Silicon Valley's product strategy won't work with health care, says Apple veteran

Posted:
in General Discussion
Robin Goldstein, a former Apple executive who served most recently as Senior Manager of Health Special Projects, assails the tech industry's approach to health tech.

Health records


In an opinion piece published to CNBC's website Thursday Robin Goldstein, who served in a wide variety of roles in her 22-year career at Apple, argues tech companies need to take a different approach to product failure when it comes to health-related devices. In particular, the "fast fail" strategy is not an option.

"This is the mindset Silicon Valley has brought to every space it enters: A bad product or poor user experience doesn't have any ramifications beyond that particular product or experience, and they can always wipe the slate clean and start again," Goldstein writes. "In the world of digital health this is a big problem."

There are three reasons for this, according to the author. The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider," and that the old adage, "You don't get a second chance to make a first impression," applies especially to the health sector.

She mentions Theranos, the controversial blood testing startup that collapsed last year in scandal and indictments, leading to the company's official dissolution earlier this week. Theranos sought to emulate Apple, while its founder Elizabeth Holmes saw herself as a new Steve Jobs, but the company not only failed to come up with a working product, but was allegedly committing fraud.

"Every new microfluidics testing venture is now subject to both increased scrutiny and has to to overcome a general suspicion regarding the technology, its effectiveness, and actual benefits," Goldstein writes. "In other words, everyone who follows Theranos has the burden of proving they're not Theranos before even getting to the question of whether their product will pass the risk/benefit analysis discussed above."

Goldstein's piece, aside from the sharing of her credentials, does not mention Apple directly, nor does it refer specifically to any of Apple's initiatives. Apple has launched some ambitious health-related products in the last year, including a huge health records digitization effort, while numerous news stories have had Apple Watches literally saving users' lives.

"The size of the healthcare market and relative ease with which products can be developed, as well as the current appeal of applying algorithms and machine learning to the imprecision of the human body, requires that extra care be taken," Goldstein writes. "High tech cannot view digital health as simply the next great market opportunity.

Goldstein, according to her LinkedIn page, left Apple after 22 years in November 2017. Her final title was Senior Manager for Health Special Projects, and she had previously served principal counsel, and senior engineering manager and NewtonOS product marketing manager.

Some emails that surfaced in 2016 had Goldstein, then an attorney for Apple's health division, expressing interest in cardiac monitoring hardware, and Parkinson's support.
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Comments

  • Reply 1 of 27
    thrangthrang Posts: 727member
    Apple seems insanely careful to NOT do what she says is endemic in the tech industry. It doesn't mean they don't swing and miss on occasion, but I suspect Apple is treading VERY deliberately with Health initiatives...
    lollivermwhitepatchythepiratetmayRayz2016watto_cobraairnerdmike1cyberzombiebrucemc
  • Reply 2 of 27
    rob53rob53 Posts: 1,902member
    I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 
    watto_cobraGeorgeBMac
  • Reply 3 of 27
    The fast fail strategy not only does not work in health care, it also doesn't work in self-driving cars.  Sadly, a few lives had to be sacrificed before Silicon Valley finally learned that lesson.
    sweetheart777
  • Reply 4 of 27
    sflocalsflocal Posts: 4,200member
    rob53 said:
    I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 
    The caution in the industry caused by the implosion of Theranos and the outing of Elizabeth Holmes as a fraud was I think a necessity.  People were claiming the next big thing and essentially throwing a smoke-screen at the faces of investors.  I'm actually glad that now everyone has to basically prove that they're not producing some kind of vaporware and pretend it's real.

