
No more dieting and other things we do differently after reporting on healthcare - sergeant3
http://www.vox.com/2015/5/20/8621527/health-tips-reporter
======
merpnderp
I don't know about the author, but I buy my insurance not for my yearly
cholesterol checks, but in case I need to hop on a plane and get treatment at
a major medical center.

Narrow networks are unequivocally bad for people needing specialist care,
which happens to be the main reason for health _insurance_.

~~~
rsync
_Nobody_ buys their insurance for yearly cholesterol checks.

They _think_ they do, and a lot of the ecosystem (providers, employers,
politicians) reinforce that idea, but it's not something that actually exists.

That's because regular, routine costs (like new tires for your car) are NOT
underwriteable. You can't insure for them, nor can you buy insurance for them.

If your insurance company is providing new tires every year or giving you
wellness checkups every year, you're paying cash money for that _somewhere_.
Even though they say it's an insurance benefit. It's not. Because math.

It's very difficult to have any kind of discussion about this when even this
most basic of accounting identities is misunderstood.

~~~
greggyb
To be fair, annual checkups (of many varieties), are not covered solely
because people can't math.

If an annual checkup reduces the risk of a high-value payout then it makes
very much financial sense for the insurance company to pay for the annual
checkup for you, as an incentive for you to get one.

In fact, if the average insuree is very unlikely to pay directly for an annual
checkup and the annual checkup helps to reduce the likelihood of high-dollar-
value insurance claims, then it is reasonable for a "free" annual checkup plan
to be cheaper than one that does not offer such "free" benefits.

Note: I am not disagreeing with your statements that the insuree is definitely
paying for regular costs, nor that people don't math well. I am just raising
some of the nuance around what behavior makes sense for an insurance company
given irrational insurees.

~~~
obastani
Actually, if the insuree is rational, it _especially_ makes sense for the
insurance company to pay for the annual checkup. If the insurance company only
covers me when I get really sick, I lose money by going for the annual checkup
-- I'm "better off" waiting to get really sick, and then having them cover all
of my expenses.

~~~
maxerickson
You've defined rational as valuing money over health.

(the jargon rational economic actor maximizes value, not dollars)

~~~
greggyb
Just an addition: rationality in economics assumes a logical[0] ordering of
preferences and behavior which maximizes value within this ordering.

[0] Think transitivity: I prefer A to B and I prefer B to C; I must not prefer
C to A. There's more nuance, but this is enough for the intuition. Without
this ordering, maximizing value makes no sense.

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breischl
I'm surprised there's so much hating on this article. I guess it's not the
most original thing ever, but I think most of the points (with the possible
exception of #8) are pretty well known and accepted. Fad diets are mostly
crazy, overuse of antibiotics is rampant and harmful, overscreening can be a
problem...

~~~
EugeneOZ
Maybe intent was good, but some advices are harmful. For example, 1 and 7.
While in general it's not lie, but they can lead to thoughts "eat everything
you want, just try to eat more "healthy" things, and "don't go to screenings
at all".

~~~
breischl
If you tell someone to be careful not to fall off the right side of a bridge,
and they then run away and fall off the left side, does that mean your advice
was harmful?

Just because someone might overreact doesn't mean you shouldn't warn them.

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yellowapple
If you're going to write an article with highlighted, bolded, enlarged exerpts
to distract me from the main text, could you _please_ put those exerpts in the
right place? It's really jarring when I'm reading something about health
insurance only to be interrupted with some segue about dietary studies that
would have been more relevant 10 paragraphs earlier.

------
brixon
Regarding #3. The advise I get from my family (5 people in the medical field)
is that hospitals will kill you. You go to the hospital to fix your problem
and get out as fast as you can. You will heal faster at home and you will
sleep better too.

~~~
pacaro
this. I broke my ankle a few years back and needed surgery, the staff in the
recovery room were surprised that I discharged myself the same day rather than
stay overnight, and didn't look especially happy when the reason I gave was
that I didn't want to get sick.

------
jobu
_" First of all, some studies are just poorly designed or hopelessly biased.
Second, even the best individual studies have their flaws and limitations.
This isn't because all science is bad or untrustworthy. It's because it's an
iterative process, and it takes many studies to get at the truth of the
matter. Individual studies will almost never give the final word on a
particular question. That's just how science works."_

It's pretty basic, but I think a lot of people lack this insight and it causes
them to lose faith in all of science when they see contradictory studies.

