Medicine’s another thing he doesn’t know about then

His next grift.

“Tax – the health giving miracle”

Pfffftt… Any fule knows that the only natural sweetener that Cures All Ails is that most natural of products : Honey!

So he wants to tax highly processed foods?
The vegans won’t be happy

He does have a sort of point in his garbled outpouring.

The term T2 diabetes is a catchall for a number of symptoms. The best way to reduce those symptoms is to lose weight and get fit. However, big Pharma has developed drugs that also alleviate those symptoms so now sufferers don’t have a choice between losing weight or dying but between losing weight or taking drugs.

Most people choose the latter.

Of course that’s a gross generalisation, so don’t shout at me 🙂

Sigh.

There is no such thing as “Ultra Processed Food”. It is a catch all term to describe different things to different people. As such, it cannot, EVER, form a serious part of the study of dietetics as you cannot measure something that isn’t defined. It’s bullshit, which is why Dr Chris Von Grift has to spend much of his awful book slagging off proper dietetics research, as otherwise he can’t come to the conclusions he does.

Am I surprised that Dr Grift and Mr Account Grift have a meeting of mnds on the subject? No. Am I disappointed that the universe wastes oxygen on these two? Obviously.

“My two can cook – not Master Chef, but edible. It helped that they were fed by their dad, quite often.”

Can one infer a dig at the ex Mrs Murphy’s domestic skills?

Virtue signalling – look at me I’m the epitome of a modern dad.

Isn’t so obvious to me that socialis/zed medicine is causing obesity, given obesity prevalence in USA vs Canada vs Europe or these days even places like India. Modern, increasingly sedentary, lifestyle and material abundance seem more likely candidates. People, at least the ever-increasing proportion who can afford to purchase the calories, like to stuff their mouths with cake even if they have to pay for the consequences (in monetary terms or health terms) and as far as I can see, they’ve done so throughout history. Tales of fat gluttonous unhealthy kings have been a thing since the year dot, haven’t they?

@JG’s path is commendable but it does take a degree of intentionality that renders it a minority pursuit, unfortunately. And likely an even smaller minority if drugs promise an easier route. But if that ease is the thing that ensures millions of people get those health and quality of life improvements, it’s still possible for the drugs to be a net positive for society despite their attendant harms. Likely not as good an outcome as we’d get if we all just collectively decided to pay attention to our health incentives and look after ourselves properly… but human nature doesn’t seem wired in that more effortful direction.

The satandard treatment for T2 is Metformin 500mg, 2 to 4 tablets a day.
There are 20 supplier on the NIHCE list. It’s a generic drug.
3p a tablet, 12p a day, less that £50 a year.
Monitoring blood tests probably cost more than that.
Who is getting rich?

No disputing that having to pay for your own medical treatment puts the financial incentives more squarely in front of the individual. But saying that makes the problem “self-correcting” looks very over-optimistic – the US obesity epidemic didn’t self-correct itself and the Indian one isn’t either.

At any rate, the medical costs aren’t necessarily more punishing than the quality of life costs. If the physical and emotional limitations of being fat and miserable aren’t an incentive to shape up, would the prospect of a drug bill, possibly decades hence, really tip someone over the “healthy living” edge? A lot of the drugs are cheap once they have become generic, the really gruesome expenses of type 2 diabetes come when you start having to think about amputations etc. Frankly, the main thing that puts me off having to have a foot amputated isn’t the prospect I might get invoiced for it.

It’s true collectivising health care costs turns personal problems into social problems. Same goes for the social security payments being made to people who are too sick to work because they’re too fat to be healthy. But as Chris Snowdon points out, this social burden is prone to exaggeration by “something must be done” health campaigners – it’s mitigated by the fact serious fatties tend to die young, at considerable saving to the Treasury.

In the US, the healthcare cost is still socialized, even if there’s no NHS.
The poor (Medicaid) and the old (65+) (Medicare) is directly government paid, and accounts for ~75% of healthcare spending in the US (but roughly 25-30% of population). Guess which demographics have the highest rate of T2 Diabetes and Hypertension?
Add in the almost ridiculous Obamacare subsidies, and ~90% of healthcare spending is directly or indirectly paid by government.

@Henry

Would be a more convincing argument if the US was a nation of fit and trim people before Obamacare came along, but fair enough, it would be wrong to treat it (as European politicians tend to scaremonger) like there’s no public health spending there whatsoever. In fact the public spending alone is comparable, per capita, to the NHS.

The fact so many people get health insurance through jobs is another problem with Jim’s claim that decollectivising health care solves the incentives issue – depending on copay etc, insurance via your employer can still mask the financial costs of your health treatment from you just like it would if the state pays. (Though you still feel the costs of ill health to personal wellbeing so it’s not like the incentives are totally removed.) The US is also unusual among rich countries in that about 8% of people are uninsured even now. Not many developed countries where more people really do feel the cost impact of health care directly – your bill coming out of your MediSave account in Singapore maybe, but even there they have a lot of public subsidies in MediFund/MediShield and top-ups for eligible elderly people’s MediSave.

