Of Nike Sneakers and Healthcare reform

You know, when your major health problem as a civilization is that people can get too much food with too little effort, that’s a sign that you’re doing something very right.

In a more philosophical sense; I strongly question the assertion of moral hazard, both of safety equipment and health practices. I work in business; I know sadly well how a well-meaning attempt to solve a moderate problem can turn into a bigger one later on. But this doesn’t always happen. Normally, things work. Normally, when people evaluate shrouded engines versus non-shrouded engines, they do studies, engage in math and science, and come up with an answer.

Yes. The book Deep Survival by Laurence Gonzales, specificallyhe cites Normal Accidents: Living with High Risk Technologies by Charles Perrow, and The Limits of Safety: Organizations, Accidents, and Nuclear Weapons, by Scott Sagan to back up this assertion.

[quoteI doubt that this is true. First, it would seem that some of the Tarahumara are great runners because they run a whole lot. Probably more than most ultra-marathoners, and definitely more than the average person. Maybe they are good because they do it very often. Or as this [cite]
(UltraLegends.com is for sale | HugeDomains) states:

Like African-Americans with basketball, Canadians with hockey, and Dominicans with baseball, when a disproportionate amount of cultural value is placed on being good at something, you often see individuals excel in disproportionate amounts.

While our own lifestyles may be deleterious to our health, I’m not sure we have much to learn from the Tarahumaras. From the same cite

Would you really want to hold up a society, where the average life expectancy is 45, as a model of health? Maybe the reason why they don’t get heart disease, etc. is because they are already dead.
[/quote]

I’ll address the issues you brought up singly, but first, you realize you are citing somebody’s term paper? The primary cite for that term paper is Lutz. Lutz got most of his information from someone named Van Pelton (SP?, iirc) who ran a mission for some Tarahumara in Cree.

This is talked about in Born to run. A group of indians basically living in welfare off of a mission pretty far from their tradittional lives is not a good example of the tradittional life any more than visiting an Indian Casino is a good example of what it was like to be a Mohican. The author specifically visited and searched out Tarahumara who were living their traditional lifestyle away from civilization.

There are relatively few of these left as they’ve been uprooted and chased further and further from their native lands almost continuously since the 1600s.

But on to your items:

Superathletes vs. Superrunners? I stand behind my characterization of the Tarahumara as superathletes. I don’t think you get what a Tarahumara means by “running.” They live on the sides of sheer cliffs. They run up and down canyons and mountains, some of which are deeper than the grand canyon, across raging rivers and territories prone to flash flooding. Their main sport involves kicking a wood ball up and down these canyons and rivers and chasing after it. We think of “running” as putting one foot in front of the other and repeating at speed. Their running is a total body multi-sport activity.

Hygiene? Your term paper is wrong. The Tarahumara where bright white skirts and brilliantly (almost peacock type) shirts. They are pretty clean and hygienic. Again, perhaps your cite is thinking of the pathetic welfare Tarahumara of Cree. Google some pictures.

Here:

http://allwedoisrun.com/tarahumara.htm
Those clothes look nicer than what you or I normally wear. They dress like that all the time. Clearly they get washed more than “once or twice a year.” The stuff about just falling asleep whereever they get tired is total bullshit, as is the bracing next to a tree, according to the firsthand experience of the author who went to study them. I accept that over a sophomore’s report which frankly reads kind of racist to me.
Life Expectancy- I’ve seen that 45 figure cited multiple times, and it all comes back to Lutz and I’m not sure how he derived it. It may very well be true for all I know. The Tarahumara live in the near innacessible wilderness of Copper Canyon. So do the marijuana growers, who will customarily shoot the Tarahumara (or anyone who stumbles into their territory) on sight. One of their great champions lost his son in this fashion as the book was being written. It’s a common death. Then too, the flu and several other western diseases have wreaked on them as they tend to when indigenous peoples encounter modern humans.

What the average age is is not the point. A fifty year old Tarahumara won the Leadville 100 wearing tires! The book cites eyewitness accounts of 95 year old men going out for 30 miles up and down the equivalent of the Grand Canyon and across rivers.

The Cree mission from which much of Lutz (and your sophomore’s data) is derived even cites the onetime longevity of the Tarahumara as the world’s most long lived people prior to their Western encounters.

So no, you really can’t compare the welfare Tarahumara to the traditional Tarahumara.

Great point. When you’re 65 do you want to be 300 pounds, on oxygen, riding a rascal, or living in a nursing home watching tv while you wait 10 years in a medicated hell to die of congestive heart failure, or cancer, or would you rather be capable of running up and down mountains, and fucking hot chicks while in your 90s?

Because the congestive heart failure thing, you know, all those people in their 60s in scooters and oxygen, with diabetes, and cancer, and obesity… that doesn’t seem like success.

We have the ability to have the best of both worlds if we have the discipline.

Stone arches have cement holding them together. Pushing up on them weakens them. Physics makes an arch strong in one direction, only. It gets stronger the more you push down on it. The compression distributes the weight throughout the arch. That’s why we make bridges that way. Pushing up, puts all the pressure on the one point you are pushing. There is not distribution.

