Where do our sons learn not to go to the doctors? Does that now create a social burden?

[HereSince1628]

With the ACA we have a system that helps spread the costs of healthcare to everyone. Of course, it's based on a concept that healthcare is something we are all in together. That essential point of view requires a change in mindset.

Currently, focus on that change is about some sticker shock, SHARING the costs means some will pay more. I think that's a reasonable thing, if people who haven't gotten care turn out to actually begin to get it in the next few months.

Now that everyone who is able must participates in the cost, the cost becomes everyone's business. Getting preventive care may actually hold down costs. Society has an interest in seeing that everyone gets the care.

So, I see a problem with the habit of men not accessing the healthcare system outside of emergencies and advanced health problems. .

The gender bias in self-denial of healthcare is pronounced in America. That habit must change to help keep healthcare costs as low as possible.

We can carp about having to share the costs of other people's healthcare, and men having to contribute to maternity/reproductive costs of women is currently making a lot of noise.

That steam is a result of an asymmetrical pattern of healthcare use. Not because women necessarily have more health problems, but also because men don't seek healthcare as often as women.

If men turned up in Dr's offices with a frequency much closer to that of women, the historic differences in insurance costs wouldn't be as large in either the short or long term.

So, rather than engage in complaining about unfairness as in men paying for maternity, I'd like to see society help men overcome the burden of the social lesson that keeps them out of Dr's offices. Society now has an interest and shouldn't be penalized with costs of treating preventable disease and treating diseases that can be managed at lower costs if treated early.

Under this new social contract, male slackers who don't seek healthcare will be unnecessarily (and thereby unfairly?) adding to everyone's costs of healthcare.

[polly7]

1. That's a great point, and I just want to add my opinion from here

in Canada. Every doctor's waiting room, public tv psa's, etc. stress the need for early detection and regular physicals for everyone - it's just common sense that a healthy population and stopping potentially deadly diseases that may be easily spread, or conditions that often develop into life-threatening, complicated care is much better both for humanitarian and economic reasons (though I hate thinking of any of this in terms of cost, but it's there).

Every member of the population absolutely needs access to any and every type of physician visits, diagnostics and treatment for a plan like this to work, no matter the gender, age or economic status.

[HereSince1628]

2. American waiting rooms have similar messages...not seen unless you are there

Our mindset needs to change, and that includes the mindsets of people who have learned to not seek preventive care.

There is a gender bias in that, and very likely other detectable socio-economic bias.

[polly7]

4. We get so many commercials / psa's on a lot of our local tv channels stressing

the importance of seeing your doctor and paying attention to body changes and symptoms. One channel from Yorkton (Saskatchewan) tv has had the same couple on with funny little skits and exercises, things to look out for, how to eat right, when to see a doctor - early! .... for years. I've watched them change from really young adults to middle-agers, and they're still the only commercial I never turn off. You're right, you have to be in a doctor's office to see those pamphlets there, but really, the mindset here is completely different when it comes to genders and seeking care. I'm actually blown away while reading all of this.

[FarCenter]

3. A Check on Physicals

"Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better”

This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well.

Among physicians, researchers and insurers, there is an ongoing debate as to whether regular checkups really reduce the chances of becoming seriously ill or dying of an illness that would have been treatable had it been detected sooner.

No one questions the importance of regular exams for well babies, children and pregnant women, and the protective value of specific exams, like a Pap smear for sexually active women and a colonoscopy for people over 50. But arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.

http://well.blogs.nytimes.com/2013/01/21/a-check-on-physicals

[HereSince1628]

7. Sort of doesn't look like basic preventive care available under the ACA

but with respect to bronze and silver plans an extreme verging on strawman status.

But your underlying point isn't one that should be dismissed out of hand.

Getting the amount of care right and at a fair price is now not just an issue for HMOs and Insurers. It's now a social problem because everyone has a stake in paying the cost.

Of course, 'the right amount' is going to be debated. It should be. Unfortunately, the words 'death panels' will almost surely be included in the debates that touch national imposition of policy.