I think the 90% government-paid figure for the US is off. From memory it’s nearer 50:50 once you include both local, state and federal government contributions. Quick Google suggests the national healthcare expenditure breakdown is 34% federal government, 15% state and local government for a total of 49%. Versus 27% by households, 17% by private businesses and 7% other private revenue. Still fair to describe US healthcare as less collectivised than Canada or most (all?) European systems. https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet#:~:text=The%20largest%20shares%20of%20total,the%20households%20(27%20percent).

When people say they want affordable health care, they are lying.

People don’t want affordable health care. When a spouse or a child or a parent is in need of health care in a serious way, affordability is not what pops to mind first and foremost. People want the best health care money can buy and they want someone else to pay for it.

All the problems in delivering appropriate levels of quality health care at an appropriate cost can be traced to this simple fact.

Your very simple test is flawed, Tim. US HFCS contains between 42% to 55% fructose and the rest (40%+) is largely glucose + some minor sugars. Fructose and glucose are monosaccharides. Sucrose, a disaccharide, is a sugar composed of glucose and fructose subunits, joined by a single ether bond; so table sugar is 50% fructose and 50% glucose. So there is little difference in fructose consumption between the two populations.

Where Spud is wrong is in claiming that fructose consumption is the main cause of type-2 diabetes. The EFSA regards fructose consumption as a low-risk factor for type-2 . This is partly because it does not trigger the production of insulin in the pancreas and also because it is metabolised exclusively in the liver whereas glucose can be metabolised in other tissues. And this is why type-2 diabetics, like my brother-in-law, can eat fruit as a dessert. Fructose is also 73% sweeter than sucrose at room temperature, allowing diabetics to use less of it per serving.

Fructose consumed before a meal seems to reduce the glycemic response of the meal. And fructose-sweetened food and beverage products cause less of a rise in blood glucose levels than do those manufactured with either sucrose or glucose. So it looks like Spud is barking up the wrong tree.

@Dennis

“When people say they want affordable health care, they are lying.”

Spot on. Where it comes to the costs of paying other people’s health care bills – whether via your insurance premiums or taxation – people do seem to rediscover the joys of affordability. For you and your own, though, who’s settling for less than the best? Doctors and pharma companies aren’t exactly incentivised to provide the most affordable form of health care either.

There is definitely a paradox in this, which @BiND and @JG were getting at. If your family doctor were to provide you with the best form of medicine known to science, and you were eager to swallow it all up, then for a lot of the ails of modern life that would involve nothing more than doctor’s orders to eat less and better, incorporate movement and strength into your lifestyle, and if you haven’t done so already then give up smoking. The smoking stats are well down across the developed world, but exercise and diet trend inexorably in the wrong direction despite being an easier (or at least less intrusive) fix than stuffing ourselves with drugs or having bariatric surgery. To the extent that we desire better health – and surely, you’d think, we do, what could be more important? – it turns out we desire absolutely top-notch medicalised health care, but are rather less keen as soon as we are expected to put in legwork or sacrifice of our own.

This is a lacuna that killjoys use to justify the government making health and lifestyle decisions for us, but also that some conservative types use to heap moral opprobrium on those they see as lazy and short-sighted for not looking after themselves better, and who “take the easy way out” by swallowing pills instead. I’m not inclined in either of those directions myself, but I do think it says something interesting about the frailty of human nature. And says something about our culture and society that we’ve come to view health and wellbeing through such an overly medicalised lens.

Away from obesity, similar comments apply to “go for walks, take up a hobby, get out and meet people” as part of the answer to the so-called mental health epidemic. “Social prescribing” is coming into vogue in the UK, not least because from an NHS point of view it’s cheap. Won’t help everyone, but there’s enough of an evidence base behind it to say recommendations like that are genuinely “good medicine” too, not merely “affordable medicine”. But as much as we say we want the best possible treatment, how many people who would substantially benefit from those recommendations will actually follow them? As opposed to the number who’d take a pill if presented with a purely pharmaceutical solution?

This man makes confident pronouncements on subjects that a 5 minute read of the Wikipedia article would tell him are incorrect.

If Richard Murphy spent five minutes researching before forming an opinion, he wouldn’t be Richard Murphy… Now would he?

@HHG
There is no such thing as “Ultra Processed Food”

Yes. Yogurt is classed as a UPF. News to me that giant factories existed in 5,000BC

One of my pet hates of food nazis is their demonisation of ‘mechanically recovered meat’ – it’s no different to making soup/stock with a chicken carcass, marrow bone, fish head etc

@Andrew C

Six month ban for 29 points? Should be three years & retest

Bianca Williams will appeal and win with “charities”, protests, Labour etc backing her

Theophrastus:

This is partly because it does not trigger the production of insulin in the pancreas and also because it is metabolised exclusively in the liver whereas glucose can be metabolised in other tissues. And this is why type-2 diabetics, like my brother-in-law, can eat fruit as a dessert. Fructose is also 73% sweeter than sucrose at room temperature, allowing diabetics to use less of it per serving.