    I just started reading "Bad Blood", a book about Elizabeth Holmes and Theranos.  I'm only in a few chapters, and even then I'm stunned at the fraud she was already doing at the beginning.  She did a demo which didn't work, but on the monitor were pre-recorded results from an entirely different test.  She lied about it and when confronted about it by her then first CFO (Henry Mosley), she fired him on the spot for not being a "team player".  Disgusting.  She has serious issues.
    patchythepirateStrangeDayswatto_cobraJWSC
  • Reply 5 of 27
    rob53rob53 Posts: 1,902member
    sflocal said:
    rob53 said:
    I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 
    The caution in the industry caused by the implosion of Theranos and the outing of Elizabeth Holmes as a fraud was I think a necessity.  People were claiming the next big thing and essentially throwing a smoke-screen at the faces of investors.  I'm actually glad that now everyone has to basically prove that they're not producing some kind of vaporware and pretend it's real.

    I just started reading "Bad Blood", a book about Elizabeth Holmes and Theranos.  I'm only in a few chapters, and even then I'm stunned at the fraud she was already doing at the beginning.  She did a demo which didn't work, but on the monitor were pre-recorded results from an entirely different test.  She lied about it and when confronted about it by her then first CFO (Henry Mosley), she fired him on the spot for not being a "team player".  Disgusting.  She has serious issues.
    I chuckled when I saw your comment about vaporware. That's how it's been since the beginning of computers and it's still prevalent with all the early announcements of products that never quite seem to come to market. The medical field is no exception with all their new drugs, both FDA-approved and not, being broadcast every day on TV. We haven't changed and I doubt any market will. 
    watto_cobra
  • Reply 6 of 27
    SoliSoli Posts: 8,193member
    thrang said:
    Apple seems insanely careful to NOT do what she says is endemic in the tech industry. It doesn't mean they don't swing and miss on occasion, but I suspect Apple is treading VERY deliberately with Health initiatives…
    It certainly seems like Apple is being more careful (and less exploitive) than many health-based companies: Theranos, Martin Shkreli, whomever makes EpiPen, any whomever makes Fentanyl, and all the companies that have used lobbyists to push their opioids, boner pills, etc.

    I feel like Apple has a better moral center as a company than most, but being so large they probably have to be more careful because there's so much focus on them and lawsuits are more likely to happen as a result.

    edited September 6 watto_cobra
  • Reply 7 of 27
    Hmm... based on her history (Newton), she is well-versed in failed products.  Product marketing folks are typically the team that works to develop the product roadmap based on technology innovation, understanding of the market, etc.  

    Newton was a flawed product that eventually worked, but too late. Palm capitalized on the handwriting recognition using a simplified solution.  

    The last Newton I used at a PC Expo tradeshow booth in 1998 in NYC. It was coupled to an IR scanner that would read barcodes of visitors to our booth who were interested in our tech product.  Clunky by today’s standards, but it worked. 
    watto_cobra
  • Reply 8 of 27
    The truth is out there
    watto_cobra
  • Reply 9 of 27
    thrang said:
    Apple seems insanely careful to NOT do what she says is endemic in the tech industry. It doesn't mean they don't swing and miss on occasion, but I suspect Apple is treading VERY deliberately with Health initiatives...
    True, because (and you likely know this but not many others) the chairman of the board of Apple is Dr. Art Levinson, erstwhile CEO of biotech giant Genentech until they were absorbed by Roche.   He certainly knows about proceeding deliberately with the inherently conservative FDA, achieving successful scientific outcomes with statistical significance, and marketing any resulting medical products with aplomb, not bombast.   Dr. Levinson is an enormous behind-the-scenes mover and shaker of Apple Inc.
    edited September 6 Soliwatto_cobraJWSCHypereality
  • Reply 10 of 27
    irelandireland Posts: 17,388member
    Sounds to me as if her piece is a warning to investors of health tech startups.
    Soliwatto_cobra
  • Reply 11 of 27
    rob53 said:
    I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 
    I would go a step farther. Theranos was at root a fraud. They never had a product that worked. They never had anything like a product that worked. They knew they could not make a product that worked. It was a straight up fraud from the moment they had the idea. That really is a bit different from Apple or Google, or whomever that have a working model, an actual hardware device that does something, but may fall short of standards.

