An aspect worth noting is, that our society is more and more redefining the meaning of "health" from the absence of illness to perfection of some universal subjective standard, which disregards factors like age or sex.
White teeth have at least some roots in biology - generally the younger you are, the whiter your teeth - still it makes no sense to compare the whiteness of different aged people and judge their health based on them.
Ethically we are on a dangerous path: Orthodontics for children are standard in Europe and the US, countries like Japan are catching up quickly. Teeth-whitening is common in the US and is becoming more popular in Europe, too. Orthodontics includes oral surgery more and more often. Korea is all in and full blown plastic surgeries are becoming the standard [0].
These surgeries cause pain and hinder you to eat properly for months. Still we are on a path to include them in our definition of health. In Korea parents often pay for them as a present for graduation.
People who the majority perceives as disabled or even just ugly are not necessarily unhealthy. We should make a clear distinction between body modifications and medicine. Unfortunately our ape brains see a high status individual and cluster these things together. This lets us worry about health problems we previously did not even know we had, making us psychologically and often physically unhealthier in the end.
Another big problem is, that we ignore the fact that we age. I do not think that care for the elderly should be an area of medicine. When your body breaks apart at 80 years old, that does not make you unhealthy, you are just old. You should not get the needed social interaction from doctors, who try to fix something that is perfectly natural to fall apart.
Some of the plethora of pills an 80 year old takes surely increase his or her life expectancy, I feel like others might not be worth the hassle. I surely do not want to ruin my last moments on earth organizing my calendar of doctor appointments trying to squeeze out the last couple of days I can possibly get.
Orthodontic procedures generally pay off in the long run. Straight teeth and an aligned bite are typically more functional. Straight teeth are easier to clean and preserve.
In many EU countries health insurance pays for them because a long term financial argument can easily be made.
Bad teeth can cause severe health issues and get expensive later in life.
Another big problem is, that we ignore the fact that we age. I do not think that care for the elderly should be an area of medicine. When your body breaks apart at 80 years old, that does not make you unhealthy, you are just old. You should not get the needed social interaction from doctors, who try to fix something that is perfectly natural to fall apart.
'Naturally' or 'natural' is a poor argument to make about not caring for the elderly.
If the elderly is not able to walk, eat, or think, then they're sick or disabled. It doesn't matter if you are 80 or 20 years old.
I think there's a pretty wide gulf between caring for people with a disability, and keeping your teeth toilet-bowl white after decades of drinking tea or coffee, or whatever.
I am not saying you should not care for your body, when you are old. I am just thinking that the amount of care you put in should have a positive ROI in quality of life and I am not so sure about that in any case of so called elderly care.
Good idea. Until we have said cure lets not pretend that you can fix ageing by visiting the doctor twice every week, effectively offloading needed social interaction to them.
Edit: This view might be radical on HN, but while I do believe that we can fix ageing and that eventually someone will, I am not quite sure if we really should.
The NHS approach of putting monetary value on a year of life and comparing the drug costs to that is a good approach to reducing the spend on tired old bod's.
I agree with you completely. While I'm not totally on board with what the NIH is described as doing, what you say is not against what the parent said. The issue is that new bods are very likely to have a lot more useful year left, which counts in the equations.
Let's say the NIH values a year of life at X. There is a 90 year old and a 10 year old who need the same treatment that costs 10X. We should be much more willing to give the treatment to the 10 year old because he has a much better chance of 'earning back the investment', whereas statistically, the 90 year old is overwhelmingly likely to die in the next 10 years.
Strictly speaking, if it costs 10x then the 10 year old will have to live to 110, whereas the 90 year old need only live to 100 to "earn back the investment".
So, your maths is incorrect, try "5x the cost". But I take your point.
First of all, 10X is not a factor of age! "X" was meant as an arbitrary monetary unit, and the cost is the same 10X for both the kid and the 90 year old.
Second, "returning the investment" doesn't mean "reaching 100 years old". It just means "getting more years of life for the same cost".
Even if the boy lived only to 30 or 40, he still lived 20 or 30 years, whereas for the 90 year old living up to 100 or 110 would be extremely rare.
