About medicine, I would say: run from doctors as well as from lawyers and priests. Of course you have to learn to do your homework. It is almost twenty years since I have seen a doctor (I was 11 years old). Everyone should learn to take care of themselves and of their family. It’s not only learning some tips. You really have to study. If you still think you need health insurance, you have to study harder. Learn about yourself, it’s the single most important thing every human being should do.

1) Avoid ALL purebred dogs,get a mixed breed, preferably around thirty to forty lbs, with ears that stick up straight. Basically something that looks like a dingo.
2) Vaccinate your animals. Seriously. Disease is real and vaccines are cheap insurance.
3) Feed you dog or cat a value added brand of pet food, but don’t get suckered into the latest fad or designer pet food. Dogs eat dog food, people eat people food, and never the twain shall meet. And always remember that millions of animals are killed in shelters every year because no one will put a bowl of dog or cat food in front of them.
4)Learn what your dog or cats ideal body condition is and feed to that. Obesity in pets, like people, is out of control, and is a leading cause of cardiac, orthopedic and other problems.
5)Stay on top of your animals oral hygiene. This sometimes means a “dental” under anesthesia, but after we clean their teeth its your job to keep them that way. Again, so many problems in pets, especially in old age, are actually the direct result of poor oral hygiene.
6)Regular exams and bloodwork later in an animals life will pick up little problems before they become big ones.
7)Accept that all living things die, usually after one or two life threatening episodes. When your pet is young and healthy make a list of what makes your dog or cat your dog or cat, ie the things it likes to do the most. When it can’t or won’t do the majority of those things, consider a humane euthanasia. Please don’t wait until its gasping its last breath.
If you want to avoid all vet bills, don’t get a pet. It’s a free country, and last time I checked you don’t have to own an animal. If you do decide to own an animal, either bring it to a vet you trust and follow their advice, or don’t bring it to a vet at all. We are not here to argue with you.

Thanks for your post and very practical checklist (note to self: go to bed at 10pm!).

You mentioned unhealthy fats. What are your thoughts about saturated fat from natural sources (diary, …)? They’re typically condemned by modern medicine, but I came across pretty convincing arguments from the Weston Price foundation that saturated fat is essential for our health. (They basically argue that saturated fat did historically not produce the effects now associated with it, and those effects happen to coincide with the appearance of of modern foods and even the substitution of saturated fats). Also in weight training circles people it is appreciated to be good for testosterone (hence muscle growth).

In short, I’ve reinstated saturated fat in my diet (mostly through diary). But the question remains.

I know one time when my son was about 4. He fell off the monkey bars and hurt his arm. I saw it happen and told him to suck it up. Three days later still hurt. Turned out he broke it. Ooops. Those stick with you.I do however use the nurses on call. Its great!!

“Don’t go to the doctor or clinic for every sniffle….” A lot of insurance companies have nurse lines you can call for free to get advice on whether to see the doctor. All three times I have called, I ended up not going in. They told me to see if I still had the symptoms in a week or to watch whether a particular symptom got worse or something like that. I love that nurse line.

“Don’t listen to your friends and relatives for health care advice.” Actually, it depends on who your friends and relatives are and how their judgment compares to yours.

I tend to err on the side of not going in, hoping things will magically fix themselves. But if I think to myself, “My mom would kill me if she knew I noticed this symptom [say, black dots on my tonsils] and didn’t go in,” that’s how I decide it’s time to at least call the nurse line.

Or another way to say it is that if I died, would it be embarrassing if my friends found out I knew about these symptoms?

My dad is much worse than me–he can wake up in a pool of blood after falling off the back of his truck and going unconscious for awhile and think he doesn’t need to go to the doctor. I think he turned out to be right about that, but my mom thought it would be a good idea to check for a concussion.

Also, some people’s friends and relatives actually know what they’re talking about. Relatives have some of the same genes as you, for example. And some might be doctors.

Whether you are single or in an open relationship, when you are good at self reflection, screening your partners well, engage in safe sex and do regular STD testing, a kink/multiple partner lifestyle can be a stimulating and rewarding activity, with minimized health risks and maximized mental benefits.

But then, English language does not even have a word to describe responsible, honest and rewarding non-monogamous sexual behaviour – after all, “promiscuous” is synonymous with indiscriminate and lacking standards. I find those assumptions as culturally-determined and open to be questioned as most readers here do the idea of having to work for the rest of their lives.

But I must assume that our situation may be typical of many families here in America.

Preventative measures won’t help our two daughter’s ear infections, (surgeries cost over $3000 after bargining with the doc) or my wife’s dental work (recessing gums expose nerves due to poor genes=$3000, or my crown, or our $500 premiums per month on top of what our employer kicks in.

When it comes down to making over $3000 for a one hour surgery….training or not, technology or not…its just plain shitty greed!!!

I have 6 years worth of college ed …just two shy of their 8. WHy is it they feel obligated to charge over $2000 an hour when the state caps mine at less then $30 and hour?

Its greed- plain and simple…. and you know it.

I think Maus’s case gives the lie to that – being forced to work an otherwise unnecessary job just for the ‘healthcare benefits’. I do feel for your predicament, Maus.

