This is truly the Trumpian era.
Cuba is in fact a fine example of how much can be accomplished cost-effectively … given having absolute authority to implement your plans.
It also I think provides some further support for the simple point I was making. Cuba has very little wealth inequality compared to the United States and for many reasons, including its size, does not have the structural factors that lead to health inequities either. Inequalities in health care contribute to and perpetuate wealth inequalities and very much so wealth inequalities result in health outcome inequalities, more to the downside than the up.
Our path to dealing with this will certainly not be the path of Cuba (nor would many us want it to be), probably not even that of Finland or Iceland’s social democracies, “the Nordic model” (that perhaps more would like see us emulate some aspects of). But clearly our consistently slightly less than our wealth based peers healthcare outcomes data is embedded in structural factors that are large in scope and magnitude. Frankly given those structural factors we should be doing worse.
Frankly, you are comparing the USA with a third world nation as if that’s normal in any sense. Is that what the USA aspires to do - to achieve better outcomes than in the developing world?
There are thousands of these out there - variations on a theme - but here’s just one. In 2016 this chart would have continued to climb for all other countries and actually turned south for the USA.
Frankly: ‘This chart is a powerful indictment of our current health-care system’
This is one of those things that bugs me. No one is asking for ‘free stuff’. We’re asking that We The People ‘promote the general welfare’ of our fellow citizens, and provide for those who cannot provide for themselves. The way one side talks, they would gladly stop working if they got ‘free stuff’. Meanwhile, others believe that there is virtue in being productive and would work – and contribute to the well-being of the country and its citizens – even if they didn’t have to. Yes, there are freeloaders. There are people who game the system. But why project prejudices onto the majority for the failings of a few? Keeping citizens healthy and productive is good for the country, and brings such huge benefits that the freeloaders are just a cost of doing business.
Unlike some politicians who want free money, and want to spend money we don’t have on things we don’t need, others want to buy things we need and they explain how they would be paid for.
Actually it brings up an interesting aside: what does “third world” mean today? Anything? What did it mean?
Looking it up it seems that how I had thought of it was completely wrong and that it actually came out of The Cold War in reference to the nonaligned nations, neither “Western” nor part of the Soviet bloc. Cuba even then was not “Third World.”
In sloppy usage use of the archaic term has meant the least socioeconomically developed countries. If that is the use being meant then Cuba and its healthcare system is NOT on the list. Actually it gets placed in the “high human development” grouping. Its number 68 position of 188 is well below the United States’ number 10 position to be sure and in less archaic than “Third World” terminology it would still place it the uppermost portion of “developing countries” (along with China and Brazil, and above both of them).
In any case, what is “normal” to do in any sort of analysis is to look at the examples that fall out of the expected patterns and try to figure out why. Why does the U.S. not do quite as well as one would expect if one only looked at its wealth and expenditures? Why does Cuba do much better than one would expect looking only at those factors? Is there anything to learn from countries that have punched outside their socioeconomic weight class on these measures?
So if we’re dying earlier, “we’re” definitely concerned much-we’re meaning the US government
Its no wonder we’re getting fat. Every day there is some fast food place adding yet more calories to their already high calorie foods. The latest I saw was a pancake with ice cream or something on top. Come on! Glad I dont like that combination and glad I dont have the money to go out for meals that often. Maybe once a year. Now pizza comes home, we dont eat at wherever we get it from! But that I am doing well at avoiding. The trick is not to asked the husband if that is what he wants for dinner!!:eek::eek:
A pancake with ice cream, my god how crazy and new and not something that has been served at every diner and breakfast place for as long as I can remember.
“Keeping citizens healthy and productive is good for the country”.
But how exactly could this be accomplished?
After eating too much fat and sugar for 60 years, the human body begins to break down. These people then go to the doctor or hospital and want to be “cured”. The problem is the “cure” is eating less and better food and exercising on a regular basis, but people don’t want to hear that. They want a pill to take so they can get back to their ice cream and easy chair.
Probably close to 90% of the people that live in the USA don’t really care what they are eating and don’t bother to exercise at all. Which is easier, going out for a run or sitting on the sofa watching TV and drinking a beer? Which tastes better, a spinach salad or a hamburger smothered in bacon? People are free to choose either option and there is no way the government can influence their decisions. Everyone already knows they should eat right and exercise. Education is not the answer.
Don’t blame the government, the health care industry or anything else but the individuals who freely choose not too take care of themselves.
And don’t blame the Food Industry. Supermarkets are full of fresh fruits and vegetables and other foods that are good for people.
This isn’t about “those lazy people over there”; this is about the most simple of economic incentives. The same incentive is why the insurance industry is such a mess, and why there’s no transparency in medical pricing.
