> My theory as to why there is an epidemic of fat and heart problems is
> a high pressure sedentary work life. Who goes down to the basement to
> find files, walks upstairs to the managers office for a confab, walks
> to lunch as the main meal of the day a few block down the street and
> then over to the park to people watch? Who takes a half hour nap
> during their two hour mid-day break like civilized people used to?
> High stress, high fat, high sugar, high salt, poor sleep, long
> commutes, etc creates the supersize problem, which in turn super-feeds
> the super size problem.
No doubt poor diet and lack of exercise is responsible for a lot of heart disease, though not all of it (heredity is no doubt also a cause). So should those patients for whom it is determined that the major cause is heredity (80%? 90%) be judged not at fault for their condition, and be treated, while those who got sick because of an unhealthy life-style be left to die as a punishment for their bad conduct? That is one possible approach to take, but it needs discussion, not just assumed as a matter of course.
> Anyway, the medical field I think is moving away from bypass to
> roto-routers, coiled stints, shunts, and other less invasive, and
> theoretically less expensive alternatives.
To some extent. But it's not unversally true that medicine is trending to less expensive procedures and equipment. If that were true, the problem of medical expenses would be trivially easy to solve, like the problem of personal computers, TVs, digital cameras, etc., being very expensive when first introduced, but becoming steadily cheaper.
> The imaging systems and techno do-hicky costs
> are vast and the equipment is mostly leased so procedures costs are
> devoted to paying the equipment rentals. Why rent? Maintenance
> agreements, upgrades, and replacements, mean less in-house technical
> staff, etc. Every piece of gauze, every sterile wipe, every needle,
> and half the tools are one-use disposable wildly expensive
> pre-packaged gold. Take a relatively simple thing like a plastic
> cylinder with a rubber end that fits a small spray can of albuterol
> (an asthma medication). Seventy-five dollars!
No doubt there is a lot of waste of this kind. Who is going to demand that it be wrung out of the system? (I'm asking this as a genuine question -- I don't know the answer.)
> At one time, hospitals were essentially factories with full kitchens,
> industrial laundry rooms, sterilization and packaging rooms, steam
> boilers, and large industrial maintenance staffs with shops. All or
> most of that is gone, replaced with outside contracting, rental
> equipment, and disposables. All of that was replaced on the theory
> that it was more cost effective for the hospital as a business
> facility. Sure it was more cost effective for the hospital, but not
> for the cost of the care, which was duly transferred over to the
> patient bill.
So should we go back to the older type of hospital? (Again, a genuine question.)
On Sep 19, 2004, at 2:44 PM, joanna bujes wrote:
> Huh? I'm saying that sometimes we DO choose triple-bypasses. But we
> don't do so for trivial reasons. We choose medical procedures because
> we need them.
Sorry, I misread your post -- didn't hear the tone of voice, I guess.
Jon Johanning // jjohanning at igc.org __________________________________ A sympathetic Scot summed it all up very neatly in the remark, 'You should make a point of trying every experience once, excepting incest and folk-dancing.' -- Sir Arnold Bax