, albeit one that's on the insurance company's
| payroll.
| jandrese wrote:
| That "medical professional" has literally 90 seconds to
| review your case and say yes/no. They've never met you.
| They don't know your doctor. All they have are some notes
| on the case, a billing code, and a quota to reach every
| day. They get bonuses based on how much money they save
| the insurance company.
|
| All of that cost savings makes US healthcare cost double
| what it does anywhere else in the world.
| nradov wrote:
| I think you're a little confused about causality. All
| healthcare systems, including fully socialized ones,
| perform similar types of case review to ration care and
| hold down costs. US healthcare costs might be high now
| but would be even higher if the payers (including the
| Medicare / Medicaid government payers) paid every claim
| that came in without denying those that fail to mean plan
| coverage rules.
|
| If we want to hold down costs then we'll have to put a
| greater focus on preventative care, stop expensive
| treatments for terminal patients, impose price controls
| on providers, and stop subsidizing drug development for
| the rest of the world. None of those measures are
| politically popular.
| nradov wrote:
| Legally speaking the insurance company isn't overruling
| medical professionals. They're simply refusing to pay.
| Patients still have the option of paying for treatments
| out of pocket. (I do understand that for poor patients
| this is a distinction without a difference, I'm just
| clarifying the legal issue.)
|
| Some states have recently passed laws which limit the
| authority of health plans to conduct medical reviews or
| deny payment for services that providers deem medically
| necessary. This will reduce hassles and expenses for some
| patients, but it will also accelerate the inflation of
| insurance premiums paid by everyone else.
| ddfs123 wrote:
| Even for non-emergency, the short amount of time before a
| health issue turn serious means that it's already hard for
| you to take second opinion.
| yellottyellott wrote:
| other than normal doctor's office visits, i have no idea
| what i'm going to pay when i get a small procedure done.
|
| a basic heart ultrasound cost me over $1k while my
| vasectomy cost me a $60 copay. i was expecting those prices
| to be flipped.
|
| and don't get me started on labs. i've gotten bills for
| basic screens years later for thousands of dollars.
|
| you can't shop around if you don't know what you'll pay
| until months after it happens. if you call the insurance
| company beforehand you wait on a static filled line with a
| call center in india, and even with the CPT code they can't
| give you a straight answer.
| WalterBright wrote:
| > i have no idea what i'm going to pay when i get a small
| procedure done.
|
| All you gotta do is ask.
| jandrese wrote:
| They don't know. Nobody does until the bill is processed.
| There are a thousand factors that might affect your
| coverage. This is the nightmare I'm living through right
| now. Even if you have the code and doctor and patient the
| help desk at the insurance company can't say for sure if
| they will cover it or not. That comes down to the
| discretion of the claims adjuster. You won't know if
| something is going to cost $100 or $10,000 until after it
| is done.
| WalterBright wrote:
| > They don't know
|
| It works every time I asked.
| jandrese wrote:
| The provider or the insurance company? The provider can
| give you the cash price, but that's a made up number with
| no relation to reality. The Insurance company can give
| you what the standard discount would be on that
| procedure, but they can't say if they'll cover it, give
| only that discount, give nothing, or anything in between.
| red-iron-pine wrote:
| and then wait 3 weeks for them to get back to you, as
| they contact your insurance and work out what they can
| get away with billing
| xbmcuser wrote:
| To me that is the funny thing today if you look at markets
| Chinese markets under it's communist system are actually
| freer than US. China is not interested any 1 company getting
| a monopoly and becoming more powerful than the government so
| they promote finance multiple companies resulting in a truer
| capitalist market than the US.
| HPsquared wrote:
| It's so ironic. Market competition is definitely intense
| over there.
| corimaith wrote:
| Not really. Chinese SOEs comprise around 60% of market
| capitalization and around 23% of GDP, far higher than USA
| or other developed economies.
|
| While they do have a competitive market, the government
| very much does pick and choose winners and loosers here
| like Huawei, resulting in consolidation into a few large
| conglomerates like every other country. Their (software)
| tech scene certainly dosen't like more particularly
| "capitalist" than Big Tech, nor is the Fed pumping
| subsidies to Tesla like BYD, if anything they're sidelining
| Elon Musk.
| lolinder wrote:
| > Chinese markets under it's communist system are actually
| freer than US
|
| Right up until the moment that the CCP decides to purge
| your entire sector, sure. I don't know if it counts as
| "free" if the government stands ready to nuke the sandbox
| they so generously let you play in.
|
| https://www.reuters.com/technology/beijings-regulatory-
| crack...
| adam_arthur wrote:
| You would expect market cap of the largest players to
| decline if the market becomes more competitive... which
| was China's primary goal with their recent crackdown.
|
| They proactively forced interconnectivity and limited the
| ability for companies to make "walled-garden peudo-
| monopolies", as we have in the US with Apple and Google.
|
| If the same happens here (through act of congress, or
| legal outcomes), you can expect their market caps to
| decline as well. A decline in market cap doesn't speak at
| all to whether it's beneficial to the industry or
| consumers
| lolinder wrote:
| > They proactively forced interconnectivity and limited
| the ability for companies to make "walled-garden peudo-
| monopolies", as we have in the US with Apple and Google.
|
| WeChat is _the inspiration_ for the idea of the
| "everything app" that so many US companies want to create
| but have always failed to. Has it somehow been newly
| limited in its ability to control an absurd percentage of
| all Chinese internet-connected activity?
| adam_arthur wrote:
| This was and is part of their goal, yes.
|
| https://asia.nikkei.com/Business/Technology/Beijing-asks-
| Ten...
|
| "Beijing asks Tencent to lower WeChat's mobile payment
| market share"
|
| https://www.forbes.com/sites/zennonkapron/2022/11/09/chin
| as-...
|
| https://www.business-standard.com/world-news/china-may-
| impos...
|
| "China is planning to introduce a new mobile payment
| regulation aimed at reducing the market share of Tencent
| Holdings' WeChat app, similar to efforts made by the
| National Payments Corporation of India to curb Google Pay
| and Phone's growing dominance in the market"
|
| China's methods are more authoritarian than are viable in
| the west. But the general premise of a competitive market
| being better for society than dominance by a small number
| of firms is supported well by history
| Supermancho wrote:
| > China is not interested any 1 company getting a monopoly
| and becoming more powerful than the government
|
| Those are 2 different things.