It's painfully telling that we (or at least some of us) somehow consider the effort in keeping a person alive an "investment" that must be "earned back".
We a species have finite resources and can't sink all of them into every patient. Every time we treat or don't treat someone (and it's not possible to treat everyone of everything), we're making implicit statement in the form of a mathematical inequality about how we value money against human life and quality of life. The question here is whether these statements about how life balances against resources are self-consistent or not. And if they're not consistent, then that means you can re-arrange your decisions to save more lives at the same cost, or alternatively save the same number of lives at less cost. The route the NIH apparently went was to try to make their decisions consistent by explicitly giving a dollar value to a year of human life.
>We a species have finite resources and can't sink all of them into every patient. Every time we treat or don't treat someone (and it's not possible to treat everyone of everything), we're making implicit statement in the form of a mathematical inequality about how we value money against human life and quality of life.
We spend more on dog food than we do on millions of patients.
So, no, it's not a question of "finite resources".
Or, rather, it would be, if we were anywhere near exhausting our resources.
Treating the cost of saving a life as a cost is a completely different question than treating it as an investment. Human lives have value, in and of themselves, irrespective of whether or not sinking some number of dollars into extending them can — let alone should — be "earned back".
Whatever you call it, the value that patient N derives from cost C needs to be compared to the value that patient N+1 would derive from that same cost C.
When the NIH (or equivalent) turn that into a C/expected number of years, they're doing a scarce resource allocation problem. Unless you have infinite resources to give every patient every available treatment, you have to do allocation somehow.
Giving a 10-year old a treatment that you'd deny a 90-year old seems perfectly sane and rational to me.
I can't tell if you're agreeing with the concept and just disagreeing with the terminology, or if you believe there's a fundamentally better way?
If an additional year of life is valued at "X" and the cost of the treatment is "10X", the 10 year old has to live to 20 and the 90 year old to 100 to "break even" (assuming a discount rate of 0).
I literally cannot figure out where your math went off the rails.
Yes. Hopefully euthanasia will be a thing should I reach the decrepit stage. One last party (perhaps with a bit of morphine), followed by drifting to an infinite sleep... sounds fairly dignified.
Sorry, but this sounds a bit short-sighted. While nobody should be sentenced to suffer severe pain for the rest of his life, just because your body isn't as capable as it used to be doesn't necessarily mean that you want to end your life. Often there will be people that you will leave behind and you certainly don't want to explain them that it's your decision to do just that.
On top of that, this is also dangerous from a social perspective where people could get a feeling that they are supposed to go once there is nothing they can contribute to society anymore.
We should rather focus on allowing making "regular" dying more dignified rather than promoting euthanasia.
I do think it should be a personal decision. Also, euthanasia is certainly not preventable (I think of a certain gentleman that took the bottom of the river approach).
I have seen a few old people live beyond their time and wait for death though. It is quite harsh and undignified. "I am just so tired and I want to go."
It is beyond offensive to imply that 60 year old individual is worth less to society than a 30 year old individual, and that there are life-saving measures appropriate for the latter that are too costly for the former.
I mostly disagree although I understand and appreciate the sentiment of your post.
You have to consider first of all that we're working with scarce resources. When we're not, it's not even an issue to compare two lives if you can save them both. But in the case that there are limited resources and you happen to have to choose between focusing on two different groups of people and make that tradeoff, you inevitably have to base your decision on something.
Now if you have a 15 year old kid and an 80 year old person, and both are dying from some preventable disease at a rate of 1% per year, and you have a scarce budget to focus on researching one particular disease, which one do you choose to focus on?
Well flipping a coin is probably shit. But making a ranking based on qualify adjusted life years[0] probably makes more sense. Of course it's not perfect, but it's not beyond offensive if you ask me to go about reasoning like this to partially inform policy decisions.
I ask this in seriousness -- why do we judge the possibility of the future as more valuable than the certainty of the past?