    That said, Apple needs to, and is, following a very careful and cautious strategy toward medical devices. I would expect other companies will announce wrist band/watch devices for blood pressure, glucose, and other monitoring just so they can beat Apple to market. They will fail. The real competition will then come from the established medical device makers, who you can be sure are working very hard to get a working, reliable, tested, product to market. It very well may come down to would you rather buy a needle-less glucose monitoring wrist device from Apple or Accu-Check. The latter is a known company in that space.
    edited September 7
  • Reply 12 of 27
    Robin Goldstein,  The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider,"
    That's rather a one-sided defense of a broken industry.
    The fact is:  We do not have a HealthCare industry.   We have a DiseaseCare industry run by large corporations that put their profit before our health.  And, in fact, the adage is very much true:
    "There's no money in dead people.  There's no money in healthy people.  The money is in the walking dead."

    And, that DiseaseCare industry is supporting itself in every way that it can -- including blocking tech devices that promote health by not recognizing their utility to promote health.   They want to keep "healthcare" under their control and their umbrella.  And, they use the FDA as cover to block consumer grade medical devices from becoming "medical devices".  Another strategy is to create a culture among healthcare professionals to not trust these devices or recognize their utility.   So:  you go to a doctor and show him your results and he disses them and ignore them.

    Meanwhile, at $3 Trillion a year that DiseaseCare industry is bankrupting our nation while doing nothing to actually promote health!  (And no, treating a disease is not promoting health!).

    That is, 75% of that $3 Trillion is spent treating the symptoms of chronic diseases -- 50% of which could have been prevented with a healthy lifestyle.   It is THAT that Apple and other tech products can impact by promoting healthy lifestyles -- and what our DiseaseCare industry is fighting tooth and nail.

    (Which is not to say that Apple doesn't have to recognize and respect the power of that DiseaseCare industry.  It's just that they don't need to be controlled by it as GoldStein implies.)
  • Reply 13 of 27
    And, that DiseaseCare industry is supporting itself in every way that it can -- including blocking tech devices that promote health by not recognizing their utility to promote health.   They want to keep "healthcare" under their control and their umbrella.  And, they use the FDA as cover to block consumer grade medical devices from becoming "medical devices".  Another strategy is to create a culture among healthcare professionals to not trust these devices or recognize their utility.   So:  you go to a doctor and show him your results and he disses them and ignore them.
    ...
    That is, 75% of that $3 Trillion is spent treating the symptoms of chronic diseases -- 50% of which could have been prevented with a healthy lifestyle.   It is THAT that Apple and other tech products can impact by promoting healthy lifestyles -- and what our DiseaseCare industry is fighting tooth and nail.

    Pray tell, what "consumer grade medical devices" have been "blocked" by the FDA? 
    JWSC
  • Reply 14 of 27
    zoetmbzoetmb Posts: 2,314member
    Robin Goldstein,  The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider,"

    That is, 75% of that $3 Trillion is spent treating the symptoms of chronic diseases -- 50% of which could have been prevented with a healthy lifestyle.   It is THAT that Apple and other tech products can impact by promoting healthy lifestyles -- and what our DiseaseCare industry is fighting tooth and nail.

    Please.  You can't force people to lead a healthy lifestyle. There are millions of people in this country who rarely eat much besides high-fat, high-salt, high-sugar processed carbs and who never exercise beyond walking around a shopping mall, if that.   In 2015-16, the incidence of obesity in the U.S. was 39% and it's continually rising. 