[Bluenorthwest]

12. I think the real 'social problem' is the built in promise of profit for Insurance Companies.

Why should we be speaking of how to control costs inside a for profit system? If cost was an issue, we'd cut out the profit factor. In Canada, you can address health care as a social issue, they do not have anyone profiting from it. Obama was very clear that he feels Insurance Companies deserve to profit greatly anytime you or your kids get ill. That's how it is.
Cut out the profit or don't even think about trying to force people into care you think they should have which they don't want. Like so many here, you sound like you

[SharonAnn]

55. My stepson died at 41 of a massive heart attack. Probably preventable.

He'd had "really bad indigestion for a couple of days" according to his coworkers and was taking lots of OTC antacid medicine. He died in his sleep.

The autopsy showed massive blockage of the arteries, 100% and 90% and that he'd had a significant heart attack within the last year. Turns out that 6 months earlier he'd had the same symptoms but they'd eventually "gone away". But I had talked to him several times during those months and he'd said he just felt tired all the time and depressed. That was not like him at all, so I kept suggesting he see a doctor. He said "I hate doctors!", of course I already knew that. However, if I'd been living in the same city I probably would've dragged him to a doctor and we would've learned that he had incredibly high cholesterol and would've checked further. He was thin and always had been, but he smoked heavily which contributed.

Supposedly his hatred of doctors had something to do with his early years with his mother and all the "cod liver oil" type stuff. I really don't know. It's just so sad that treatment was available but went unused. Perhaps this is why single men die younger, they don't have a spouse to drag them to the doctor when "things aren't right".

[FarCenter]

59. Did you have his cholesterol level measured during the autopsy?

Most Heart Attack Patients' Cholesterol Levels Did Not Indicate Cardiac Risk

Jan. 13, 2009 — A new national study has shown that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event, based on current national cholesterol guidelines.

Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL).

"Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit," said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study's principal investigator.

While the risk of cardiovascular events increases substantially with LDL levels above 40–60 mg/dL, current national cholesterol guidelines consider LDL levels less than 100–130 mg/dL acceptable for many individuals. The guidelines are thus not effectively identifying the majority of individuals who will develop fatal and non-fatal cardiovascular events, according to the study's authors.

http://www.sciencedaily.com/releases/2009/01/090112130653.htm

He should have gone to the doctor with the symptoms that he had during the first attack. That is acute care, not preventive care.

An EKG during a routine physical may or may not have picked up the fact that he had a heart attack already. I'm not sure whether a stress EKG will be covered by the ACA health plans. A stress EKG is not usually part of a routine physical, although it is for a high-cost evaluation like the Princeton one.

[grasswire]

78. Lately we have learned that cholesterol is not the problem, inflammation is.

It is inflammation of the arteries that allows particles to cause plaque and blockage.

[FarCenter]

79. And statins probably work as anti-inflammatories, rather than by cholesterol lowering.

I think there's a saying -- Half of what you learned in medical school will be wrong in 10 years. We just don't know which half.

[grasswire]

81. exactly

which is why I have fired the last two doctors who tried to insist that I take a statin.

[FarCenter]

82. It doesn't matter how statins work; it only matters that they do

For example, aspirin was known to relieve fever and pain for decades before they figured out the biochemical process by which it works.

[lumberjack_jeff]

70. "No one questions the importance of regular exams for (insert demographic here)"

The people singled out for the importance of their preventive care never include the ones most likely to die of a preventable cause in the next year.

Why... it's almost like no one gives a shit.

[FarCenter]

72. The question is whether a routine exam results in finding something that can be prevented

A routine physical has positive value if the physician can find something to vaccinate for, medicate, irradiate or cut out.

On the other hand, it has negative value if the physician errs in the finding and treats the patient for a condition that the patient doesn't have.

So you have to take into account the diagnostic abilities of the examiner and the detection power of the commonly used tests.

And the most powerful prevention of disease and injury is a function of nutrition, exercise, and behavioral modification to avoid smoking, drinking, drugs, multiple sex partners, reckless driving, lack of caution on the job, injurious sports activities, and so on. The physician has little influence of over these.

[Fumesucker]

5. Doesn't that mean though that the long term cost for men should be higher?

That seems to be the opposite of what one would logically expect if preventative care saved money, health care costs should be lower for women who seek preventative care more often than men who should have higher costs.