That is, why do people tend to be more sad when a kid has cancer than an old person? A child hasn't had decades to interact with and influence other people's lives. In terms of the sadness inflicted if someone were to die, an older person will have affected hundreds of lives, built things, had families, etc.
A child hasn't really impacted anyone except their parents.
I feel there's an underlying attitude that older people have had their time, and it's only right that a young person gets their chance.
But I'm not at all sure if that's true, and I wonder how much of this conversation is based on an assumption that we haven't explored verywell.
Tou need to luck at marginal cost: An old person is going to die, 100% chance, and that will cause sadness, etc. The question is what is the marginal value in each extra year of life, not is the death itself undesirable.
But you touch on a deeper question also: "saving lives" is a very modern idea. Traditionally, death was quote common all all corners of society, and the solution was to make more new people.
I suspect the idea sounds 'wrong' when talking about adults, but most people feel it is intuitive when talking about young children. Which person should you rescue first, the 4 year old or the 64 year old?
We're not talking about research funding. The comment I replied to referenced NHS placing a monetary value on a single year of life, which directly means that young people are "worth more" than older people.
> What scarce resources are you referring to in the developed world?
What kind of question is this? You think we have infinite medical researchers with infinite resources and infinite budgets? All countries, including the richest ones, have budgets.
> Bill Gates turns 60 this year. It's pretty safe to assume he'll accomplish more in the next 20 years than you will in your lifetime.
Oh god you can't really think that's a good argument, can you? Citing Gates as your anecdotal evidence to make a point about policy that affects millions of people is outright silly. It's like saying government policy should prevent people from going to university, and dropping out once they get in, because hey Bill Gates did it and look how that turned out. Why refer to one of the most extreme outliers in modern history as a justification for medical policy for completely different, average people?
I don't even get what your point is. I made the point that it probably makes more sense to save 1% of 15 year olds (or 25 year olds for that matter, considering the other post on how children distort our perspective of morality), than 1% of 80 year olds, or 60 year olds for that matter, given a common situation of scarce resources and the need to make a trade off. (again in cases where resource scarcity doesn't matter, the discussion is irrelevant).
If you want to counter that with the point that 'but some 60 year olds are still productive, look at bill gates, his impact will be tremendous the next decades' then you fail to see how statistically that 60 year old may have already been dead 35 years earlier, and that statistically for every bill gates you'd save at 60, in this hypothetical situation, you'd give up a younger bill gates who now dies at 25, and it may be said that despite his tremendous impact late in life, it doesn't rival his impact earlier in life, and that this (having more impact before 60 than after 60) probably holds true on average, generally speaking. No amount of anecdotal evidence changes that fact.
You don't need infinite resources for a finite amount of people. You are exaggerating the choice.
The point is that you don't need to give up a younger Bill Gates for an older one.
As for the impact of his accomplishments, I think we'll need to wait until the end to evaluate it. You could argue that saving millions of lives and offering tens of millions better, healthier lives is more impactful.
The scarce resources implied here is the money that the government spends on medical treatment for the elderly, poor and disabled. Bill Gates obviously could always buy his own medical treatment.
Sure, but the money Bill Gates spends on medical treatment takes resources away from other things. Even if supply is elastic enough to adjust, it's unlikely to adjust immediately, and the adjustment will still reduce resources that would have been consumed elsewhere.
Money is a claim on future productivity. Spending it causes people in the world to adjust what they're doing to satisfy what you're asking for. Most of our claims aren't very large though, so this isn't particularly noticeable except in aggregate.
Yes, if you have to treat everyone with Alzheimer's or cancer, that could be expensive. On their the hand, once you develop inexpensive cures, it's not such a burden.
Let's say the treatment guarantees until life expectancy of 88, ignoring a few details. Do we say that 28 years of life is worth the same as 58 years of life, keeping in mind budget is fixed?
Resources are scarce; their use must be prioritized. The answer to the difficult question of how to apportion health spending is not to take offense at being asked. You don't get to take that way out; it's not an option.
I don't know why this comment is being downvoted. If medicine still advances at the rate it is now, by the time we will be 60, the average old age will be in the 100s.