|
| Monopoly doesn't mean "more powerful than the government".
| I'm not sure what that means, since the CCP disappears or
| coerces anyone who might threaten the supremacy of the CCP
| (or Pooh Bear) in any way.
|
| Capitalism results in a single winner, for many industries.
| CCP prefers kingmaking in various industries, because it's
| easier for the government to control a few players than a
| multitude. This isn't what "fair market" means, in context.
| It's modern communism. State owned companies that are
| directed by government, rather than direct investment or
| day to day management. China learned from Russia's
| failures, I would say. I would also concede it's less
| regulated, under a political lens.
| wisty wrote:
| There's also a lot of regulation and lots of subsidies (the
| US has similar per capita public spending to Canada - old
| people on Medicare are not cheap). If something is so heavily
| regulated and subsidised that the private sector is only
| there to outsmart the government to line their pockets, it's
| inferior to even a public system.
| froh wrote:
| "free" is newspeak for "rules only apply to the poor, ie.e
| the lower 99.9%"
| drdec wrote:
| >>the free market-based US healthcare system
|
| >market, maybe, "free" market? I doubt it.
|
| The consumer of healthcare is doubly removed from the price
| of healthcare. This is the opposite of a free market.
|
| The patient did not pay the doctor, the insurance company
| does. In most cases the patient does not pay for insurance
| their employer does.
|
| So the normal pricing forces of a free market are removed.
|
| Then we need to talk about certificate of need laws which
| restrict the supply...
| Spooky23 wrote:
| The free market aspect is the insurance marketplace.
|
| If you're poor, you're fucked. If you're old you're ok. If
| you work for the government or certain companies, you have
| access to world class care. Everyone else is on a spectrum
| from high quality PPO to the shittiest Cigna plan.
| pclmulqdq wrote:
| There is nothing free about the health insurance market.
| It is regulated to hell to the point where a common
| complaint of actuaries I know is that they are not
| allowed to price your health risk.
| caseysoftware wrote:
| ^ When the grossly overweight 60yo smoker pays the same
| amount as a health-conscious 30yo, we have a problem.
| FirmwareBurner wrote:
| Isn't that socialism?
| caseysoftware wrote:
| Maybe but I'm more concerned about a) easily demonstrable
| and measurable risks not being addressed and b)
| separating people from the consequences of their own
| choices.
|
| Ignoring risk and consequences doesn't make them go away.
| azinman2 wrote:
| What about the 60 year old with autoimmune issues? That
| have expensive drugs but it wasn't "their actions" that
| led to this?
|
| The entire system only works if healthy 30 year olds are
| putting in somewhat similarly (it will be cheaper
| regardless). Insurance is based on the idea of spreading
| risk. Without it insurance cannot function.
| AlexandrB wrote:
| On the subject of (b), shouldn't tobacco companies be
| paying the risk premium for their customers? Why does the
| buck stop at the individual consumers and not those
| making money from their misery?
|
| To put it into more technical, economic terms: why should
| the individual tobacco consumer bear the full cost of
| their externalities while the tobacco company does not?
| caseysoftware wrote:
| > _why should the individual tobacco consumer bear the
| full cost of their externalities while the tobacco
| company does not?_
|
| Because people are well aware that smoking is dangerous
| and can freely choose to smoke or not.
| Temporary_31337 wrote:
| Definitely disagree with at least the 'can freely choose
| to not smoke' Nicotine is highly addictive much more so
| than many illegal drugs.
| caseysoftware wrote:
| Don't use quotation marks if you're going to rephrase
| what I said.
| nradov wrote:
| It's usually not the same amount. The Affordable Care Act
| (Obamacare) explicitly allows health plans to set
| premiums based on age and smoking status. However, this
| might not capture the full risk differential for some
| members.
|
| https://www.cms.gov/marketplace/private-health-
| insurance/mar...
|
| There's a deeper philosophical question here about how we
| should spread risks and costs across society. Like should
| some plan members pay more because they have a history of
| cancer, or because they engage in risky activities like
| flying light airplanes?
| pclmulqdq wrote:
| Ironically, two of his three factors are still able to be
| priced in: age and smoking status. Weight, gender, and
| many other risk factors are not, though.
| throw0101d wrote:
| > _^ When the grossly overweight 60yo smoker pays the
| same amount as a health-conscious 30yo, we have a
| problem._
|
| It depends on what your goals are. The reasoning behind
| why the ACA ("Obamacare") is the way it is:
|
| > _Suppose you want to make health coverage available to
| everyone, including people with pre-existing conditions.
| Most of the health economists I know would love to see
| single-payer -- Medicare for all. Realistically, however,
| that's too heavy a lift for the time being._
|
| > _For one thing, the insurance industry would not take
| kindly to being eliminated, and has a lot of clout. Also,
| a switch to single-payer would require a large tax
| increase. Most people would gain more from the
| elimination of insurance premiums than they would lose
| from the tax hike, but that would be a hard case to make
| in an election campaign._
|
| > _Beyond that, most Americans under 65 are covered by
| their employers, and are reasonably happy with that
| coverage. They would understandably be nervous about any
| proposal to replace that coverage with something else, no
| matter how truthfully you assured them that the
| replacement would be better._
|
| > _So the Affordable Care Act went for incrementalism --
| the so-called three-legged stool._
|
| > _It starts by requiring that insurers offer the same
| plans, at the same prices, to everyone, regardless of
| medical history. This deals with the problem of pre-
| existing conditions. On its own, however, this would lead
| to a "death spiral": healthy people would wait until they
| got sick to sign up, so those who did sign up would be
| relatively unhealthy, driving up premiums, which would in
| turn drive out more healthy people, and so on._
|
| > _So insurance regulation has to be accompanied by the
| individual mandate, a requirement that people sign up for
| insurance, even if they're currently healthy. And the
| insurance must meet minimum standards: Buying a cheap
| policy that barely covers anything is functionally the
| same as not buying insurance at all._
|
| > _But what if people can't afford insurance? The third
| leg of the stool is subsidies that limit the cost for
| those with lower incomes. For those with the lowest
| incomes, the subsidy is 100 percent, and takes the form
| of an expansion of Medicaid._
|
| * https://archive.is/HzS1G /
| https://www.nytimes.com/2017/07/10/opinion/obamacare-
| repeal....
