Monday, January 22, 2018

AMA:2018 edition

Welcome to the 2018 version of AMA. I started asking for questions back in December, and didn't get any. Last call was Jan 19. I got one, then several more as I was working on the first. Thank you!

If you and some buddies had just donated $1 million to the Tomorrow Project (cancer research project), how would you want them to spend the money?

The Tomorrow Project is the largest Alberta research project. It aims to "reveal what causes and what may prevent cancer and chronic diseases." I think I'm part of the project, though I haven't heard from them in a while.

When I was a child cancer was just beginning to be a word. People whispered it because hearing you had it was a death sentence. The health system was getting a grip on preventable disease through vaccines (and don't get me started on those anti-vax idiots), plus better diet and lifestyle choices. Now that we weren't dying of other things we were noticing cancer. The tobacco companies, bastards that they are, denied and obfuscated research in order to continue raking in the obscene profits extorted from the deliberately caused addiction to a deadly product. There is no reason on earth for tobacco to be a legal product.

Now that you know where I stand, we can address a generous donation to the Tomorrow Project. As near as I can tell, they seem to be doing just fine as is. They've got a reasonable sounding plan, and seem to be going about it in a sensible way, even if an email I got from them had incomprehensible instructions about an account. They probably have contingency plans in case funding is cut (most likely because the Conservatives get in), and a wish list of items they put forward to the government in hopes of more funding. A generous donation would probably fund the next item on the wish list, which is probably a smarter thing than I would think of.

None the less what would I spend the money on? Let's review where we are now, and where I think we should go. Lots of people think in terms of curing cancer, but I think this is misleading. Cancer isn't a disease we get, like catching Spanish Flu because someone sneezed on you and you died quite soon after. Nor is it a condition we inherit, like we inherit our eye colour, although we may inherit vulnerabilities to conditions that may lead to cancer. I think of it more like a bodily process that gets out of control, to the point we need medical intervention or die.

There are various therapies, such as cutting out the offending cells and hope you get them all, or killing the offending cells by various means, without killing the ones around them. This is a difficult process because the cancerous cells started out just like the normal cells beside them. No doubt there are other legitimate therapies that I don't know of, but all of them are starting behind the 8 ball. Typically by the time it gets noticed, cancer has already recruited more players, and is a lap or two down the track.

There are a great many conspiracy fantasy fuelled therapies. No end of them, and what they all have in common is trying to exploit desperate people to make a bit of money. Such people are despicable (said like Daffy Duck, only with more slobber.) Note this does not include the medical system where they may have come up with a promising experimental therapy, and put bluntly, need a group of humans to try it on.

We already know a lot about preventing cancer and some chronic diseases from happening to you, and learning more would be good if people already did the things we know about. Sensible diet and exercise is huge. Not smoking and not hanging around smokers is huge as well, and don't tell me about your grandpa that smoked a pack a day and died sound as a bell at 90 because an enraged hooker killed him for not paying up. Funding that goes toward prevention is a good thing, and at the same time we're most likely also preventing a host of other issues from happening.

I'd like to see funding and research for a health system that finds a cost effective way of routinely monitoring our health. I see a doctor once a year for an annual physical. A once a year reading doesn't give you any idea what your average health related numbers are, or how they are trending. A high cholesterol count might be a short term thing because you pigged out over Christmas or have dialled way back on aerobic workouts to let an injury heal up, or it could be next in a series of gradually increasing counts. Same number, but drive entirely different treatments. With more detailed trends you could get a grip on things at the beginning of a trend away from normal, rather than when a huge departure is red flagged, and it's all hands on deck and correspondingly expensive.

I'd like to see an annual report that goes out to every individual showing the average health care cost, and your specific cost. If the numbers could be broken down, getting the average cost for a person in your age group might be more meaningful, just like triathlon results. There could be lots of reasons why your cost is above or below the average by a significant amount.