[HereSince1628]

10. Yes, certainly for preventive care and early treatment

but maybe less cost in later treatment such as kidney dialysis, amputations, bypass surgeries, etc.

At least that's the message that we have been given to believe about preventive medicine.

[Fumesucker]

13. I'm not sure which part of my post you're agreeing with

It seems odd to me that the sex which seeks preventative care more often has considerably higher overall medical costs than the sex which stereotypically tends to ignore medical problems until they are dire, a behavior which is supposed to cause medical costs to be higher.

[HereSince1628]

17. Well, your claim seems to reference a data point...

mine follows the projection we are trained to believe.

[Fumesucker]

20. Silly me, referencing data when everyone knows better

Evidently my snark detector is in need of a recalibration.

[Bluenorthwest]

16. Where is some proof that all things being equal, men have a 'habit' of not seeing doctors while

women are known to be hyper proactive, never refusing dietary changes or anything like terrible men do. Tell a woman to quite smoking and they do it instantly without whining and with no side effects at all! No woman has ever had a drinking problem, and if they did they'd stop at once when seeking preventative care and a doctor told them to stop. Women are never too heavy nor addicted to drugs. That's all stuff men do.

[HereSince1628]

18. It's widely known that men don't seek medical care...here are newspaper articles

that are based on the phenomenon.


http://abcnews.go.com/Health/story?id=116898&page=1

http://usatoday30.usatoday.com/news/health/2009-08-13-men-doctor_N.htm

http://www.today.com/id/23816393#.Um-zdBAt1-w

[bemildred]

26. +1. That idea deserves consideration.

I can see easy criticisms too, but ...

[lumberjack_jeff]

56. The lifetime cost for women's health care is 1/3 more, largely due to longer lifespan.

It's also why people who smoke don't have higher lifetime costs - because they die young.

Per capita lifetime expenditure is $316,600, a third higher for females ($361,200) than males ($268,700). Two-fifths of this difference owes to women's longer life expectancy. Nearly one-third of lifetime expenditures is incurred during middle age, and nearly half during the senior years. For survivors to age 85, more than one-third of their lifetime expenditures will accrue in their remaining years.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

[MindPilot]

6. "if you're well enough to crawl to the bathroom, young man, you're well enough for school!"

To this day when I wake up feeling a little ooggy and think I might call in sick, I hear my mother's anti-malingering voice in the back of my head.

"if I take you to the doctor and he doesn't find anything wrong, you are in deep trouble little mister."

So I guess that's how I learned to avoid medical care. That and the fact that going to the doctor in and of itself is such an unpleasant experience that I do not do it unless what ever is wrong is in fact life-threatening or I literally can't take the pain any more. And the reality is that unless something is visibly broken or leaking, doctors don't have much to offer.

[HereSince1628]

21. Yes, but a study not long ago also suggested machismo was a factor

http://usatoday30.usatoday.com/news/health/2009-08-13-men-doctor_N.htm

Many things, including non-virulent viral and bacterial illness, and minor injuries, are transient. You just need to be 'patient', to heal and become well. Toughing it out becomes a component of patience, and of course toughness and macho move together

[ScreamingMeemie]

23. Girl here. My mother said the exact same thing.

My husband used to say that if he didn't go to the doctor, there wasn't anything wrong with him.

[seabeckind]

8. Boss said work's more important n/t

[HereSince1628]

31. I'm sure that attendance rules for work do influence people's choices.

[Bluenorthwest]

9. Do you have any sort of figures or stats to support your assumption that men as a whole have

a 'habit' of refusing needed medical care? If we are going to discuss this as an actual issue, we need to see that is not just some prejudiced idea or one based on limited exposure to men outside one's own family. The people I know who are resistant to medical care are women and the men are far more frequent seekers of care. The anti science movements are filled with women refusing vaccines for their kids, that's not some male movement.
Perhaps it is regional, or about the age of your male circle?