    Walk into a Walmart or big-box store that sells food and watch what people load into their shopping carts and the size of their bodies.   33 million Americans ate 16 or more bags of potato chips in 2017.  In 2016, 15% of adults over 18 still smoked in the U.S.    There are plenty of people in this country who never really walk at all as they live and work in environments where they drive everywhere.    A CDC study found that almost 90 percent of adults in the United States failed to meet government recommendations for vegetable intake.                                               

    That's not to say that health care in the U.S. isn't a disaster, but it's not the fault of the medical profession that Americans don't take care of their health.   It's their own stupidity, the culture of instant gratification, an addiction to fat and sugar and the refusal to take responsibility for their own actions.    While it may be true that doctors and medical institutions make their money from treating disease instead of preventing, how could a doctor or hospital help Americans lead a healthier lifestyle?  The reality is they can't.   I don't know of any doctor who doesn't regularly say, "you should lose some weight" or "your blood pressure would be lower if you lost weight" or "you're going to be diabetic unless you lose weight and reduce carbs."   

     

     

    edited September 7 JWSC
  • Reply 15 of 27
    JWSCJWSC Posts: 142member
    Robin Goldstein,  The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider,"
    That's rather a one-sided defense of a broken industry.
    The fact is:  We do not have a HealthCare industry.   We have a DiseaseCare industry run by large corporations that put their profit before our health.  And, in fact, the adage is very much true:
    "There's no money in dead people.  There's no money in healthy people.  The money is in the walking dead."

    And, that DiseaseCare industry is supporting itself in every way that it can -- including blocking tech devices that promote health by not recognizing their utility to promote health.   They want to keep "healthcare" under their control and their umbrella.  And, they use the FDA as cover to block consumer grade medical devices from becoming "medical devices".  Another strategy is to create a culture among healthcare professionals to not trust these devices or recognize their utility.   So:  you go to a doctor and show him your results and he disses them and ignore them.

    Meanwhile, at $3 Trillion a year that DiseaseCare industry is bankrupting our nation while doing nothing to actually promote health!  (And no, treating a disease is not promoting health!).

    That is, 75% of that $3 Trillion is spent treating the symptoms of chronic diseases -- 50% of which could have been prevented with a healthy lifestyle.   It is THAT that Apple and other tech products can impact by promoting healthy lifestyles -- and what our DiseaseCare industry is fighting tooth and nail.

    (Which is not to say that Apple doesn't have to recognize and respect the power of that DiseaseCare industry.  It's just that they don't need to be controlled by it as GoldStein implies.)

    GBM, we all know the healthcare industry has some serious problems when it comes to accounting/billing practices, patchy use of actuarial data, and an emerging reproducibility crisis in medical research.  But your’s is an exceedingly negative view of the industry.  Healthcare is likely the single most regulated industry in the US.  By its nature it is subject to multimillion dollar lawsuits on a regular basis.  These factors would take their efficiency toll on any industry.

    You will always find bad actors in any industry.  But to paint the entire healthcare industry as a corrupting influence on the nation’s health is deeply misguided and rather one-sided as well.  The vast majority of people in healthcare (and I include managerial leadership) are good people who are committed to providing the best services and care possible to their customers.  They do this in spite of the many burdensome regulations they must comply with and the constant risk of lawsuits.

    From my own experience, my company’s healthcare provider offers ample incentives for employees to maintain their health through several different rewards programs.  My provider knows full well that it costs much less to fund preventative care than to fund emergency care or care for those already suffering from disease or injury.


    edited September 7
  • Reply 16 of 27
    zoetmb said:

    Please.  You can't force people to lead a healthy lifestyle. There are millions of people in this country who rarely eat much besides high-fat, high-salt, high-sugar processed carbs and who never exercise beyond walking around a shopping mall, if that.   In 2015-16, the incidence of obesity in the U.S. was 39% and it's continually rising. 