|
| * https://thehealthcareblog.com/blog/2023/02/15/all-
| three-legs...
|
| The goal of the ACA in the US was getting closer to
| universal coverage, and that means 'subsidizing' bad
| behaviour to a certain extant.
|
| Certainly smokers and such should practice more (so-
| called) 'personal responsibility', but there are a lot of
| situation where the pre-existing condition is not smoking
| or other lifestyle choice, but something genetic /
| congenital. So unless we want to get into (social)
| Darwinism and leave those folks on the sidelines, the
| lifestyle folks can end up coming along for the ride when
| society decides to protect other non-lifestyle pre-
| existing people.
| caseysoftware wrote:
| > _The goal of the ACA in the US was getting closer to
| universal coverage, and that means 'subsidizing' bad
| behaviour to a certain extant._
|
| Yes, therefore separating people's lifestyle choices from
| the plainly obvious risk and consequences involved.
|
| But if you can socialize your losses (banks) or bad
| decisions (people) and avoid some of the consequences, I
| get it.
| Spooky23 wrote:
| The problem with your outlook is you can't follow through
| unless you're a sociopath. Are you willing watch your
| parent/child/friend/spouse reap the consequences of their
| "lifestyle choices" and suffer and/or die? I have watched
| that happen - i guarantee you that you wouldn't.
|
| Last year, my wife died from a recurrence of metastatic
| melanoma. By your standard, that suffering was her
| "fault", because she failed to use sunscreen as a
| teenager. If insurance was rated like general liability
| insurance, she would have been dropped 8 years ago when
| the original cancerous lesion was removed. Fuck that
| noise.
|
| I would have bankrupted the entire family to fight for
| the 60% survival rate in a few months, and she would have
| suffered even more without adequate care at the end.
|
| We have Medicare "socialism" because social security was
| allowing the elderly to support themselves and live
| longer. Many were neglected and dying in inhumane ways,
| or saddling families with the burden of being a full time
| caretaker. It's gross that we live in a society drowning
| in riches, but we take a principled stance to avoid
| taxation for rich people, at an incalculable human cost.
| AlexandrB wrote:
| But what's the point of a health care system where only
| those that don't need it can afford it?
| pclmulqdq wrote:
| The point of insurance is to cover unforeseen costs. Not
| to foist bills you know you're going to have onto other
| people.
| goldfeld wrote:
| Yes, those bills should be paid out by the state such as
| happens in developed countries like Brazil.
| pclmulqdq wrote:
| Choose two from: Good/fast/free.
|
| Those "civilized" countries universally have very long
| wait lists that make health outcomes worse.
| 6gvONxR4sf7o wrote:
| Even the insurance side isn't really a free market. I've
| only ever gotten like two choices of insurance provider
| at any job I've had. More than two plans, but very
| limited provider choices. You can't get a job offer and
| then during onboarding say, "sorry, this insurer is
| unreliable, can we use this other provider instead?"
| jandrese wrote:
| It is incredibly frustrating to have only one option for
| insurance provider, and then discover that a solid
| majority of the health care providers in your area don't
| take that insurance because they have such a bad
| reputation.
|
| Then you get into the wonderful world of getting receipts
| for every procedure and manually submitting them, only
| for them to be rejected so you have to call and tell them
| to provide the service they promised you. The insurance
| isn't even cheap! My monthly deduction would be close to
| the same price as an Obamacare plan, and that doesn't
| include the employer contribution. Healthcare is such a
| racket.
| SoftTalker wrote:
| > the patient does not pay for insurance their employer
| does
|
| Not really true, as the employer could otherwise pay that
| money to the employee who would then shop for his own
| insurance. So the employee pays, but doesn't have a choice.
| red-iron-pine wrote:
| they _could_ but they don 't.
|
| and salaries are stagnant. why would they pay extra? at
| least they're obligated to provide insurance, even if
| it's terrible and impenetrable
| SoftTalker wrote:
| Because they compete with other employers? If an employee
| costs X, it doesn't matter to the employer if X is all
| cash to the employee or split with the insurance
| provider.
|
| The entire reason health insurance got so mixed up with
| employment was as a workaround to WW-II era wage freezes.
| Employers couldn't pay more salary, so they offered other
| benefits including insurance to attract and retain
| employees. Now we're stuck with that.
| nradov wrote:
| The US healthcare system is deeply flawed but only a small
| fraction of spending goes to emergency care involving
| ambulance transportation. The vast majority of healthcare
| spending is for elective services and patients do have time
| to shop around. Self-insured employers have been cutting
| costs by pushing employees to high-deductible health plans
| with HSAs, which gives plan members a financial incentive
| to find cheaper options. Of course there are still
| challenges around getting meaningful price estimates from
| providers despite recent federal regulations on this topic.
| jandrese wrote:
| In fact it's almost impossible to get a price estimate up
| front in many cases. A procedure may involve multiple
| codes which may or may not be covered by your insurance,
| and the only way to find out if they are covered is to
| have the procedure and then check the bill. Frequently
| you won't even get the codes up front. If you call they
| can't even say if a particular procedure will be covered
| or not, the call centers are just not set up to do that.
| There is incredible complexity as the procedure may or
| may not be covered depending on patient, provider, plan,
| how much they've spent this year, region, if the doctor's
| front office made a clerical error at any point, if the
| insurance company made a clerical error, if the claim is
| processed on a Wednesday vs. a Friday, etc... If you have
| a procedure done twice the coverage may be totally
| different on the second time, with some parts covered
| that were previously not covered and vice versa.
|
| Thankfully you can often get denials reversed after the
| fact by calling and complaining, but that takes an hour
| and is another roll of the dice. The only people who like
| the US system are wall street people who own stock in the
| companies.
| FollowingTheDao wrote:
| There is no free market when pain and distress is involved,
| that is for sure.
|
| When I am psychotic I cannot exactly choose which psychiatric
| hospital I want to check into and ponder about the price to
| put it off for another day.
