In preface, I think you took my 'Evil Overlady'
without her smileys...  :)

--- Ronn! Blankenship <[EMAIL PROTECTED]>
wrote:
> Deborah Harrell wrote:
> >- Ronn! Blankenship wrote:
> > > OTOH, where *does* one¹ hold the line on health
> > > costs?
> >_____
> > > ¹Be that "one" the government, an HMO, a private
> > > insurer, or the individual.
> >
> >No easy answer - I do think people should take more
> >responsibility for their own health re: lifestyle
> >(habits, nutrition, exercise), which would reduce
> >significantly (~40-50% IIRC) the big killers like
> >heart disease and stroke.
> 
> Although there are still people who are active, eat
> well, take their 
> vitamins every day ;-), etc., and as far as they or
> their doctors can tell 
> are in good health until the day they present at the
> ER with what turns out 
> to be a heart attack, stroke, cancer, or some other
> disease which leads to 
> long-term, perhaps permanent, disability . . . not
> to mention healthy 
> people who have accidents that leave them disabled
> and requiring expensive long-term medical care . . .
 
Well, yes, of course - I did say that healthy
lifestyle changes could reduce arteriovascular disease
by ~40-50%; that leaves ~50-60% still extant.
 
> >   Educating children about
> >their bodies and health would be essential (and a
> few
> >"scare" tactics like cutting open a heavy smoker's
> >lung should be included - I will never forget my
> first look *and smell* of that disgusting blackened
> mass!). OTOH, avoidance of environmental toxins is
> essentially
> >impossible, so we do need agencies to watchdog
> >industry and research potential carcinogens etc.
> 
> Is it your opinion, then, that all cancers are
> caused by exposure to 
> toxins, and could be avoided if the toxins were
> removed from the environment?
 
Nooo, many are unfortunate genetic changes, in either
the parent's genes (ie congenital) or in the
individual cell during division (ie spontaneous) and
the body's immune system for some reason was unable to
destroy the malignant cells; others are from some
non-chemical insult, like a virus or radiation. 
However, many chemicals *are* known carcinogens (eg
benzene, asbestos); I was pointing out that research
into health effects of industrial chemicals, although
not cheap, is ultimately more cost-effective than
poisoning large populations and then having to deal
with the aftermath.
 
<snip> 
> OTOH, you may have heard the same story I did on the
> news today about the 
> woman who was stopped when she set off the metal
> detector at the 
> airport.  The detector kept going off, even after
> she had removed all 
> traces of metal from her person and clothing.  It
> turned out that what was 
> setting off the metal detector was a clamp which had
> been left in her 
> abdomen after surgery some four months earlier . . .
 
Ouch!  Hadn't heard that one.  That's why one is
supposed to have an instrument count before and after
surgery, but *before* closing the patient.  :P
 
> >As Evil Overlady, I would institute local programs
> >(tailored to the community/culture) to work
> >intensively with folks and their particular
> >addictions, be they food, nicotine or whatever; but
> >after a specified time (to be
> researched/negotiated),
> >if the person returned to the deadly behavior, care
> >for that aspect of their health would be
> eliminated.
> 
> Okay, so we outlaw alcohol, tobacco, and all other
> "recreational" drugs 
> (including coffee and tea?), as well as
> unhealthy/excessive food.

No no no!!!  Where is the personal responsibility in
*that*?!  How does 'educating and providing an
intensive treatment program' morph into 'outlawing'?! 
As Evil Overlady I have no intention of engaging in
foolishly dangerous actions, remember? <VBG>  I would
*not* want to promote a black market in these things!
I just want to link _actions_ to _consequences_, along
the lines of "It is not my job to rescue you from your
deliberate ignorance."
 
<Therefore I snipped your argument about wiping out
things, b/c that is obviously a losing battle!>
 
> Most "unhealthy" foods are not unhealthy
> unless consumed in 
> excessive amounts and/or to the exclusion of other
> foods, leading to an 
> unbalanced diet.  Who will be the food police 

Once again, NO!  Educate, treat if necessary, and make
clear the consequences of *deliberate ignorance* of
one's freely-made choices.  Personal responsibility is
paramount (with exceptions, as now, for children and
the mentally deranged or retarded, who clearly cannot
be held fully responsible for their ignorance).

> And what about when 
> new research shows that what was formerly considered
> bad for you is indeed 
> good for you, at least in moderation, and what was
> good is now bad for you:  

<BOSEG>  I was sooo happy when dark chocolate (small
amounts, in truth) was found to have beneficial
antioxidants!  (you did see my 'Chocoholic' sig?)

>(Did you happen to notice one
> of the headlines on the 
> new issue of _Scientific American_:  something to
> the effect that the 
> government has been giving us bad advice about diet?

Nope, but I take any 'new pronouncement' with a grain
of salt, and it's wise to consider even "known facts"
with a critical eye (was it one this list we discussed
how the "drink 8 glasses of water a day" was recently
found to be based on a *misreading* of a ~1947
paper?).

> And what do we do about AIDS and other STDs?  Leper
> colonies on isolated islands, perhaps?

Once again: educate, treat if needed (frex, it's very
cheap to treat some STDs, and since cost was the
bugaboo that opened this up, has to factor in) and
allow people to make their own choices.  But AIDS is
as much a social as medical problem (one frex: a woman
gets it from her cheating husband - or in some
societies, it is not even considered wrong for a man
to go elsewhere for 'bodily needs' if his wife is ill,
cycling, or pregnant.  Even an _Evil_ Overlady can't
fault the innocent spouse in such a case. <sad smile>
And I use M->F transmission b/c it's technically more
likely, not trying to be sexist).
 
> To open another COW, what do we do about conditions
> which have genetic causes?  

Shades of _Gattaca_...

> If a young person tests positive for
> Huntingdon's disease, do we 
> sterilize that person before puberty so they won't
> pass along the bad genes 
> and then offer them euthanasia when the symptoms
> start in their 40s?  How 
> about children with hemophilia, cystic fibrosis, or
> Down's syndrome?  (And 
> how about their parents?)  Mandatory prenatal
> genetic screening followed by 
> mandatory abortion if the fetus is not "perfect"? 
> And if so, where do we 
> draw the line on what is considered a genetic 
> "disease"?  Homosexuality?  Below-normal
> intelligence?  Above-normal intelligence?

Now you're talking social engineering (if I understand
the term correctly), which is quite beyond 'trying to
reduce medical costs.' [Aside: How much has the
missile defense program cost thus far?]

<serious>
As someone who does have a spontaneous mutation that,
if passed on, has a 50/50 chance of causing mental
retardation, various cancers and behavioral deficits,
this is not an academic issue for me.  At the time
that I would have considered starting a family with
the right man, there were no prenatal tests available;
after a great deal of painful consideration, I chose
not to have children.


In the not-to-distant future, we will be able to
prevent or treat many if not all of the diseases you
mentioned.  While I applaud elimination of needless
suffering, I do not like the idea of
"custom-designing" a child to be a blue-eyed,
red-headed 6' 7"  basketball player who paints and
likes pythons. Will we tinker with our genes? 
Probably.  

Debbi
GSV Uplifted

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