    Walk into a Walmart or big-box store that sells food and watch what people load into their shopping carts and the size of their bodies.   33 million Americans ate 16 or more bags of potato chips in 2017.  In 2016, 15% of adults over 18 still smoked in the U.S.    There are plenty of people in this country who never really walk at all as they live and work in environments where they drive everywhere.    A CDC study found that almost 90 percent of adults in the United States failed to meet government recommendations for vegetable intake.                                               

    That's not to say that health care in the U.S. isn't a disaster, but it's not the fault of the medical profession that Americans don't take care of their health.   It's their own stupidity, the culture of instant gratification, an addiction to fat and sugar and the refusal to take responsibility for their own actions.    While it may be true that doctors and medical institutions make their money from treating disease instead of preventing, how could a doctor or hospital help Americans lead a healthier lifestyle?  The reality is they can't.   I don't know of any doctor who doesn't regularly say, "you should lose some weight" or "your blood pressure would be lower if you lost weight" or "you're going to be diabetic unless you lose weight and reduce carbs."   

    Yep, you're pretty much on target here. 

    It's America. You can choose to make bad decisions if you want to––don't study, don't brush, don't move, drink and eat poorly, etc. As always, there are consequences, both personal and societal, but you're still free to eat what you want, weigh what you want, and be as stationary as you want. 

    You can't say you've never been told to shape up in all those regards because doctors are in some secret industry cabal to undermine your health. They usually have much better things to do.
  • Reply 17 of 27
    zoetmb said:
    Robin Goldstein,  The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider,"

    That is, 75% of that $3 Trillion is spent treating the symptoms of chronic diseases -- 50% of which could have been prevented with a healthy lifestyle.   It is THAT that Apple and other tech products can impact by promoting healthy lifestyles -- and what our DiseaseCare industry is fighting tooth and nail.

    Please.  You can't force people to lead a healthy lifestyle. There are millions of people in this country who rarely eat much besides high-fat, high-salt, high-sugar processed carbs and who never exercise beyond walking around a shopping mall, if that.   In 2015-16, the incidence of obesity in the U.S. was 39% and it's continually rising. 

    Walk into a Walmart or big-box store that sells food and watch what people load into their shopping carts and the size of their bodies.   33 million Americans ate 16 or more bags of potato chips in 2017.  In 2016, 15% of adults over 18 still smoked in the U.S.    There are plenty of people in this country who never really walk at all as they live and work in environments where they drive everywhere.    A CDC study found that almost 90 percent of adults in the United States failed to meet government recommendations for vegetable intake.                                               

    That's not to say that health care in the U.S. isn't a disaster, but it's not the fault of the medical profession that Americans don't take care of their health.   It's their own stupidity, the culture of instant gratification, an addiction to fat and sugar and the refusal to take responsibility for their own actions.    While it may be true that doctors and medical institutions make their money from treating disease instead of preventing, how could a doctor or hospital help Americans lead a healthier lifestyle?  The reality is they can't.   I don't know of any doctor who doesn't regularly say, "you should lose some weight" or "your blood pressure would be lower if you lost weight" or "you're going to be diabetic unless you lose weight and reduce carbs."   

     

     

    LOL... You make a pretty convincing case for why we need to emphasize HealthCare over DiseaseCare!

    But, when you say " but it's not the fault of the medical profession that Americans don't take care of their health".   You are only partially correct:   Privately, most physicians agree that they give healthy lifestyles a wink and a nod before prescribing their pills and procedures.  But most work for large organizations who tell them how to do their jobs which is generally:   Mention losing weight, eating "healthy" and exercise, then prescribe the pill of procedure.  But, I agree with that publically, the DiseaseCare's answer to HealthCare is:   "Ain't my job!"

    And, you ask, "How could a doctor or hospital help Americans lead a healthier lifestyle?"
    For hospitals:   Bellview in NY, the nation's older hospital, is initiating a nutrition program to educate, train and support people in eating a healthier diet.   That includes how to shop/select healthy foods, how to prepare it, and ongoing support when they run into difficulties -- because eating healthy in America is hard!

    For physicians:  it would have to be team effort with nutritionists,  exercise physiologists and health coaches again educating, training and supporting the patient while the physician monitors the results and progress and provides DiseaseCare when necessary (which it usually isn't if the program is being followed.   The number one cardiology center in the nation, the Cleveland Clinic already has multiple programs using that approach:  one is their preventive cardiology department, the other is their functional medicine department and a third is their wellness center.  All of them have had impressive results.