Right now, people who have insurance have the same incentive to overspend needlessly, because they don’t have to pay; it’s free!, and covered by insurance!
I didn’t quote the entire chain, but my complaint isn’t even about giving “free” insurance to people, but about the incentives for poor behavior that leads to obesity and self-inflicted type 2 diabetes. Just giving everyone free (no copays, no penalty) insurance is a horrible incentive towards a healthy lifestyle. And proper incentives already exist; look at all of the “wellness” plans offered by employers. Quit smoking, and halve your deductible. If you’re overweight and agree to free WeightWatchers, halve your deductible.
When you propose free everything, you combine the already-horrible incentives of our current insurance system (for those who are insured) with the lack of any type of control over self-inflicted harm.
That is a very simplistic approach to health.
Poor diet and lack of exercise are bad for your health, but so are a hundred other things. Poor sleep is bad for health. Social isolation is bad for health. Chronic anger is bad for health. The life expectancy gap between someone who weighs 400+ lbs and someone of a healthy bodyweight is about the same as the life expectancy gap between rich and poor, between smokers and non-smokers, or between college graduates and high school graduates, or between white women and black men. For each comparison group the gap is about ~10 years.
There are a lot of things that affect health and at the end of the day 90% of people die from complications of old age.
I am rather doubtful about this. We don’t have to extrapolate what happens when the economic barriers to healthcare are removed. That is the default condition in the western world.
It does not appear to lead to a significantly more unhealthy lifestyle than the US. Money is nice, but if you are not incentivized by the risk of strokes, impotence, loss of limbs or heart attacks, a few more bucks are not going to do it.
Is u’s being sarcastic?
Anyway, I was not sure what it was they put on top but I shall be sure to remember it when I see it again
They’ve got pills for so many other bad habits.
I’d like to go cold turkey from food but I cant because of my diabetes. I’d be glad to take some other type of pill to keep my hunger down and keep my sugar normal
Cant afford to buy all the fresh vegetables in season or out. There are families that are economically unable to eat healthy. Of course the same families may not care.
More exercise. Some things are just so depressing 
I just came back from Italy. My traveling companion and I both noticed that even though the cuisine was a little on the heavy side (lots of carbs, lots of dairy, lots of oil), people weren’t as overweight as Americans. We also noticed that there were a lot of smokers, despite health statistics being more favorable towards Italians than Americans.
Could the key be in the fact that Italians practice better sleep hygiene? Does the Italian siesta confer stress management benefits? It is also true that Italians are more active than Americans, even when socializing. Maybe all of these things combined mitigate the negative health consequences of a pasta-laden, nictotine-rich lifestyle. It probably also helps that Italians have better access to medical care, enjoying twice the number of physicians per capita as Americans at much less cost (see the first link).
Education - the USA has to do something about sugar, for example it’s insane how much people consume in just soft drinks and fruit juices.
The body won’t have it - any more than a can a standard can a day and all additional sugar converts straight to stored fat.
What chance a public health campaign? Zero, I’d imagine. Politicians bought and paid for again.
I honestly don’t know. I did some research, apparently in Japan nearly 30% of men smoke, but life expectancy for men is 80.5 years. Thats four years higher than men in the US.
I’m not sure what all factors play a role in it. I just feel like there are probably dozens of lifestyle factors that all play a role in health, and we should be focusing on whatever ones we can that people can incorporate into their own lives.
Supposedly the Mediterranean diet is arguably the best diet for prevention of vascular disease, so that may play a role in Italy’s health.
Smaller food portions might be a factor, too - American portions are huge in comparison to other places.
The USA has the most affordable and most nutritious food in the world. Unfortunately, it also has the most affordable junk food in the world – everyone can afford it, and many (most?) live entirely on it.
How much junk food with sugar is there available there as here in the US?
Also do they eat the food and not junk? How about desserts? Do they eat between meals? Do the mothers all work so they have to pick up take out on the way home from work?
Education is the right thing, especially the younger crowd. Sometimes the craving for sugar just is too much. Availability will always be there, I guess
Oh so sad but true…
oh boy how true!
For Americans in particular it’s not sugar per se it’s HFCS; best we understand atm is it coats receptors that send signals from the lower gut to the brain.
But you can do your own research on that if interested. Except for one chart that tells the story 
People say this all the time, but I’ve never seen it, excluding places like Olive Garden, Red Robin, or other crappy chain places where they deliberately try to make you feel “value” by loading you up with unlimited quantities of cheap carbs. Dining in, say, hotel restaurants or local, non-chain restaurants all over the world has been pretty consistent for me, quantity-wise.