------
startupfart
Medical friends here advise against the modern day trend of getting lots of
tests "just in case" \- even routine scans in healthy people can flag up
unrelated stuff, which then causes stress, and potential for unrequired
further tests and invasive procedures. One chap in the office went in for a
well-man scan, ended up thinking he was going to die due to a tangent one
doctor took him on (turned out to be a boring congential thing; he was
perfectly healthy with it).

When you have a problem, sure, get it checked. But, don't go looking for
problems and tests for problems!

------
dimino
I don't understand the title, this writer performs the act of "getting
healthcare is dangerous" after she reports on healthcare?

I get that she "stops dieting", which is something different, I guess, from
her normal behavior, and sure, the writer probably does start ignoring new
health studies after reporting on healthcare, but then the list of seven
things becomes just paragraph titles, completely unrelated to the original
heading of the story...

I'm all for grabbing extra pageviews, but this format wasn't well executed,
given the content.

------
mrfusion
One a similar note I recently spent a few hours trying to figure out if
saturated fat is ok or not and whether coconut oil is healthy.

(I still have no clue)

~~~
dibujante
Consider this: many diseases correlate strongly with obesity.

Obesity correlates strongly (well, causates, but causation -> correlation even
though correlation -!> causation) with calorie consumption.

Calorie consumption correlates strongly with food consumption of all types.

People who eat more (saturated fat | coconut oil | salt | carbohydrates | fat
| protein | the brain tissue of Emperor Penguins that have naturally died)
tend to eat more food, which leads to obesity, which leads to health problems.

Basically more studies need to control for obesity. It's appalling how few do.

------
somebodyother
Wow, this made me realize journalists can really write about anything without
being concerned about spreading harmful, false information. I don't get the
feeling the author has gained a more responsible approach to writing, just
fresher blurbs to put in their health articles.

~~~
breischl
>>without being concerned about spreading harmful, false information.

So exactly which part do you think is "harmful" and "false"?

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SebKba
I like the "stop dieting" and graph about what causes vs protects against
cancer. The "don't get healthcare" is ridiculous though. But then again,
especially in the US unnecessary back surgeries for example are insanely
common...

~~~
scrumper
Read it carefully - the chart implies roughly equal weighting between 'cause'
and 'prevent' for some foods, but the axes are scaled very differently either
side of the dividing line.

~~~
heynk
I believed they are scaled equally. Each 'step' from the middle indicates an
increase or decrease in risk by a factor of 2. If you're at 0.5, you're half
as likely to get cancer; 2, twice as likely. 0.1 is 10x less risk, 10 is 10x
more risk.

The graph was also created by Vox and includes the words 'cause' and 'prevent'
for exaggeration, but the individual studies mostly imply correlation.

------
mtVessel
Pro tip: If you're going to pull out the "combined experience" cliche,
anything less than 25 years just emphasizes how little experience that is.

------
dublinben
>Before we started reporting on health, we had no medical training.

If I already knew these seven things, am I qualified to be a healthcare
reporter for Vox?

~~~
MrZongle2
After seeing the quality of a few articles on that site, you may be _over_
qualified to be a reporter for Vox.

------
rwmj
I'm dubious about the "over-screening" problem. At the moment it may be that
we would overreact to every pre-cancerous spot. But surely once we're used to
screening and have done the studies over years, we'll know which cancers can
be ignored and which ones need to be treated. [This assumes of course that
whole body screening can be made very cheap and easy]

~~~
jasonmp85
Look at the thyroid cancer graph: over twenty years the detection rate has
increased by about 15x without any concomitant decrease in mortality.

With any diagnostic measure, you must ask whether the information it produces
is actionable. If anything, they way you've phrased it is backward: _first_ we
find a new treatment (via research) and once it gives us an action to perform,
_then_ we can justify the screening. If catching a cancer earlier helps,
screen. If not (prostate or breast screenings too early in life), don't.

Obviously if you have family history, risk factors, or something with high
specificity like a BRCA mutation, you treat. But many of those things are
discovered with a simple history/physical (H&P), which is _the_ important
screening your primary physician should be performing.