[HereSince1628]

15. I can't make the Census Bureau's Stat link work...

it claims women visited the doctor 416.3 million times, as compared to men's 280.8 million visits.

but here is a link to another census bureau page that references the difference:

https://www.census.gov/newsroom/releases/archives/health_care_insurance/cb12-185.html


The disparity is fairly widely known and is present in other English speaking nations, including England and Australia

The phenomenon is referenced for the US in articles such as


http://abcnews.go.com/Health/story?id=116898&page=1

http://usatoday30.usatoday.com/news/health/2009-08-13-men-doctor_N.htm

http://www.today.com/id/23816393#.Um-zdBAt1-w

[Bluenorthwest]

24. Going to more appointments is not much proof of your assertions

The link to the Today Show is an article in which a doctor simply offers his own observations, no stats, no figures, no nothing. Just wise cracks about not stopping for directions. Cute stuff, but not really factual. Sexist, yes, factual, no.
When a straight couple has a child, I have noted that the woman goes to doctors regularly but the man does not add even one appointment for the pregnancy. That alone will mean women go to more appointments with doctors than men even if everyone is doing everything perfectly.

[HereSince1628]

29. Another reference to the Census Bureau analysis

It's unfortunate that the link I had for the census bureau page no longer works. I'm sure you thinnk I'm trying to be deceptive...and so I suspect this may have gone past a need for 'data'.


http://www.ahrq.gov/news/newsroom/news-and-numbers/061610.html

Men Shy Away from Routine Medical Appointments
AHRQ News and Numbers, June 16, 2010
AHRQ News and Numbers provides statistical highlights on the use and cost of health services and health insurance in the United States.

Just over half of U.S. men (57 percent) see a doctor, nurse practitioner, or physician assistant for routine care, compared to nearly three-quarters (74 percent) of women, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ). Routine care is typically defined as a visit for assessing overall health rather than one prompted by a specific illness or complaint.

The Federal agency's 2007 survey asked respondents if they had made an appointment within the past 12 months for routine care, and it found that:

Fewer Hispanic and Black men made routine medical care appointments than White men (35.5 percent, 43.5 percent, and 63 percent, respectively).
Uninsured people ages 18 to 64 were only about half as likely as those with private insurance to make an appointment for routine care (36 percent versus 69 percent).
About three-quarters of respondents who said they were in excellent health reported making an appointment for routine medical care versus half of those who said that their health was fair or poor (76 percent versus 52 percent).
A little over half of poor respondents reported making an appointment for routine medical care compared with three-quarters of those with higher incomes (54 percent versus 75 percent).

[Bluenorthwest]

37. So 57% vs 74%? A 15 point difference is all this is about? Interesting take to lump all men

into that narrow difference.Anything 'our sons' learn they learn from their elders, Mom and Dad. This goes for 'our daughters' as well. Note that in this thread more than one person says 'Mom told me not to go to the doctor'.
If your son is like that and I am not, perhaps the difference is not in our mutual gender but in the fact that we had different Moms?

[HereSince1628]

51. Actually, those numbers are on percents of people having vistis, not numbers of visits

As strictly as you want to parse this I'm surprised you missed that.

In terms of numbers of appointments it's closer to a 40% difference. According to the census bureau page that no longer works, women visited the doctor fior non-urgent care 416.3 million times, as compared to men's 280.8 million visits.

My point is society has an interest in getting all the cost benefits from preventive care participation. That's why ACA requires some free preventive health service in the form of an annual physical.

The reality is men in the US and other English speaking nations seek such help with a frequency less than women. To curb the socialized costs associated with not seeking

[lumberjack_jeff]

85. 74% is 30% more than 57%

Women are 30% more likely to go to the doctor than men.

[HereSince1628]

92. The difference you cite is in percents for each seeing a doctor at least once

in the study period for non-urgent care.

The difference is much more pronounced when the number of visits.

The visits to the clinic are the unit of service around which primary care costs are built, and I think, an important thing to consider when considering differences in care seeking.

Similarly, -having- insurance isn't the same as using it.

Rather than piss and moan about men paying for someone else's care, something everyone does who pays for insurance and something everyone does with respect to funding medicare, a more constructive approach is to get men to quit self-denial of care.

If there are cost savings to be gained for the system through preventive care, getting men to more fully participate in the receipt of care would help realize those savings, and curb the growth of healthcare costs.