Supporting a foot arch is contradicting basic physics as well as millions of years of evolution which has “designed” a foot to support weight in that fashion.

Any mason knows an arch gets its strength from downward force and from the strength of its base.

Pushing up from underneath is stupid. Arch supports are stupid.

My point is that they can be. Arch supports are one example. Unnecessary surgeries are another. Did you know that knee cartilage can heal? Doctors have been performing arthroscopic surgery and permanently removing cartilage so that people’s knee joints are bone and bone, ensuring the need for knee replacement and effectively crippling people for life over recoverable injuries.

Michael Jackson had unlimited healthcare. Did it help or hurt him? Heath Ledger?

I’m not a holistic touchy feely guy saying we should all live without healthcare, but I think we expect a lot from our doctors and expect a surgical or medicinal intervention to proplems which are not really best solved by surgical or medicinal intervention.
Then again, perhaps it mostly really does suck. The book cites a study that shows 4 out of five runners in this country will be injured this year with foot, ankle, or knee problems.

You know what the correllation is? The cost of the shoes you wear. The higher the priced shoes, the more likely you are to get injured.

Orthopedists and sports doctors decided we could run faster, easier, if we could extend our stride. So, they designed shoes that let you land on your heel instead of the ball of your foot. They are cushioned to absorb the impact. Unfortunately that cushioning only works at the heel. The ankle and the knee takes the same impact as always. More in fact, since you are now landing in a fashion that puts stress on the joint in a way it was not evolved to handle.

If you put your arm in a cast it atrophies and gets weaker. We put our feet in bigger and more cushioned “casts” and expect them to get stronger?

Doctors used to prescribe leeches and drinking mercury for certain illnesses.

I think medical intervention is not something to be done lightly.

No.

I think we have to rethink our expectations of healthcare.

For example. Most of us with pets provide healthcare to them through a vet for their entire life and receive excellent care over their entire life for a modest cost without insurance.

In fact, I think overrall our pets receive better healthcare than we do. We have rational expectations of what a vet can do.

I propose that we step up a few notches and treat ourselves to healthcare as good as what we offer our dogs.

The Men Who Live Forever:
http://www.menshealth.com/cda/article.do?conitem=3b4b1ca01e91c010vgnvcm10000013281eac____

First off you’re not Cosmo Kramer, and I’m not Bob Sacomanto.

Second, say your dog has kidney failure, and you can’t afford treatment then your dog is put to sleep. Do you feel this is the ideal plan for humans?

How about say a kidney failure human patient has insurance, but the company manages to weasel out of their contract, should the person be killed?

No. I was painting broadly. Obviously modification is needed in upgrading human health care to veterinary standards.

I think standard, basic care could be made as cheap and available and reasonable as veterinary care is. I think one should be required to insure one’s children for catastrophic medical coverage, and if one fails to do so, I think there should be medicaid for children.

Once you’re an adult though, I think it’s your problem to either have the means to pay for major catostrophic illness, purchase insurance to cover it, or take your chances and live with the consequences.

Even in catastrophic medical circumstances though, I think we can upgrade. I think we painfully and expensively prolong the inevitable end of life process with heroic measures as a matter of custom. I respect a person’s right to have them if they want them and can arrange payment, but I do not think it is owed to them as a right.

It’s either covered or it’s not. If it is and the company won’t pay, that’s insurance fraud and the company should be held accountable.


On another note, you’re talking “put to sleep” and “killed.” I don’t favor that (though I do favor patient requested euthanasia. Nobody should be made to suffer.) There’s a difference between not providing heroic and expensive life sustaining measures free of charge to all who want them, and killing someone.

You didn’t rescue any of the thousands dying in the Congo today, did you? That doesn’t mean you killed them.

The only thing foot arches have in common with stone arches is the name. Your “physics” argument is stupid.

Not true. Stone arches have mortar. Foot arches have cartilage. Stone arches like the Brooklyn bridge have suspension cables. Foot arches have ligaments. Stone arches are designed to support weight from above. Foot arches have evolved to support weight from above. Stone arches compress and strengthen under load. Foot arches compress and strengthen under load. If you support a stone arch its ability to distribute weight disappears and the entire load is focussed on the support point. If you support a foot arch its ability to distribute weight disappears and the entire load is focussed on the support point.

It’s a pretty basic shape and the physics really isn’t open to argument.

Stone arches are rigid. Foot arches have evolved to flex.

A stone arch does in fact compress under load. A sensitive enough measurement of a stone bridge for example, will indeed show that bridge compressing and flexing as a load crosses it. This will happen in exactly the same way a foot arch will compress as the center of balance of a load moves across it.

The flexing and compressibility of various types of stone (i.e. concrete) is a carefully planned and accounted for quality in the architectural engineering and indeed different kinds of concrete and masonry are formulated and used for different applications based on their ability to flex. The Hoover dam is designed to flex, as are the concrete foundations of skyscrapers. Rebar would not be needed if concrete did not flex.