Ummmm.. not quite.. And a good example of how peeps Get Things Wrong even though they’re not dwelling in the solanesque depths of intellect.

Fructose does get metabolised (almost) exclusively in the liver… Into glucose…
The reason it usually doesn’t trigger the glycemic response, and the resultant insulin spike, is that it generally also doesn’t leave the liver, as long as Paracelcus is observed.
The glucose produced out of fructose that way is pretty much immediately used locally as fuel and the raw material for lipid modification/production, and as such isn’t “counted” by the whole machinery that regulated blood sugar level.
Unless you apply Paracelcus and there’s so much glucose produced out of fructose it bleeds out of the liver into the bloodstream, of course. Which is a common issue with heavy alcoholics whose liver is …well… shot..

Fructose does indeed “taste” a hell of a lot sweeter than glucose, which is why peeps have a tendency to use less of it.
Fun bit there is that, once again, part of that is because glucose only tastes “sweet” if there’s an excess of it.
All those taste buds are quite capable of pulling in and metabolising glucose on their “business end”, and in a similar manner as happens in the liver with fructose, that glucose isn’t registered/counted at all.
You actually need a relatively impressive concentration of glucose for it to register as “sweet” at all.
The reason saccharose tastes so sweet is because a tiny fraction hydrolises in the mouth into glucose and fructose, and it is that fructose ( which cannot be directly metabolised, but is detected as a saccharide.) which makes up the bulk of the “sweet” registration in the mouth.

Which brings us to fruit and diabetics. While ripe fruit does contain a “fair amount” of fructose, it doesn’t contain all that much. Just enough to be attractive to potential carriers of seeds. And hydrolysed from saccharose during the ripening process.
The rest of the sugars ( more correctly : polysaccharides) are in storage/structural form: saccharose/glycogens, pectin and cellulose.
Cellulose we cannot metabolise even if we wanted to, pectins only about half, and most fruits, unless you’re talking cultivars specifically bred and selected to carry lots of sugar, like modern grapes, don’t carry all that much saccharose/glycogens. Usually just enough to produce that fructose and “reward” that seed carrier.
(Yes. Plants cheat…)
So a diabetic can usually eat ( some) fruit(s). Because they’re mostly indigestible bulk that tastes sweet, but actually contains relatively little that triggers that nasty physical response.

Which brings us to my morning quip about honey that most people seem to have missed.
The Woo Crowd that is generally up in arms about all that High Fructose Evil UltraProcessed Stuff, is generally lyrical about honey, quoting its many beneficial effects as a Natural Product that even the Ancients knew of and used to their Benefit.
Ignoring the bit where most of their quoted stuff comes straight from Galen, his Humoric Theory descendants, and the resulting 18th/19thC Romantic Naturalists, there’s a weeeee little thing about honey…:

If people haven’t been mucking about with it, it contains on average about 40% fructose…
In fact it’s pretty much the only natural bulk source of it, being the result of enzymatic conversion from glucose during maturation in the hive after having passed through the bees’ “honey stomach” where that enzyme is introduced to the collected nectar..

Peeps can waffle on about UltraProcessed Foods being a bane of Modern Evil Human Society, but in fact we’re at least 34 million years late to the party..
And thats just honey….

@Henry

“Not disputing your googling, but my 75% number is based on hospital/healthcare systems’ reimbursements- the average hospital/health system (25 years experience coding/billing) receives ~75% of its reimbursements from CMS ( Medicare/Medicaid).”

Hospitals are the most obvious healthcare cost centres but they only account for a surprisingly small proportion of health expenditure, under a third, which might help explain why our figures diverge?

https://web.archive.org/web/20230801151413/https://www.cms.gov/files/document/highlights.pdf

That breakdown gives 31% for hospital care, 20% physician and clinical services, 9% retail prescription drugs, 5% medical services in a bunch of other settings (schools/workplaces but also ambulance providers and residential mental health and substance abuse facilities), 4% nursing care/continuing care retirement communities, 4% dental care, 3% home health care, 3% other professional services (physical therapy, optometry, podiatry etc), 2% other non-durable medical products (includes over-the-counter medicines, medical instruments, and surgical dressings), 2% durable medical equipment (includes glasses, contact lenses, hearing aids).

The four largest sources of funds for health expenditure are given as 28% private health insurance, 21% Medicare, 17% Medicaid and 10% out-of-pocket. But presumably these split very unevenly between the expenditure categories above – given the demographics of people needing hospital care, I’m sure you’re right about Medicare/Medicaid being a much bigger deal there.