    The problem is not lack of ability.   It's mostly lack of reimbursement.  But these organizations seem to have overcome that obstacle.

    Obviously, it CAN be done!
  • Reply 18 of 27
    JWSC said:
    Robin Goldstein,  The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider,"
    That's rather a one-sided defense of a broken industry.
    The fact is:  We do not have a HealthCare industry.   We have a DiseaseCare industry run by large corporations that put their profit before our health.  And, in fact, the adage is very much true:
    "There's no money in dead people.  There's no money in healthy people.  The money is in the walking dead."

    And, that DiseaseCare industry is supporting itself in every way that it can -- including blocking tech devices that promote health by not recognizing their utility to promote health.   They want to keep "healthcare" under their control and their umbrella.  And, they use the FDA as cover to block consumer grade medical devices from becoming "medical devices".  Another strategy is to create a culture among healthcare professionals to not trust these devices or recognize their utility.   So:  you go to a doctor and show him your results and he disses them and ignore them.

    Meanwhile, at $3 Trillion a year that DiseaseCare industry is bankrupting our nation while doing nothing to actually promote health!  (And no, treating a disease is not promoting health!).

    That is, 75% of that $3 Trillion is spent treating the symptoms of chronic diseases -- 50% of which could have been prevented with a healthy lifestyle.   It is THAT that Apple and other tech products can impact by promoting healthy lifestyles -- and what our DiseaseCare industry is fighting tooth and nail.

    (Which is not to say that Apple doesn't have to recognize and respect the power of that DiseaseCare industry.  It's just that they don't need to be controlled by it as GoldStein implies.)

    GBM, we all know the healthcare industry has some serious problems when it comes to accounting/billing practices, patchy use of actuarial data, and an emerging reproducibility crisis in medical research.  But your’s is an exceedingly negative view of the industry.  Healthcare is likely the single most regulated industry in the US.  By its nature it is subject to multimillion dollar lawsuits on a regular basis.  These factors would take their efficiency toll on any industry.

    You will always find bad actors in any industry.  But to paint the entire healthcare industry as a corrupting influence on the nation’s health is deeply misguided and rather one-sided as well.  The vast majority of people in healthcare (and I include managerial leadership) are good people who are committed to providing the best services and care possible to their customers.  They do this in spite of the many burdensome regulations they must comply with and the constant risk of lawsuits.

    From my own experience, my company’s healthcare provider offers ample incentives for employees to maintain their health through several different rewards programs.  My provider knows full well that it costs much less to fund preventative care than to fund emergency care or care for those already suffering from disease or injury.


    I agree that I have negative view of the industry.   Most insiders do...  I'm not alone in that.

    And yes, most individuals in our DiseaseCare industry ARE good people trying to do their best.   But, the system and the large organizations who employ them don't give a damn about your health.   They're only interested in their profit.   And, the nurse and physician who works for them (yes, for them - not for you) better toe the line or they are out of a job.
  • Reply 19 of 27
    farmboy said:
    zoetmb said:

    Please.  You can't force people to lead a healthy lifestyle. There are millions of people in this country who rarely eat much besides high-fat, high-salt, high-sugar processed carbs and who never exercise beyond walking around a shopping mall, if that.   In 2015-16, the incidence of obesity in the U.S. was 39% and it's continually rising. 