[Fumesucker]

14. See post #6

[Bluenorthwest]

28. That poster says he does not go to the doctor because of how his Mother dealt with doctors.

The OP says her sons are the same way. Perhaps it is not the sons at all.

[liberal_at_heart]

19. I understand that for this to work everyone has to have insurance. That's what the

mandate is for. I understand that for their own good men should go see the doctor, but I am tired of this because it benefits me I get to tell people what to do crap. When did we become a society that tells everybody what to do? You can't force someone to go to the doctor. You can't even shame someone to go to the doctor although I'm sure some on DU would try.

[HereSince1628]

25. I suspect we've always been subject to the will of culture

Why in many places is football seen as inappropriate for children and a terrifying source of head injury?

Culture is always informing us on what is right and should be done.

[liberal_at_heart]

27. but people will still play football and people will still let their children play football.

Telling people what to do doesn't work. It doesn't work for republicans and it won't work for democrats.

[HereSince1628]

30. You can also think about the introduction and acceptance of seat belts and car seats

Yes, terrible impositions on personal and parental rights.

Yes, few people respond well to being told what to do. That doesn't mean that society has no interest in getting them to change their beliefs and behavior.

[liberal_at_heart]

35. I know people that don't wear seat belts, and I know people who only wear seat belts because

they have gotten tickets. What are we going to do? give people tickets for not going to the doctor? In most states it is illegal to smoke near doors. Do people call the police when someone does? Do the police come out and issue tickets to people who smoke near building entrances? No. It's impractical and stupid. What next? Will we make junk food illegal? Will we ticket people for eating junk food? We already tax it and guess what? people still eat junk food. The best you can do is educate them what is healthier for them and let them as grown ass adults make the decision for themselves.

[HereSince1628]

38. Yes, a specific action is public education to create cultural awareness and peer pressure.

It was and is done for tobacco use, per capita consumption was over 4000 per year in 1960 and it is now down to ~350



and such social campaigns are being carried out against junk food and HFCS, cholesterol etc

[liberal_at_heart]

39. I am a sugar addict. Shame does not work on me. I try my best to be healthy but it is my damn

business whether or not I eat sugar, not yours, not anybody else's. Peer pressure does not work on adults. That is a high school game.

[JVS]

22. The customer service is absolutely abhorrent.

Bring back housecalls

[daybranch]

32. Let us get real!

While I strongly agree that men, myself included, should seek more preventative care, I have great difficulty believing many people in our society do not know the answer to the question. We men are conditioned to be tough through out our lives. Muchd I have great deal of trouble going to the doctor. Even though my wife encorages me to do so, I need men to say lets go.
of this comes from other men and male dominated activities but it is reenforced by our mothers who expect us to be strong andf uncomplaining like our fathers. Then if we do get sick, many women like to build their own egos by telling us what babies we are to be sick and how we cannot take pain .
I can take pain, I do not complain, I am very physically strong, and I view going to the doctor as a signof weakness. In fact if I go to the doctor with the same illness as my wife , I am told that the doctor "is not impressed", because I am able to resist the disease better than my wife and why am I there. So my efforts at preventing increased sickness are repulsed by the medical community.
Men, we need to seek care when we think things may be wrong, and timely examinations regardless. We need to be men, and make good independent decisions. That is true strength.

[HereSince1628]

36. That's the state of affairs relative to macho. I'm sure The Marlboro Man felt that way early on

http://usatoday30.usatoday.com/news/health/2009-08-13-men-doctor_N.htm

Wayne McClaren, THE Marlboro Man, was about as tough and macho a semiotic as a '60s American ad agency could muster.

Much suffering and dying of various cancers, respiratory and cardiac/vascular diseases is strongly statistically associated with smoking, and the majority of Americans now understand that...including the Marlboro Man himself (you can read about Wayne McClaren on Snopes).

Certainly the insurance companies who have added costs to policies accordingly for smokers believe smoking is a health risk...

By making everyone share the costs, society has a vested interest in other people's risky health behaviors. In as much as failure to seek preventive care is believed to add to medical costs, paying society now has an interest in overcoming the resistance to preventive care in an effort to curb costs.

