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by SRasch 3083 days ago
I relate to your sentiment, but it seems to me that promoting healthy lifestyles and inventing new cures doesn't have to be in opposition.

Like you, I spend a lot of time figuring out how to live better. But also grateful for the medicine I got for illnesses when they do arise.

I use and apply free health advice. Then again, I also use gym and supplements, which may have made VCs rich. Likewise, in cures, I appreciate that they are available in the low probability I get seriously ill. I am sure many suffering from alzheimer, cancer or other age-related diseases, would want there to be cures.

In the goal increasing healthspan, can't one favour the all-of-the-above approach? Primarily rely on healthy living like you suggest, yet support people developing cures for diseases.

PS. Almost all cures come from the US, 57 % of them, and 13 % from Switzerland. While this health care system is dysfunctional in many ways, it also is the market new cures are being developed for. In Europe, where I am from, most drugs are purchased by a single large purchaser, which has negotiation power to buy a drug at close to marginal cost. This makes drugs cheaper, but also makes less people try to invent new cures. So, it's a bit of a trade-off between the present and the future.

1 comments

I am fine with all of the above. The problem is that our increasing focus on solutions someone can monetize and make a mint off of are steadily crowding out other options. YC has a lot of power. Adding their muscle to the goal of finding business solutions to health issues is very likely to deepen that problem.

I quit taking the flu vax years ago and have done better since. In the eyes of some people, this makes me a nutcase antivaxxer even though flu vaccines are not required.

When I was growing up, anyone getting vaccinated was a success. People who didn't weren't all that uncommon. Now we are shooting for 100% of the population being vaccinated and you need to justify not getting it.

The further we go down this road, the more those options narrow rather than expand. I am some nutter who "lives in a bubble" for preferring to limit my exposure to germs as effective prevention rather than live on prophylactic antibiotics all the time, never mind that one of the outcomes of putting people with CF on antibiotics constantly is a high incidence of C-dif infections which are then treated by surgically removing your colon. Limiting my exposure to other people and their germs is not viewed as a reasonable choice for avoiding that outcome.

I am not seeing similar amounts of muscle put into policy changes that are more family friendly, people friendly etc. Saying there is nothing wrong with developing this stuff ignores the context in which this is occurring. If all of the above were equally accepted answers, I would not get so much ugly and threatening push back for talking about the choices I have made. I should not need to defend the idea that I would just rather not be sick, thanks, and I am willing to limit my social life to have that. But I get outright attacked for that.

So you would be wise to be a tad more skeptical about where such things lead. They tend to lead to promoting one path over another, at the expense of the other, rather than a broadening of options.

Path dependence is a real phenomenon, yes, but then again, so is doing things that can be done, as opposed to those that can't.

How much effort do you think it would take to force the adult population into "healthy lifestyle" (as defined by the usual good diet and lots of exercise, etc.)? How would one even do that? I can't imagine anything over a) upending the industrial revolution and getting us all back to the farmer's life, b) just forcing everyone by arbitrary government restrictions on everything, or c) doing massive brainwashing of everyone. All of those strategies are infeasible, and could have bad side effects.

OTOH money spent on biomedical research can lead to figuring out one cause of one disease, and a subsequent cure. Then another. Then another. A lot of those could allow us to sidestep the lifestyle requirements, which I believe to be a good outcome. It expands options. (This - using medicine to not change lifestyle being good - is where I think our beliefs strongly differ.)

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> I am some nutter who "lives in a bubble" for preferring to limit my exposure to germs as effective prevention rather than live on prophylactic antibiotics all the time,

What? Who on Earth does "prophylactic antibiotics"? I thought this was restricted to surgery and some other very special cases...

> Limiting my exposure to other people and their germs is not viewed as a reasonable choice for avoiding that outcome.

This is a very reasonable strategy and is often used, but has lifestyle costs, so people avoid doing it anyway... No blame to be put on doctors for that one.

> When I was growing up, anyone getting vaccinated was a success. People who didn't weren't all that uncommon. Now we are shooting for 100% of the population being vaccinated and you need to justify not getting it.

When you were growing up, polio was a thing. Now, it isn't. There's not just a correlation there, there's actual causation. We're shooting for 100% vaccination for some of the things, because vaccines work, and happen to work superlinearly - the more people are vaccinated, the more likely it is those who are not vaccinated will not get infected either. And some people can't be vaccinated for health reasons, so they rely on that so-called "herd immunity".

My dream job was to become an urban planner. Historically, city planners considered health effects of the design decisions that were made. This is basically no longer done.

Yet one thing harming health in the US is that most people find that long commutes are not an option. They are a necessity. The time spent behind the wheel is not only bad for your health, it robs you of time to do things like go to the gym or cook from scratch.

Most Americans don't want to spend that time behind the wheel. But there are huge obstacles to arranging to avoid it. Many Americans wish they had other options. If those options were made available, you would not need to force people to take them.

Though I wish you had just dropped it and walked away like you indicated you would do.

FWIW, I'm totally with you on what you just wrote about commute and urban planning. Seeing my city (in Europe) destroyed by developers is deeply saddening. We've opened up cities to the free market, and now everyone treats building as investments, putting residential and commercial structures where it makes zero sense, only further congesting the city. TBH, I don't feel like anyone is doing any actual urban planning anymore.

> Though I wish you had just dropped it and walked away like you indicated you would do.

Yeah, I should have. Couldn't stop myself. But I'm going to now. No more comments on the health stuff.