    Walk into a Walmart or big-box store that sells food and watch what people load into their shopping carts and the size of their bodies.   33 million Americans ate 16 or more bags of potato chips in 2017.  In 2016, 15% of adults over 18 still smoked in the U.S.    There are plenty of people in this country who never really walk at all as they live and work in environments where they drive everywhere.    A CDC study found that almost 90 percent of adults in the United States failed to meet government recommendations for vegetable intake.                                               

    That's not to say that health care in the U.S. isn't a disaster, but it's not the fault of the medical profession that Americans don't take care of their health.   It's their own stupidity, the culture of instant gratification, an addiction to fat and sugar and the refusal to take responsibility for their own actions.    While it may be true that doctors and medical institutions make their money from treating disease instead of preventing, how could a doctor or hospital help Americans lead a healthier lifestyle?  The reality is they can't.   I don't know of any doctor who doesn't regularly say, "you should lose some weight" or "your blood pressure would be lower if you lost weight" or "you're going to be diabetic unless you lose weight and reduce carbs."   

    Yep, you're pretty much on target here. 

    It's America. You can choose to make bad decisions if you want to––don't study, don't brush, don't move, drink and eat poorly, etc. As always, there are consequences, both personal and societal, but you're still free to eat what you want, weigh what you want, and be as stationary as you want. 

    You can't say you've never been told to shape up in all those regards because doctors are in some secret industry cabal to undermine your health. They usually have much better things to do.
    Yep!   And don't you worry Farmboy!   We'll pay to treat the diseases you created with your bad choices.   That's why our DiseaseCare system is racking up a $3 Trillion a year bill!

    Maybe we should go back to before the ACA where those who got sick couldn't get insurance to pay for their DiseaseCare.   That would solve the money problem.   It would be killing the Americans who make those bad choices (and some who just had bad luck or bad genes).   But at least it would save money.  Do Ya Think It Would Work?
  • Reply 20 of 27
    SoliSoli Posts: 8,193member
    farmboy said:
    zoetmb said:

    Please.  You can't force people to lead a healthy lifestyle. There are millions of people in this country who rarely eat much besides high-fat, high-salt, high-sugar processed carbs and who never exercise beyond walking around a shopping mall, if that.   In 2015-16, the incidence of obesity in the U.S. was 39% and it's continually rising. 

    Walk into a Walmart or big-box store that sells food and watch what people load into their shopping carts and the size of their bodies.   33 million Americans ate 16 or more bags of potato chips in 2017.  In 2016, 15% of adults over 18 still smoked in the U.S.    There are plenty of people in this country who never really walk at all as they live and work in environments where they drive everywhere.    A CDC study found that almost 90 percent of adults in the United States failed to meet government recommendations for vegetable intake.                                               

    That's not to say that health care in the U.S. isn't a disaster, but it's not the fault of the medical profession that Americans don't take care of their health.   It's their own stupidity, the culture of instant gratification, an addiction to fat and sugar and the refusal to take responsibility for their own actions.    While it may be true that doctors and medical institutions make their money from treating disease instead of preventing, how could a doctor or hospital help Americans lead a healthier lifestyle?  The reality is they can't.   I don't know of any doctor who doesn't regularly say, "you should lose some weight" or "your blood pressure would be lower if you lost weight" or "you're going to be diabetic unless you lose weight and reduce carbs."   

    Yep, you're pretty much on target here. 

    It's America. You can choose to make bad decisions if you want to––don't study, don't brush, don't move, drink and eat poorly, etc. As always, there are consequences, both personal and societal, but you're still free to eat what you want, weigh what you want, and be as stationary as you want. 

    You can't say you've never been told to shape up in all those regards because doctors are in some secret industry cabal to undermine your health. They usually have much better things to do.
    Yep!   And don't you worry Farmboy!   We'll pay to treat the diseases you created with your bad choices.   That's why our DiseaseCare system is racking up a $3 Trillion a year bill!

    Maybe we should go back to before the ACA where those who got sick couldn't get insurance to pay for their DiseaseCare.   That would solve the money problem.   It would be killing the Americans who make those bad choices (and some who just had bad luck or bad genes).   But at least it would save money.  Do Ya Think It Would Work?
    Are you suggesting that all diseases have a casualty that is created by the infected person's choices? Do you really not think that we should have experts dealing with diseases as well as preventive medicine?
    edited September 7
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