[BKH70041]

33. Pffffft! Good Luck With That

When I was in my teens and early 20's I was invincible. A lot of young men feel the same way. I didn't go to the doctor unless I was really, really sick. For what other reason should I go? There wasn't any as far as I was concerned, and young men are the same way today.

So why should they pay $600 a year for insurance for something they probably won't even use? That's a hard sell. $600 can buy a lot of beer. $600 is filling up the car with gas 15 times. $600 could be several months of groceries for a single man. A very hard sell. And what society thinks doesn't mean anything to them.

In ACA, short of holding a gun to their head, it's not going to happen. If it doesn't happen, the foundation of ACA becomes a lot less stable.

My solution is Medicare for all, and in order to keep your Medicare from year to year you have to have a physical. No physical, you pay a big fine. That's about the only way you're going to get the preventive healthcare needed to catch things early and keep costs down.

[Arugula Latte]

46. But they are at high risk for injury, accidents. They should understand that.

Also, you're required to buy car insurance even though in most years you won't make a claim.

I agree that Medicare for all would have been much better. I hope the system can evolve to that.

Baby steps, though.

[former9thward]

34. In the last 40 years I have been to a Dr. about once a decade.

And all those times I realized it was a waste of my time. People do not need to go to a Dr. just for the sake of going to a dr. If you need to go then go.

[HereSince1628]

44. What has been, is not what should or must be.

As I said above, the socialization of cost requires a rethinking, and perhaps, re-education about views of when and what type of healthcare is appropriate.

If someone chooses to not seek routine care, develop, say cardiace disease and die without treatment, that personal choice places no cost across society. But many people seek care once they have angina, or drop to their knees, and require expensive surgery and hospitalization.

Heart surgery and recovery is likely to remain very expensive. But curbing the total costs of this treatment can be approached by reducing its necessity...including through preventive care.

Imo, society has a legitimate interest in such education and promotion of preventive care to individuals because of society has a legitimate interest in the socialization of the cost of not having preventive care

[former9thward]

47. I think it is best to be your own Dr.

Look at what problems your parents had and when they had them. Look at what they died of. Look at things like your weight, stress and activity levels. Look at the kinds of things you eat. And then educate yourself. The internet is a wonderful tool for that.

[liberal_at_heart]

49. My daughter amazes me. She will come to me and say hey mom I was feeling this way so I looked

the symptoms up on the internet and it could be this or it could be that. So we schedule an appointment with the doctor and most of the time she is right about what she thought it was.

[Bluenorthwest]

40. Our young people learn from their parents and other elders.

Poorly learned life skills sit on the shoulders of the parents. The end.

[The2ndWheel]

41. I'm sure calling men slackers and a burden will get them to the Dr. right away

Especially if their own medical choices are now everyone's business. That only adds to the appeal.

Instead of sort of trying to force men into going to the doctor more, maybe women shouldn't go as often as they apparently do? Just asking because now everyone's health is everyone's business.

[HereSince1628]

42. I think "forcing" rather overstates the case to make a strawman

What's required is educational programs aimed at getting healthier behavior

It took about 20 years for the effects of the campain to inform about smoking risks to really reverse trends in tobacco relate disease.

Clearly Americans have an independent, dare I say libertarian, streak and resent being told to do things. To be effective an education program couldn't be offensive

[liberal_at_heart]

43. all I can say is good luck with that. People's apprehension to go to the doctor runs deep.

Hell, I'm BRCA1+ and I don't even go for all the tests I'm suppose to go for all the time. Instead of going every year I usually go every three years. People will go to the doctor when they want to, plain and simple.

[sibelian]

45. Another problem with the "habit of men"?

Well, there we go.

[HappyMe]

48. I suppose never going could be a problem.

I don't think it's strictly a problem amongst men though.

I also think running to the doctor for every sniffle and hang nail might might somebody a burden on the system.

[HereSince1628]

52. I don't think it's an exclusive problem of men, either

Everyone needs to be educated to the benefit of preventive care. Society has an interest in seeing that education done.

The comparison of men and women merely illustrates the point of where some of that education needs to go.