But still, that’s America’s political football to boot around. From here it looks broken, and I wish you good luck in fixing it…

Anyway, definitely agree that the best health care is preventative, and I confess I’m not a great example of that myself – I still haven’t kicked the nicotine habit, and I hover around the upper limits of alcohol consumption. But I think my diet is pretty healthy cooked mostly from real fresh ingredients, exercise is less than when I was younger I guess, and the one big success is I rarely if ever consume sugar (and HFCS never). The only time I’ve needed a doctor in about 30 years has been for travel vaccinations and one ‘risky behaviour’-related incident best glossed over… I’m convinced that a good proportion of health is down to diet and follow the general principle of ‘eat food, mostly plants, not too much’.

Can’t remember who, but someone once said ‘most people dig their own graves with their teeth’. If this was more widely understood health at the personal and societal level could be greatly improved at little to no cost.

I meant Dr Dean thank you for writing the post.
(blush)

“The Family Health and Medical Guide”
(points out when you really need to see a doctor).

Bayer Aspirin, 500 mg tabs
A box of the old fashioned “BC” headache powders
Advil Cold and Sinus Tabs (You have to ask the pharmacist for this type)
Lemons
Limes
Coca Cola Classic (the short version ICE cold)
Band Aids
Vaseline
Rice bags heat pads
Couch
E-Z listening music
Solitude

These items cure 90% of my aches and pains even at age 65. I follow the Lifestyle/Prevention measures as listed in the post.

My only usual doctor visit is for getting @Bactrim to heal my BPH and stop passing blood in urine which I have been doing for 30 years about once annually. I also have an annual physical and take Vit D every day.

I enjoyed this post–thank you Medicinesux for your time to write it.

How to negotiate with your medical provider could be a book chapter in itself. First of all, realize that probably at least 1/4 of doctors have no control over their own billing, and thus they cannot negotiate with you. They’re employed– it’s somewhat like trying to negotiate with a convenience store clerk. Also, the percentage of doctors who are employed, rather than self-employed, is increasing rapidly so in the future, negotiating with your doctor may be even more fruitless.

Second, negotiating half off of your hospital bill may mean that you’re negotiating to pay more than you would otherwise pay. Where I practice, most hospitals would gladly give you “1/2 off”– because many insured individuals are overpaying at “1/2 off”. Why? A hospital might “charge” $3000 for something your insurance company has negotiated to pay them $1100 for. The hospital puts $3000 on the bill knowing full well that they are contractually obligated to collect only $1100, and if you keep your mouth shut, this is what will happen. If you step in as the negotiator and offer $1500 cash, what do you think happens? Why do you think people tell you that the hospital jumped at the offer? By the way, you got 1/2 off. If you have no insurance, it’s a different situation- negotiate your best deal.

It’s not my ego that dislikes negotiating prices, it’s more of a practical matter. In my practice, I listen to a patient’s history, ask some questions, review their outside records, perform a thorough exam, look at their tests/films, and explain my diagnosis and the treatment options. There really isn’t a convenient point to turn the encounter into a 3rd world shopping market without things getting kind of weird. It’s a serious disruption, and when it happens, everyone notices it.

Also, it’s usually the insured patients who try to negotiate. The majority offer to pay me in cash at a higher rate than their insurance company has already negotiated for– similar to the hospital scenario. A select few do very strange things. Understand that negotiating a deal is a delicate art– if you do it improperly, the deal may not go through, and you’ll still be seeking medical help. I don’t kick patients out for trying to negotiate, but I do have a point where I say “No, I won’t provide my services for that amount.” Recovering the desired relationship with your doctor can be awkward if he’s just rejected your first three offers for payment. Be sure you’ve thought it all through before you start the negotiating.

Lastly, asking the momma question, in my opinion if your doctor changes his/her recommendation because you ask that, you should get a new doctor. The recommendation shouldn’t change if you were his/her mom. Really, you’re doctor went to college, medical school, and spent at least a few years after that in training, and they weren’t prepared for that worn-out question?

@Johnny H-this was not a nutritional post-certainly excessive carbs, proteins, or fats can be a problem-everyone’s metabolism is different. If that statement drives you crazy, then you need to re-read the stress suggestion and chill!

@Jonathan-I don’t make the laws! Sorry!

@manus-Yours is one of the problems with the current system. If the pre-existing condition issue is dealt with(and looks like it will be), then maybe you can soon switch to a job you enjoy!
Good Luck!

But they don’t address chronic illness. Some, like myself (diabetes), have medical conditions that require frequent monitoring and daily medications. And that’s just to avoid the serious complications that would likely arise in the absence of such care.

It is impossible to purchase reasonably priced health insurance in the private market when one has a pre-existing medical condition of this nature. In California, insurers are legislatively mandated to provide “guaranteed issue” policies, but the premiums are easily $800-1000 per month for someone in their forties. I would gladly pay cash for my routine medical appointments and insulin if I could secure a HDHP for $200 per month to secure against a catastrophic illness like cancer. It simply isn’t offered to folks like me. So, I keep working at a job I loathe for an income I don’t particularly need because it provides health insurance benefits that I cannot secure for myself without exhausting my ERE principle.

The fact that cannabis is illegal is irrelevant, particularly because it’s illegal for all the wrong reasons.

To be sure, harder drugs are unhealthy. But it would be wise to put cigs and booze right at the top of the list…

I eat about 15g saturated fat a day from coconut oil alone and I’m in perfect shape… If I want to get fat, sick and weak then all I have to do is reach for fat free, 100 calorie Oreos.

The evidence is so overwhelming (except maybe that from TV commercials), I beat my head against the wall whenever I hear “avoid fats”.