|
| And this is what the free market did to psychiatric
| hospitals: https://www.wral.com/holly-hill-hospital/21507953/
| mattmaroon wrote:
| The American health care system is also highly regulated.
| There's nothing free about it in any sense if the word.
| N_A_T_E wrote:
| Is the US health system free market? The government provides
| healthcare via Medicare and Medicaid for seniors, the people
| for whom life expectancy and healthcare quality have the
| highest correlation.
| defrost wrote:
| The quote is from a Crikey reporter, I (an Australian)
| wouldn't agree that the US health system is classic free
| market .. but it appears to have more regulatory capture by
| vested commercial non government profit orientated interests
| than by social policy best outcome for the masses civil
| authorities.
|
| ( Describing various systems in various countries as either
| communist of free market capitalist is pretty simplistic,
| it's not much as a linear spectrum either )
|
| I'd also argue that the foundation for a high life expectancy
| doesn't start with good health care for seniors .. unless the
| metric is "life support via artificial means" .. life
| expectancy is grounded in healthy living and excerise from an
| early age well maintained with good health programs.
| mitthrowaway2 wrote:
| > the people for whom life expectancy and healthcare quality
| have the highest correlation.
|
| What do you mean by this? Fatalities among the young will
| have a much larger impact on lowering nationwide life
| expectancy than fatalities among the elderly.
| dahart wrote:
| It's a mixed bag, but the funding source doesn't necessarily
| make it a controlled market, to the degree that Medicare and
| Medicaid pay non-government providers and allow competition
| (which again, is mixed). Medicare and Medicaid coverage make
| up one third of the US population. The other two thirds are
| on group/employer insurance, private insurance, or no
| insurance at all.
|
| For non-seniors, the medical insurance system certainly
| sometimes doesn't feel like a free market from the consumer
| perspective, but the insurance companies are private for-
| profit institutions, and the medical providers are too, so it
| may well fit the definition.
| dyauspitr wrote:
| The issue with most of these is that they have better health
| outcomes overall but when it comes down to the uncommon cancer
| your mom has, she will have a much higher chance of survival in
| the US. The difference is a lot of poor folk without adequate
| healthcare die of relatively straightforward conditions like
| diabetes while if you do have healthcare you end up getting the
| state of the art though it might bankrupt you.
| defrost wrote:
| There's nothing in the Australian health care system that
| precludes people with uncommon conditions seeking specialist
| treatments either in Australia or abroad.
|
| > she will have a much higher chance of survival in the US.
|
| Without a deep dive it looks ballpark the same, to be honest.
|
| AU Cancer Survival Rates: The 5-year
| survival for cancer in 1991-1995 was 55% and by 2016-2020,
| the rate had increased to 71%. Even with decreasing mortality
| rates and increasing survival, the number of deaths from
| cancer has been increasing.
|
| 15 Aug 2024 - https://www.aihw.gov.au/reports/cancer/cancer-
| data-in-austra...
|
| US Cancer Survival Rates: Five-year
| survival rates have also been increasing for an even longer
| period of time. The overall cancer survival rate was 49
| percent in the mid-1970s. It currently sits at 68 percent
|
| 2023: https://www.cancercenter.com/community/blog/2023/01/can
| cer-s...
| dyauspitr wrote:
| Interesting, Australia seems to be actually doing better
| with cancer survival rates. I truly wonder what the
| downsides are if any.
| Narkov wrote:
| We/Australia has a massive focus on early detection of
| skin cancer due to our overly sunny weather. It's
| possibly that we detect more cancer and treat it earlier
| thus the better outcomes?
| dyauspitr wrote:
| I would love to see those cancer stats without the skin
| cancer stats.
| grecy wrote:
| > _when it comes down to the uncommon cancer your mom has,
| she will have a much higher chance of survival in the US._
|
| A few years back my Mum in Australia was diagnosed with stage
| 4 lung cancer, given 12 months to live.
|
| For just shy of 3 years she had radiation, chemo, trial drugs
| worth nearly a million a pop all in a brand new cancer
| Center. Because she lived a couple of hours away she got free
| transport to and from and free hotel. Not pay and claim it
| back, fully free.
|
| She was on an enormous cocktail of drugs that dad would get
| at the pharmacy that raised a lot of eyebrows for the
| strength of the opiates among other things.
|
| For three years they never paid a cent. They never paid a
| cent of health insurance, never had private cover, never had
| a deductible. That would all be the same if they had never
| worked or took a decade off to pursue some hobby.
|
| Trust me when I say it was stressful and emotional enough
| without adding money or paperwork or insurance into the
| equation
|
| The comparison to my friends in the US who couldn't get a
| separated shoulder fixed because it was "out of network" or
| had to move hospitals the day after a C section because the
| insurance didn't want to pay anymore is downright disgusting.
|
| For real people living their lives the two systems are vastly
| different.
| cjbgkagh wrote:
| AFAIK Australian healthcare system is mixed public private with
| a heavy lean on private. The healthcare market is open to
| market forces as the government works through subsidies. Plus I
| think many of the hospitals are religiously run institutions
| which helps protect from private equity influence.
|
| The US has massive government regulation and dysfunctional
| state intervention in healthcare if not directly then
| vicariously with rules around Medicare. The US government helps
| make the dysfunction that private equity later exploits.
|
| So I'm not sure that it would be correct to use Aus and the US
| as examples of the either end of the private / public
| continuum.
|
| I would use UK or France as an example of a public system and
| Singapore as a light touch private, and perhaps India or Turkey
| as a laissez-faire system.
|
| The UK and France systems appear to be degrading and do not
| appear long term affordable and I think they will soon be
| adopting Canadian style Maid systems to cut cost.
|
| Germany is a weird one because it seems like half the doctors
| there are homeopaths and the Germans love their insurance but
| I'm not sure if they get value for it.
|
| Personally I'd prefer the Australian or Singaporean style
| systems but I'd classify those as mostly private.
| defrost wrote:
| Australia absolutely has a hybrid health care industry with
| layers; health, medical, surgery, pharmacy and mostly
| outcomes based regulation rather than much assistance to
| maximise financial profits.