For all intents and purposes bone is stone, cartilage is mortar, ligaments are support cables.

Many architectural principles are reflected in nature is there are some mechanical engineering type problems in both that present a highly efficient solution. The arch is one such.
Anyway, stone does flex, so this is a very silly argument you’re making.
The Ponte Pietra, a stone bridge built in 100 bc is designed to flex with its spandrel based cantilevered arch, so this argument has been settled for at least 2100 years.

Do you have any cite that I can read without having to buy?

Sorry, I wasn’t paying close enough attention. However, the paper is cited, and was backed up by other articles I found that stated a similar life expectancy.

Sounds similar to what many of the people do in parts of Peru (among other places). When I visited Colca Canyon (twice as deep as the Grand Canyon), I met plenty of locals that ran up and down the canyon at an phenomenal pace. I wouldn’t automatically call them great athletes. They were able to do it because they have to. Even the dogs there can climb at a great pace. Either way, I don’t get why you think this is relevant to the health of people in the developed world.

Is this guy wrong too?

But can they read a book, or use a computer? Can they do anything that actually makes the world run smoothly, or makes it a better place to live? If people dedicated their entire life to fitness and running, I’m sure we’d be in better shape, but we would also be a lot poorer, less educated, and less well rounded.

And the average age makes a huge difference. When the weak are weeded out, the survivors often seem a lot more special. Even our society has its outliers that would seem far more common if we stopped saving the weak among us. For example, Jack LaLane swam 1.5 miles, while towing 70 boats with 70 people at the age of 70. Gary Firth (52 years old) runs marathons while pushing his disabled son in a wheelchair. Our society is full of people like them- people who dedicate their lives to one thing to the exclusion of everything else. We could probably have a society full of people like that, but the problem would be that all those Jack LaLane clones wouldn’t cure diseases, build satellites, design buildings, etc.

More importantly, I would never want to live in a place where the average life expectancy was 45. The fact that you can gloss over that says a lot.

I’m not quite sure what this means. Is one group a subset of the other?

But in the land of the Tarahumara, that person would have probably died long before then.

It is when you consider that in nearly any other time, and most other countries, that person would have died long ago. This utopia you seem to envision doesn’t exist in my opinion. Some people are much weaker than others. Either you can try to find ways to help those people live a fruitful life, or you can let them die.

Complete nonsense.

Another great example is the Leonardo bridge, designed by… Leonardo de vinci. This was to be the masonry bridge ever (Leo not having access to modern building materials.)

Anyhow, the bridge design pretty conclusively demonstrates the flexing of stone arches (which Leo would have been aware of.) The issue with stone isn’t that it doesn’t flex, just that it is brittle and doesn’t flex a lot without breaking.

Without Flex stone, modern concrete formulation, rebar or what have you, De Vinci designed a series of concentric arches into his bridge. This enable him to produce a relatively flat arch for the deck of the bridge. As it flexed under load it would transfer its force to the steeper concentric arch within the flat arch. This was an elegant solution that enabled him to have a relatively flat bridge surface while still gaining the benefit of the compressive strength of a steep arch… all thanks to the flexible qualities of masonry!
www.vebjorn-sand.com/ images/norwegian_bridge.jpg

So, what you’re saying is, da Vinci, recognizing that an arch alone would not support the weight that would be on top of it, reinforced it with a series of under-arches… and this supports your notion that arches in shoes is a bad thing how exactly?

I stand corrected, and the fault is mine. The context was plane crashes caused by mechanical failures, not plane crashes in general.

Gonzales cites Perrow’s analysis of tightly coupled systems and gives and example of an FAA certified “safety” coffeemaker that has caused several disasters due to design flaws built in with the intent of making it safer. Same with a toilet.

These were examples of seemingly innocuous safety designs that presented serious design flaws in tightly coupled systems.

The context was only about mechanical failures. I carelessly made this specific claim a general one.

My bad. Good catch.

Well no. I’m using that to show flexing of masonry. The wooden bridge picture you are looking at is not a faithful redesign of the Da Vinci bridge, but merely inspired by the engineering concept of several arches creating a single arch.

The oil painting shows you a better representation of Da Vinci’s actual design. I’m explaining it badly, but there are basically three arches in that design within the bridge. You have the flat main span of the bridge surface as one flat arch. You have one arch angling in from one side. You have the third from the other. All three combined form one large single unsupported arch. This gives you the desirable characteristics of a less steep walking surface but the strength of a deep compressive arch.

The impractical feature of Da Vinci’s design is the very wide base (almost a dome) that would be needed, making it difficult and expensive to actually construct. Now that I think about it, Da Vinci’s bridge is not unlike the arch in the foot.

Yeah now that I pointed it out, and how your example directly contradicts what you asserted earlier: that arch supports in shoes are unnecessary and actually weaken the foot. Arch supports support the arch, in your shoe and in da Vinci’s bridge.

That sounds like anecdotes, not analysis. The data in my cite show no increase in the percent of crashes due to mechanical failure since the 50s, despite the increasing complexity of airplanes.