Due to "rectangularisation of the survival curve", probably not (there appears to be a max age of around 110). Current rates are 3 months more life expectancy per calendar year. However, in the US and various other places the improvement is seriously wobbling due to wobbly bellies.
Whiteness of teeth and eyes are biological markers of being a good potential mate with [currently] good health and [presumably] strong immune system (evolutionary "hints" of having "good genes"), an analogy of peacock's tail. Breath is another important hint, btw. These are just hard-wired to our brains.
People are mere monetizing these "heuristics" into absurd.
Yes and the author tells a story about Western culture but I kept asking "how do you know?" Eastern cultures may have the same bias but without enough technological development over their history to actualize it at the same rate that we have.
Maybe he doesn't. If I tell you a story about my culture I don't necessarily imply to know about everyone else's, too. For example I've got no clue how whitening plays a role in much of the world as a beauty standard, but I know how it plays a role where I'm from. And indeed standards may not be the same. For example in much of Asia it's often a beauty standard to have the lightest skin colour possible, for light-skinned people. While this exists in the west for dark skinned people, light skinned people generally have the opposite and getting a tanned skin is considered better than a pale one. How that works for teeth I don't know, although I'd imagine in most cities white teeth as a beauty standard are probably fairly common but it's just an assumption.
Whenever I'm in the u.s. I think people look bizarre with their super-white teeth. I mean, my teeth aren't yellow or anything, but they don't glow in the dark either.
There are some things that don't transfer so easily between where I live (switzerland, but I think germanic europe in general) and the u.s.: super white teeth, visible tattoos, and piercings. (although I'll see a small nose piercing on women every now and then)
(and if you're German, you should probably leave your puma track suit and aviator glasses at home when you go to the u.s.)
I grew up with people having natural colored teeth. People with artificial teeth color were those with false teeth. I find myself gradually getting used to it, but initially it did look like these people had quite serious dental problems: a problem bad enough to require all their teeth be replaced by artificial dentures. This is not attractive.
I have the same reaction to perfectly straight teeth or teeth without canines. It looks like false teeth. Crooked teeth isn't a good look either, of course, but forcing out all natural variation just looks like someone's had a problem. Uncanny valley: like someone with a synthetic flesh on their artificial hand.
I don't like the super white teeth either. Every person I have known, on a personal level, who had very white teeth; had a mouth full of cavities, extensive bridge work, or a bunch of money wasted on veneers?
I think teeth whitening is a bit like steroids or liposuction. It is mostly for people who have insecurities and/or lack discipline to get quick, visible results at the expense of their health. I'm adding health here because these procedures, although deemed safe, are certainly harmful in some way.
There is a natural yellowing from coffee, tea, smoking and aging that even disciplined hygeine doesn't combat.
Whitening (via oxidation) is nothing like surgery, being a meager, inexpensive, 5x5 minute habit that has a pretty big impact on perceived health and grooming. The downside is some temporary damage to your enamel, but it's less than a single cleaning at the dentist.
If anything, I'm wary of whitening toothpastes, which are ubiquitous and tend to work via abrasion.
In my experience, tattoos and piercings are very common in Germany and also in Switzerland. They are certainly no longer limited to certain groups of the population and very visible, especially now in the summer …
Germany is not quite Italy, but tracksuits in public are not common either. It is just a thing in certain subcultures. When I visited Ireland, I saw not a single child, who did not wear one.
It was in Dublin a few years ago '11 or '12, I think. To me it seemed to be like there was an age threshold at which people start to wear regular clothes.
To say something nice: People were extraordinary friendly and walked up to us from 20-30m (100 feet) away to help us when we looked even remotely disoriented :)
Well, it makes sense that it'd be Dublin. More than likely you were seeing people who live in more deprived parts of the city. I can't say I've seen many children around Dublin dressed like that, mainly teenagers and younger adults.
I hope you'd a good time while you were here! I recommend you see some other parts of the country. For instance, Cork and Galway are great cities.