|
| The current system grew out of a more fully public system
| under a many years past Whitlam government, people like the
| universal health for all aspects and wanted additional
| private services in the mix. It's evolved from there, with
| government oversight directed towards keeping things
| accessable and fair.
|
| The US _appears_ to have "massive government regulation and
| dysfunctional state intervention" as the end result of a lot
| of fingers in the pie bending regulation toward "middlecare"
| providers that don't apply splints or save lives, just diddle
| about with insurance schemes. (Admittedly that's just an
| impression from afar).
|
| > The US government helps make the dysfunction that private
| equity later exploits.
|
| My feeling is the US government is largely an arm of private
| interests in many matters.
|
| Health Care in Australia embraces public policy such as Food
| Regulation to ban and limit additives, parks and sports
| grounds to encourage exercise, limiting access to tobacco,
| and some interesting national level drug acquisition deals to
| keep pharmacy costs low.
|
| These cause a flow on of less per capita input into the
| medical side; lower heart disease, less smoking related
| issues, etc.
| cjbgkagh wrote:
| I don't disagree that there is a lot that Australia does
| right and the US would be better off with an Australian
| style system complete with a universal healthcare.
| Australia could have gone the NHS route but did pivot to
| the mixed system under Howard. Additionally it does appear
| to me that the National Disability Insurance Scheme is
| absolutely rife with fraud - I'm not even sure who'd you'd
| blame for that as it seems intentionally set up for such an
| outcome to undermine the very idea. So I'm not sure how
| well the Australian system will last even if it has lasted
| well up until now. Of course being Australia they'd combine
| NDIS with Robo-Debt and mistakenly hound a bunch of poor
| people to death.
|
| I'm assuming the rational behind drawing the distinction
| between the US and Aus systems is to somehow inform what
| the US should do, I don't think giving an already corrupted
| government system more power will help. It's very hard to
| uncorrupt things and because of that reason I think the US
| would benefit from a more laissez-faire system.
|
| Additionally Australia has many advantages that the US does
| not and the US could not emulate Australia even if they
| wanted to. I don't know how long that'll last either -
| mathematically I would assume a country could not get rich
| and stay rich repeatedly selling houses to each other but
| it does seem to have lasted a very long time. I assume at
| some point the Aus government will run out of ways to prop
| up the housing market. The combination of negative gearing
| and all sorts of first home buyer grants is just insane.
| biztos wrote:
| I had private health insurance in Germany. It was quite
| expensive and had a very high deductible -- so pretty bad
| incentives around routine health care, I never made a claim
| in 13 years.
|
| The upside was that if you needed, say, a brain transplant
| for ten million Euros, as long as it was medically necessary
| they would pay for it.
|
| Now I have a policy elsewhere that is cheaper, still covers
| me when I go to Europe, and has a much better copay structure
| while being 100% private. Downside is I can't afford that
| brain transplant, but I'll probably be OK for everything
| else.
| yladiz wrote:
| But if a procedure is medically necessary in Germany,
| public insurance pays for it too (and if they deny, you
| can, often successfully, appeal or sue them). The biggest
| difference is that you'll get an appointment much faster
| due to the quota system for public insurance patients, and
| that private insurance can cover more things that aren't
| strictly necessary.
| biztos wrote:
| The crazy thing is that I originally signed up for
| private because it was cheaper than public... at the
| beginning anyway. I much prefer the Austrian model, in
| which -- I believe anyway -- everyone has to pay for
| public, but then you can get extra private on top if you
| like.
|
| I was an employee so this didn't apply to me, but for my
| freelancer friends it seemed very unfair that they had to
| use private.
| FirmwareBurner wrote:
| _> But if a procedure is medically necessary in Germany,
| public insurance pays for it too (and if they deny, you
| can, often successfully, appeal or sue them_
|
| When you're very sick you hardly have time, money and
| energy do deal with a lawsuits so that you can get the
| care you desperately need. By the time you win your
| lawsuit you could be dead or your condition worse from
| the stress.
| rr808 wrote:
| Always when I read this I think they are comparing too very
| different societies where healthcare is just one factor.
| Americans are so much less healthy than Australians due to lack
| of exercise, poor diets, stress, no holidays, guns and crime.
| Its a miracle that if the US health is nearly as good as
| Australians it shows how great the US healthcare system really
| is.
| defrost wrote:
| Part of the Australian national, state, and local health care
| system is policy to encourage healthy life styles and to
| discourage, limit, or ban food additives, tobacco, etc.
|
| Back in the 1970s the AU Government was running campaigns
| such as _Life. Be In It_ :
| https://www.youtube.com/watch?v=GNjEge3Awl8 (many short
| segments airing with commercials on TV).
|
| Planning requirements typically require open spaces, walking
| paths, sporting facilities, etc.
|
| A "healthcare system" needs to be more than simply "immediate
| care for the injured, sick, and|or dying".
| analog31 wrote:
| Unfortunately, obesity rates are rising worldwide,
| including in Australia.
| Narkov wrote:
| > Ozempic has entered the chat.
| atq2119 wrote:
| This honestly feels like the kind of thing where 20 years
| from now we'll be more aware of the side effects and
| people will shake heads about how stupid "we" were today.
|
| If this is going to be an exception, it'd be truly
| interesting.
| gquere wrote:
| There are already a bunch of studies showing that the
| ozempic causes massive muscle loss and lessens bone
| density. And before anyone remarks "just do resistance
| training", I doubt the people that take the easy solution
| will do it in conjunction.
| Aerroon wrote:
| Do they cause it in excess of normal weight loss in the
| same time period? I'm asking because regular weight loss
| that's quick will have both of these effects too.
| apwell23 wrote:
| > Do they cause it in excess of normal weight loss in the
| same time period?
|
| I think you mean diet and exercise when you say 'normal'.
| Its not possible to have that much 'normal weight loss'
| in the 'same period'.
| Aerroon wrote:
| Correct me if I'm wrong but Ozempic doesn't cause you to
| lose weight, instead it controls your appetite. It's not
| something like DNP, right?
|
| 'Normal weight loss' here refers to eating the same
| amount of calories without taking Ozempic. You should
| lose weight at the same speed as with Ozempic, because
| it's the calories that matter when it comes to fat loss.
