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rdmcfee

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from Vancouver, Canada

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A single payer system is a step in the right direction, however, there are deeper issues with the American healthcare system.

The unit cost of healthcare is so much higher than in other developed countries.

In British Columbia, physicians bill at total of around $31 CAD ($23 USD) for a standard office visit. They pay all their overhead out of this fee. Typically doctors keep 65% of their billings and the offices take 35% for overhead. From what I can tell, a similar visit in Washington State will run between $60 and $200 USD when billed to insurance.

Why is this the case? What are the factors in the American system that prevent reasonable pricing?

http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/med...

There are two core issues with nutrition science.

The first issue is that it's extremely difficult to run a long term controlled study on nutrition. Adherence to diet interventions is difficult to measure and it drops off over time. As a result most nutrition studies are epidemiological cohort studies which are not particularly good at determining causality.

The second issue is a question of funding. Diet and exercise interventions are not something that are typically monetized be the pharmaceutical industry. As such there is little private sector funding going into nutrition studies. Couple that with the fact that they're extremely expensive and you have a serious deficit in studies.

We Vancouverites are spoiled. I just finished an 18 month stint in the Bay Area. One of the biggest inconveniences was the driving time (especially with traffic) to get to the mountains.

In Seattle now and it's a great compromise. Similar wages to the Bay Area but similar geography and outdoor access as Vancouver. And even with the exchange rate housing is cheaper than Vancouver.

The more time I spend in this industry the more I realize how many software engineers leave salary on the table.

It's great to see a tool like this which both encourage software engineers to negotiate their salary, and help them strengthen their bargaining position.

Sure, the correlation is statistically significant. Without a control to infer causality the results become much less interesting.

To infer causality in an epidemiological study such as this you need very large cohorts with very specific results.

Even with huge cohorts you still have relatively indefensible results. The 7 country study is a good example: https://en.wikipedia.org/wiki/Seven_Countries_Study

I'm a big fan of personal experimentation but it's important to always be skeptical of your own n=1 conclusions.

In this particular case, coinciding the interventions of your diet change and exercise regiment make it very difficult to know the respective contribution of each to your results.

Interesting anecdotes nonetheless.

Does it not seem possible that many of the factors leading to this gender grouping are influenced by biological age? For example, research shows that our brains are hugely influenceable until our mid to late 20's. At that point major pathways have been established which influence our thinking for the rest of our lives.

What if we counter aging such that people never leave their peak physical condition? (25 years old?)

Will they still group by the generation in which they were born?

I think this is a complex issue. I suspect that like with cars, many of these folks would have the option to buy a used item which is equally as functional for something like 20% of the price of a new item. Again, like cars, household items depreciate extremely rapidly.

There's clearly some blame to go around. Better public education on financial decision making would help. The companies providing this type of financing could alter their business model or screening processes.

Also, it seems that many lower income individuals strive to own new items because it portrays financial success even if it results in the opposite.

In addition to having similar liquor license quotas, British Columbians pay a markup of 123% for wine and 170% for spirits. Our provincial liquor board generates $1.2B per year from a population of only 4.5 million people. There are different dynamics here as we have public health insurance. Liquor and tobacco sin taxes are a form of pre-payment on future healthcare expenses of heavy consumers.

Yeah it's interesting how ancient cultures seemed to have (by trial and error I suppose) incorporated specific behaviors into their culture which, in hindsight, solve a particular problem that can be scientifically identified.

An example I love is the Canadian Inuit who traditionally ate no vegetables for 10+ months of the year without developing scurvy. The tradition of eating raw whale blubber and fish (including the broth) preserved the vitamin C and minerals from the mea, while eating cooked meat without broth drastically reduces mineral and vitamin intake.

I don't know that the biological benefits of fasting are associated directly with cultural fasting patterns in our ancestry.

I suspect they're more linked with our ancestral hunter-gatherer traits. It seems logical that early humans would go periods of time without eating while hunting, then consume a large amount of protein and fat in a short period of time.

Religious and cultural fasting, however, would likely have not occurred until the development of language which is estimated at 20k-50k years ago. That's not a particularly long time on an evolutionary scale.