Every year there is some particular person that cost the most in social services or health spending. Lets get the funding to find them and find out why. Is it the same group of people year after year, or someone different every time. Is this because they're dying of something expensive? Were they in a one time event like an auto collision? Are they dealing with addictions issues? Whatever it is, lets find solutions that fix the problem. It might be cheaper to give someone a 24 hour nanny and a place to live, rather than living through police intervention, ambulance rides, emergency medical services, and such.

We need to build a system that collects data, which seems to be in progress, but we also need to analyze that data and then act upon it. We need to make some hard societal choices about health care dollars. Suppose we develop a way of growing organs from a person's own tissues, given a year's notice. The cost isn't put a man on the moon expensive, but it isn't 3 stitches and a dressing for a cut either. If you've destroyed your liver through alcoholism, and refusing treatment, should you get a new liver? If we know that someone has inherited a condition, do we take medical action to mitigate that condition before it gets expensive? It's straightforward how to deal with people that don't want a blood transfusion based treatment (would they think the same if it was grown from their own blood?) because they're adults and can choose for themselves. But what about their children? There will be many issues, and we need to have a data driven, adult conversation about it. That where I want to see the funding going.

What’s your greatest achievement (in your opinion)? What is the next big achievement you’d like to accomplish?

Hoo boy that's a toughie. I think the biggest thing was turning my life around in my late 40's to get more active, and start dropping weight. I chose to do that, and have mostly stuck to it. Much of the other things I've done have been a reaction to external forces.

Next is straightforward. Much as I love doing my writing and photography for it's own rewards, it would be nice to be recognized somehow. For writing the bar pretty well means selling the work to a publisher and having people that are not your mother or your friends buying it. Photography is a little trickier. I don't yearn to become a professional photographer, and I'm not looking to have my work hanging in galleries downtown. Art is a very personal taste. If I can reach people that might not like it personally, yet they recognize that it's good art, I'll take that as a huge compliment and go away happy.

I guess in more prosaic terms it would be to settle into a happy and busy retirement. I was thinking saying that still being married was my biggest achievement, but on further thought, it might well be Linda's.

I know you are all about the cats...what about dogs? Aquarium fish? Horses (something my kid would ask)?
My family had dogs when I was a kid, and I probably wouldn't have a dog again. The main reason is that most dogs are all whatever you're doing right now is their favourite thing ever. They want what you want, and if you treat them well they are a fountain of unconditional love. Cats make you work a little harder to earn the love. A lot harder. I like the challenge. Plus there is no dog that can purr on your tired quads, generating vibrations that have been proven to have healing qualities.

A saltwater aquarium was on my list of things to have at one point, mainly because I wanted an octopus. A big one. In the end I realized it was a lot of work, and octopus are tough pets. I can't help but wonder how the cats would react to an octopus. I would not be terribly surprised to find that the octopuses have a civilization down there and we're going to pay terribly if the first alien spaceship is piloted by an octopus-like species.

Horses are right out. Totally and completely. I have buddies who have horses. They tell me horses are not pets, they are a lifestyle. My favourite cousin came to visit me once and was she worried about her kids? No, she worried about her horses.

What do you think of bitcoin? Local or community currency?

Bitcoin and it's ilk are a scam, just like the tulip mania of 1637, or the Southseas crash in 1720, or any number of currency crashes in the USA during the 1800's, or any garden variety MLM or Ponzi scheme put up by a hustler with the stones to raise on a busted flush. Don't get involved, or if you must, do it with money you can afford to kiss goodbye.

The various fiat currencies of the world are backed by both the stability of the government, and a complex mix of economic factors. Economists and currency traders might disagree about the value of a specific currency on a specific day, but generally they change in value slowly, and in response to recognized events. A bitcoin and it's ilk are nothing like it. The only value they have is the first people   in say it's valuable, and look for a bigger fool to buy later.

A community currency is a different kettle of fish. They are generally tied to a certain number of hours of community service, or some other recognizable value, and they are limited in the ways they can be traded in.

You get a cloudy sunset to play you out.

No comments:

Post a Comment

Looking forward to reading your comment!