| inglor_cz wrote:
| Weight loss always comes with some muscle loss and bone
| density loss, because the structure now supports less
| weight than before, and our bodies dislike to maintain
| muscle apparatus beyond what is necessary.
|
| Unless Ozempic causes significantly more muscle loss than
| other ways of losing weight, that news isn't really news.
| SoftTalker wrote:
| Conversely, this is also why the strongest powerlifters
| are huge heavy guys. They aren't necessarily healthy. But
| they are strong.
| saturn8601 wrote:
| Its a transfer of wealth from the fast food conglomerates
| to Novo Nordisk. They won't take this lying down. Ozempic
| resistant foods are coming.
| throwaway2037 wrote:
| > Part of the Australian national, state, and local health
| care system is policy to encourage healthy life styles and
| to discourage, limit, or ban food additives, tobacco, etc.
|
| Except gambling?
| defrost wrote:
| There's a book or two in the backstory of why neither
| Dentistry nor Mental Health get the same inclusion in
| traditional health systems :(
| hedvig23 wrote:
| Can you complete the assertion or cite what you were
| going to cite (if it was half done)?
| defrost wrote:
| It's complete as it stands.
|
| see: https://theconversation.com/why-isnt-dental-
| included-in-medi...
|
| , realise that mental health services also had poor
| inclusion at times and that "gambling" is being implied
| to fall under mental health services (and hence not
| addressed).
|
| On a more serious note, gambling in Australia has some
| serious industry influence that's preventing it being
| properly addressed - see: (for example) _Media Watch_
| -s2024e31- Monday 2024-09-09 _They 're Addicted_
| blitzar wrote:
| I bet you it wouldnt make much of a difference.
| grecy wrote:
| > _it shows how great the US healthcare system really is._
|
| You think paying vastly more for much worse outcomes is a
| good thing??
|
| Boy do I have a GREAT used car for you!
| saturn8601 wrote:
| >Its a miracle that if the US health is nearly as good as
| Australians it shows how great the US healthcare system
| really is.
|
| Or its a ticking time bomb: 39.6% of Americans are Obese(BMI
| 30 or higher). Fast forward 15 years and this will probably
| collapse the country. It certainly will be the No 1 issue in
| the country bar none. Ozempic may actually give the country a
| chance of some sort of future.
| mbostleman wrote:
| Free market-based US healthcare system? Which US are we talking
| about?
| globular-toast wrote:
| "Free market" is one of the best examples of a technical term
| people use with complete confidence despite not knowing what
| it really means. Furthermore, even if you do know what it
| means you probably remember it as something you learnt on day
| 1 of economics class before learning all the reasons they
| never really exist and what governments try to do about that.
| valval wrote:
| I've studied economics for years and I'm still of the
| opinion that the only government intervention to the market
| should be breaking monopolies and cartels. I'm waiting for
| a piece of literature that would convince me otherwise,
| maybe you could provide one?
| globular-toast wrote:
| I can't, but I'm curious how you think problems like
| externalities would sort themselves out. Also what about
| natural monopolies like utilities and infrastructure that
| can't really be broken up?
| grecy wrote:
| Australians (and other outsiders) use that term when talking
| about aspects of the US because that is the Hollywood picture
| of how the US functions. That is the lie that is sold, and
| people outside have no way to know it's not true. Even today
| there are hundreds of millions of Americans who say they live
| in a free market and that it's the best thing ever.
| defrost wrote:
| > Australians .. use that term when talking about aspects
| of the US because
|
| Australians have a weird sense of humour - it's clear from
| here that most aspects of US economics are decidedly _not_
| free markets but so many US citizens never shut up about
| "free markets" and have such a bicameral Capitalist v.
| Communist view of the world that it makes sense to just
| deadpan nod along.
|
| Maybe reread https://news.ycombinator.com/item?id=41856242
| and ask yourself if the article _really_ thinks the US
| health system is a proper Adam Smith free market .. or just
| a "US free market" with extra heavy air quotes.
| bratbag wrote:
| The us system is what a free market approach inevitably
| degrades into when consumers don't have a real option to say
| no to a service.
| jazz9k wrote:
| So the free market approach degrades to heavily regulated
| and government controlled?
| jandrese wrote:
| No, it degrades into monopolists with a captive audience.
| Insurance companies are modern day water barons.
| tightbookkeeper wrote:
| demographics in the US are very different than Australia, I
| suspect those in the bottom 1/3rd of US health drag it down
| significantly.
| koyote wrote:
| I assume you are referring to a larger amount of people
| living in poverty in the US?
|
| Could this also (partially) be explained by the cost of
| healthcare? Something like a downwards spiral where average
| people end up poor either due to direct costs of healthcare
| or neglecting their own healthcare due to cost?
| tightbookkeeper wrote:
| demographic differences of all kinds:
|
| - greater usage of surgeries and prescriptions, leading to
| greater exposure to medical malpractice (the 3rd leading
| cause of death in the US.)
|
| - higher birthrate. more pregnancies.
|
| - less cultural tolerance of abortion. Greater willingness
| to take on risky pregnancies
|
| - single parent homes (people with less family support)
|
| - ethnicities which are more susceptible to certain disease
| and lifestyle risks
|
| - greater exposure to crime in impoverished areas
|
| - more life time spent traveling in cars
|
| - more restricted access to health insurance (as you said
| only accessing healthcare in dire emergency)
|
| The US is a different world than most countries which tend
| to be geographically tight and culturally homogenous. It's
| very difficult to make comparisons, not to mention
| differences in data collection and reporting ethics.
| biztos wrote:
| > medical malpractice (the 3rd leading cause of death in
| the US.)
|
| Not to downplay the malpractice problem, but this doesn't
| sound remotely plausible. Do you have some sources to
| back up this claim?
|
| I googled around a bit and it appears to come from some
| sloppy misuse of statistics in a journal one time, plus
| internet amplification.
| tightbookkeeper wrote:
| The CDC doesn't record medical malpractice as a category
| for cause of death or injury. It's grouped under
| "accidents" in their statistics (their official 3rd
| ranked category).
|
| > The CDC's published mortality statistics, however,
| count only the "underlying cause of death," defined as
| the condition that led a person to seek treatment.
|
| Because of this political choice the information comes
| from 3rd parties digging into the accidents category.