Really, no visible tattoos or piercings in Switzerland? I think you may be going a tiny bit too far if you want to generalize that as an European thing. Any decently sized city in Germany will have certain parts of it or just places where you will see plenty of people with tattoos and piercings. It's no big deal and has been this way for years now.
On the other hand I have never seen the specific tracksuit+aviators combination you mention. In fact, while I have seen plenty of aviators in the wild (usually combined with jeans and t-shirt or maybe even a proper shirt), I don't think I have seen many tracksuits at all, much less Puma tracksuits. (I think if you wanna go for tracksuits you should definitely go for some authentic Adidas.) I mean, aviators are kind of a thing like, say, Chucks are a thing (you see them often enough to notice that quite a few people seem to wear the same sunglasses/shoes, but it's not as though a majority of people wears them) but tracksuits are not even that.
Or maybe we just travel in different subcultures. Germans living in Switzerland are probably quite unlike Germans living in Germany. And maybe we can generalize this even more: There can be quite a lot of diversity in different groups of people and our simplistic differentiation along nationalities is just not precise enough and our stereotypes fall short. I'm willing to bet that there are certain groups of people in Germany and Switzerland who are absolutely crazy about teeth whitening and for whom no shade of white can be white enough – both of us just don't know any of those people. And maybe it's not yet as popular here as in the US – but that's as it usually goes with these trends. I mean, the future is already here, it's just spread around unevenly – and the same is probably true for our teeth whitening future. (Or maybe we will leapfrog the trend and jump right beyond to the next trend of super-natural looking teeth-yellowing or something like that. Or maybe a competing trend will be adopted by different subcultures or something else altogether. I bet there are also plenty of people in the US who would never ever whiten their teeth.)
How common is it, really, in the US? I genuinely don't know.
On the one hand, I hear that medical (and thus presumably dental) insurance costs a fortune, and even then the "co-pay" means that many hesitate to seek treatment. I can't imagine that "my teeth aren't as white as I'd like" is something insurance companies like paying for (or rather, they don't like paying for anything, but something purely cosmetic seems easy to deny), so how are people affording this? is it just the wealthy? If I wander around poorer areas, will I start seeing ordinary teeth?
Teeth whitening is very cheap, you can buy teeth whiteners over the counter in the US, and most toothpastes you can buy in the store have whitening agents in them.
Are you sure? The handful of times I've inquired to an acquaintance about freakishly white teeth, they've always said it was just because they took really good care of their teeth, didn't drink coffee or soda, used whitening toothpaste, and had good genes.
Dental insurance is pretty cheap in the US. Medical insurance varies a lot, but for most people it is also pretty cheap because their employer pays the majority of it.
White teeth have at least some roots in biology - generally the younger you are, the whiter your teeth - still it makes no sense to compare the whiteness of different aged people and judge their health based on them.
Ethically we are on a dangerous path: Orthodontics for children are standard in Europe and the US, countries like Japan are catching up quickly. Teeth-whitening is common in the US and is becoming more popular in Europe, too. Orthodontics includes oral surgery more and more often. Korea is all in and full blown plastic surgeries are becoming the standard [0].
These surgeries cause pain and hinder you to eat properly for months. Still we are on a path to include them in our definition of health. In Korea parents often pay for them as a present for graduation.
People who the majority perceives as disabled or even just ugly are not necessarily unhealthy. We should make a clear distinction between body modifications and medicine. Unfortunately our ape brains see a high status individual and cluster these things together. This lets us worry about health problems we previously did not even know we had, making us psychologically and often physically unhealthier in the end.
Another big problem is, that we ignore the fact that we age. I do not think that care for the elderly should be an area of medicine. When your body breaks apart at 80 years old, that does not make you unhealthy, you are just old. You should not get the needed social interaction from doctors, who try to fix something that is perfectly natural to fall apart.
Some of the plethora of pills an 80 year old takes surely increase his or her life expectancy, I feel like others might not be worth the hassle. I surely do not want to ruin my last moments on earth organizing my calendar of doctor appointments trying to squeeze out the last couple of days I can possibly get.
[0]: http://www.newyorker.com/magazine/2015/03/23/about-face