|
| https://www.propublica.org/article/study-urges-cdc-to-
| revise...
| koyote wrote:
| Those examples are mostly good ones, but:
|
| > The US is a different world than most countries which
| tend to be geographically tight and culturally homogenous
|
| I am not sure how much you know about Australia, but
| homogeneity and geographically tight is definitely not
| how you would describe it.
| tightbookkeeper wrote:
| Indeed. On the spectrum of health risks Australia is more
| like the US than France, but it's far away. The most
| similar country is possibly Russia or Brazil.
| rsynnott wrote:
| > The US is a different world than most countries which
| tend to be geographically tight and culturally homogenous
|
| So, if this was the issue, you'd probably expect outcomes
| to be better in less diverse, physically smaller US
| states. Looking at, say, life expectancy by state (https:
| //commons.wikimedia.org/wiki/File:Life_expectancy_map_...
| ) doesn't seem to bear this out, really; on your theory
| you'd probably expect, say, West Virgina to be handily
| beating California or Texas.
|
| Also, of course, _Australia_, which started the thread,
| could hardly be called either geographically tight or
| culturally homogenous. Australia is roughly the size of
| the contiguous United States.
| tightbookkeeper wrote:
| If you ignore massive wealth inequality.
|
| The point about less diverse is that's it's easier to
| operate health programs which match the values of the
| population.
|
| Not that small ethnic group = healthy.
| atwrk wrote:
| Demographics (I assume you mean race?) can't be the reason.
| West Virgina is IIRC almost exclusively white and has a lower
| live expectancy than North Korea.
| tightbookkeeper wrote:
| It seems you believe "demographics" is a dog whistle for
| "which people are white".
|
| West Virginia is extremely poor.
| WalterBright wrote:
| The US is hardly a free market health care system.
|
| For example, Medicare.
| defrost wrote:
| If you wish you could take that up with Bernard Keane who
| wrote the piece.
|
| https://www.crikey.com.au/author/bernard-keane/
|
| Bernard is well across many aspects of US, UK, and AU
| political views, government systems, media etc. with his own
| particular views as we all have.
|
| In _context_ he 's writing for an Australian audience about a
| _conservative_ Australian trope that the Australian health
| system is weighed down with government meddling and would do
| better with, for example, a "US free market" approach.
|
| I think we all appreciate that's an illusion, a myth spun for
| children.
| grecy wrote:
| I think it's extremely important to see that it is neither
| a myth nor an illusion spun for children.
|
| It is a carefully constructed plan that will ensure rich
| people get a whole lot richer and poorer people get worse
| care. It's not an accident or nice story. It's class
| warfare
| dahart wrote:
| Depends on what you mean by health care. Medicare is
| insurance, not care, and while insurance is part of the
| system, Medicare often pays private healthcare providers for
| service. Medicare only insures ~14% of the US, less than one
| sixth and is only available for people 65 and older. For
| those reasons, your example maybe doesn't demonstrate what
| you imply.
| zeroonetwothree wrote:
| I expect it has more to do with Americans' high level of
| obesity and other poor lifestyle factors.
| axpvms wrote:
| Australians are not exactly a svelte lot either, ranking 10th
| in the OECD countries for obesity (US is the third), and on
| par with the UK.
| danielbln wrote:
| Yeah, Ozzies also drink like fish, at least when I was
| living there. Good lord, so much boozing.
| apwell23 wrote:
| less likely to die from drug overdoses. Older age groups
| are also less likely to die from chronic diseases such as
| circulatory problems and heart disease. Cancer mortality
| rates are lower in Australia than they are in all other
| Anglophone countries, except among American men aged over
| 65. And Australians are also less likely to die in road
| accidents than other countries
|
| So why are they getting less chronic diseases despite being
| equally obese.
| Pikamander2 wrote:
| Obesity's definitely a factor, but other developed countries
| haven't seen the same level of stagnation despite their own
| skyrocketing obesity rates. For that matter, Americans also
| smoke less compared to most of Europe.
|
| There's likely at least one other major factor, and I would
| assume that it's some variation of "inability to access high-
| quality care for financial reasons" given how much of a
| wealth disparity there is in various healthcare outcomes.
| apwell23 wrote:
| Older age groups are also less likely to die from chronic
| diseases such as circulatory problems and heart disease.
| Cancer mortality rates are lower in Australia than they are
| in all other Anglophone countries
|
| So you get less cancer because you have 'access high
| quality healthcare' ? how does that work?
| wealth disparity there is in various healthcare outcomes.
|
| Wealthy have access to good food. have less stress and
| engage in mental and physical recreation more and ofcourse
| regular screenings.
|
| Why would it depend just on one factor like hospital
| access?
| zwirbl wrote:
| Cancer mortality is not the same as incidence, you can
| plausibly have more cancer while still having a lower
| mortality
| ap99 wrote:
| Maybe the worse outcome related to other factors, e.g. diet or
| obesity rates.
|
| The figure I see thrown around is America has a 40% rate of
| obesity.
|
| Australia looks like it's 32%.
|
| European countries look like 20-30%.
|
| I think these rates alone could explain life expetancy
| regardless of health care system.
| apwell23 wrote:
| yep exactly. 'healthcare' should be called 'disease care' .
| Most ppl are too far gone to recover from their illness by
| the time they go to the doctor.
|
| All the medicines they prescribe are merely to manage
| symptoms. I have GERD and reflux. I was given PPI after many
| many tests. How does taking PPI extend my lifespan. Whatever
| has gone wrong with my body is still there.
|
| How is this not obvious to ppl making this absurd correlation
| between hospital care and lifespan.
|
| Medicine doesn't have shit of new breed of diseases and
| disorders ppl are dying from. Doctors don't have answers to
| any of modern illnesses so how does it matter if access to a
| useless person is govt funded or 'free market'.
| r2_pilot wrote:
| > I have GERD and reflux. I was given PPI after many many
| tests. How does taking PPI extend my lifespan. Whatever has
| gone wrong with my body is still there.
|
| It can potentially extend your life by reducing your
| probability of developing esophageal cancers, improve your
| quality of life in the meantime, and there are other
| complications from untreated GERD I can't recall but would
| negatively impact your life.
| apwell23 wrote:
| They are only approved for short term use because of
| myriad of side effects ( including things like life
| threatening colon inflammation, kidney disease ect)
| yodsanklai wrote:
| > The shocking truth: Australia has a world-leading health
| system -- because of governments
|
| In the US, government is elected by people. You can't blame a
| gvt for not doing what it hasn't been mandated to do.
| defrost wrote:
| Hilarious .. next you'll be saying the two party sink-hole
| the US electoral system gravitated into is representative of
| the population at large.
|
| Are you touring with this material, or is it off the cuff
| standup?
| SteveSmith16384 wrote:
| When did the people specifically asked for this kind of
| system?
| marcusverus wrote:
| The people have never specifically asked for anything,
| because we're not a direct democracy and we don't have
| federal referenda. What does that matter?
| blitzar wrote:
| We get the government we deserve.
| weberer wrote:
| >the free market-based US healthcare system
|
| The healthcare system in the US is far, far from a free market.
| Most people would describe it as a crony capitalist market.
| There's a lack of transparency, lack of competition, and
| lobbyists of established players have too much say in the
| lawmaking process.
| defrost wrote:
| See: https://news.ycombinator.com/item?id=41856242
| apwell23 wrote:
| "less likely to die from drug overdoses. Older age groups are
| also less likely to die from chronic diseases such as
| circulatory problems and heart disease. Cancer mortality rates
| are lower in Australia than they are in all other Anglophone
| countries, except among American men aged over 65. And
| Australians are also less likely to die in road accidents than
| other countries"
|
| So what does this have anything to do with healthcare system (
| govt or free market) .
|
| Looks like you conflated two unrelated things ?
| graeme wrote:
| Anyone know of a good source like Our World in Data for tracking
| life expectancy across countries?
|
| Our world in data hasn't updated life expectancy past 2021.
|
| I've half wondered if it's because the article is optimistic but
| life expectancy has stalled since 2020. Coild also be the
| underlying data hit a snag. Would love to see an update
|
| https://ourworldindata.org/life-expectancy
| zaik wrote:
| Overall, the study found that children born since 2010 have a
| relatively small chance of living to 100 (5.1% chance for women
| and 1.8% chance for men). The most likely cohort to see a full
| century are women in Hong Kong, with a 12.8% chance.
|
| How do you quantify the chance of a teenager living to 100?
| ivanjermakov wrote:
| Either they use some prediction model (accuracy of which is
| comparable to any 100-years-ahead predictions) or they keep
| hostage time travelers from 2120s.
| jjk166 wrote:
| It's assumed that the odds of dying at a given age are frozen.
| So if someone is currently 15, their odds of making it to 100
| are their odds of surviving 16 times their odds of surviving 17
| times their odds of surviving 18, and so forth. If you're in
| the US, as of 2021, for all ages over 11 your life expectancy
| decreases by less than 1 year per year, and if you've attained
| the ripe old age of 119, your life expectancy is only one month
| shorter than that of someone 2 years younger than you.
|
| Many demographic trends like fertility rate are treated the
| same way. While it is not a very accurate prediction for how
| long a current young person will actually live, it's a
| consistent metric that doesn't rely on a particular model of
| future events. It's good for discussions like this where we're
| more interested in how the value is changing than the actual
| value itself.
| kazinator wrote:
| There is a limit to how far you can postpone death without
| actually reprogramming the DNA. We have likely plateaued it. We
| are not going to have people living to 200 by just doing more of
| what we are doing, with greater fervor.
| hackernewds wrote:
| > overall, the study found that children born since 2010 have a
| relatively small chance of living to 100 (5.1% chance for women
| and 1.8% chance for men). The most likely cohort to see a full
| century are women in Hong Kong, with a 12.8% chance.
|
| I do not understand how some of the conclusions about reaching
| the limitations of reducing aging or reached given this simple
| data. not to mention a direct quote that is very inspirational in
| the article itself
|
| "if we cannot imagine it today, does not mean it is not possible"
| Pooge wrote:
| I'm not surprised; most deaths are attributed to unhealthy diet,
| lack of physical activity and alcohol consumption. [1, 2]
|
| I'm not noticing people eating more healthily, so it only makes
| sense that life expectancy isn't going up anymore.
|
| [1]: https://ourworldindata.org/causes-of-death [2]:
| https://www.who.int/news-room/fact-sheets/detail/cardiovascu...
| andrei-akopian wrote:
| > https://ourworldindata.org/causes-of-death
|
| More people die of Suicide than Malaria aparently.
|
| Somehow what actually kills people, is different from what you
| think kills people.
| n8cpdx wrote:
| The youth are drinking less, and great non-alcoholic
| substitutes are becoming available for a wide variety of
| beverages. I hope these trends make a difference long term.
|
| I've had to make very few compromises to still enjoy life while
| staying alcohol free - I can even have a decent bottle of wine,
| or a rum and Coke should I be in the mood for one.
|
| https://theconversation.com/youth-drinking-is-declining-myth...
| Eumenes wrote:
| Why should Americans trust public health or the government after
| decades of utter failure? Every single measurable data point of
| health has decreased under the 'experts' watch. Record cancer,
| obesity, heart disease, mental health disaster, etc. The
| messaging around the covid vaccines and masking was a disaster.
|
| Same thing is happening in Europe and other developed nations. UK
| considering giving ozempic to unemployed? How about subsidized or
| free gym memberships instead? Things are going to get alot worse
| before getting better. The established intuitions will continue
| to double down no doubt.
| sharpshadow wrote:
| "...the rate of improvement in life expectancy in the decade of
| 2010-19 had dropped below that seen between 1990 and 2000. People
| were still living longer, but not by as much."
|
| "The analysis looked at the period of 1990 to 2019, to avoid the
| distorting impact of the COVID-19 pandemic."
|
| At least life expectancy was still growing before COVID. Now
| after the introduction of dirty (mass production was not the same
| quality as the small batches used in leading studies) COVID
| vaccines, plus the virus itself which caused some trouble to not
| fully healthy people, we will see a life expectancy decline.
| Excess deaths did already rose worldwide.
|
| Meanwhile they want you to get more dirty vaccines..
|
| Edit: typo
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