The presence of co-pays assists in keeping people from trivial uses of healthcare. Even the majority of V.A. priority 5 veterans (those with V.A. access due to poverty) are required to pay co-pays for that purpose.


The difference that prevail in healthcare seeking also suggests why in our society the "fairness" boogey man presents his ugly head with respect to men now sharing in the burden of women's reproductive health costs. If that difference was much smaller the boogeyman would have less traction.

Getting men to seek preventive care would help reduce that delta. Moreover, the now universal participation mandate in 'fair share' creates a society wide interest in curbing costs...including cost savings that result from participation in preventive care. Consequently it seems that there is a social role for public health education programming/campaigns to achieve those cost savings.

[HappyMe]

57. I'm not interested in getting into a gender war.

Calling men slackers and burdens doesn't help your case.

I'm a woman and basically never go to the doctor. So, I guess I'm a slacker and a burden also. What sort of education are you talking about and how would this be accomplished? What about the people that constantly run to the doctor? I think getting hourly workers (men and women) to give up any where from 1/2 to an entire day's pay is going to be a stumbling block to getting people to go to the doctor.

[tammywammy]

50. I work with a guy that hasn't had a physical in years

He told me he hadn't been to the dentist in probably 5 years either - and he has insurance.

I told him "you know your annual physical is covered 100% right?" and he didn't even realize that. The physicals were covered 100% since before ACA. Not only is it covered, but we get $100 into our HSA from the company for having one.

I have to have a physical every year to get my birth control prescription renewed and I can go over anything else that's bothering me (not sleeping well, etc).


Side note - he's a highly paid engineer, it's not that he can't afford to go to the doctor or dentist either. Plus we have a generous flextime policy at work and it's very accomodating to people that need to go to the dr/dentist.

[lumberjack_jeff]

53. Making insurance mandatory will encourage men to get the preventive care they need.

Men die younger of EVERY preventable cause than women.

I'm for single-payer. Single payer as implemented everywhere else in the world doesn't ask for more taxes from women than men, despite the fact that women use the system more.

As a step toward single payer, removing gender as a rating criteria was a reasonable first step.

On the other hand;

The main use of men is getting them into the insurance pool to contribute to the cost of caring for women and children.

There is a legitimate gripe here, and it seems apparent that improving mens health is considered a potential side-affect, not a purpose.

[HereSince1628]

60. I'm think historic and current attitudes give legitimacy to an unfortunate pov

Men certainly are involved in reproduction. There must be some legitimacy to having them at least partly accountable for healthcare costs associated with that.

The notion that healthcare is a personal rather than a social interest has been the barrier to the US joining the rest of the developed world in cost-saving national health care.

That's something that can and will change over time.

Personally, I'm not concerned that men must pay into the pool.

I am concerned that through socialization and cultural pressure are discouraged from participating in preventive healthcare that would BOTH improve the quality and duration of their lifespans AND help curb costs associated with delaying healthcare.

[lumberjack_jeff]

67. Young men are roughly 20% more likely to be uninsured than young women.

http://www.ncbi.nlm.nih.gov/pubmed/14754940

I don't think that it's all, or even primarily, socialization and cultural pressure. It's largely because they don't have the same access.

Because of the ACA, they now do... even if it is pretty expensive.

[HereSince1628]

71. Certainly cost and access are important

It would be interesting to see what Dr.s visits among -insured- men and women look like, but I don't have such a link.

[Capt. Obvious]

54. YOU TRY GETTING A FINGER UP THE BUM!!!

[HereSince1628]

76. I must admit it would be difficult to do a prostate palpation self-exam

And that is probably the reason many men DO seek a physicians help with that

[AngryAmish]

87. I'm just glad my doc gets me drunk first.

[HereSince1628]

89. I don't really understand that.

The exam isn't painful,

Are your protests linked to a personal issue?

[AngryAmish]

91. I guess you just missed that one, then.

[SoCalDem]

58. I don't think sons are taught to NOT go to the doctors.. It's just that girls

are "introduced" to more doctoring because their female issues often need more tending to as they mature into early adulthood, and then of course childbearing. Then once they are mothers, they of course tend to be "in charge" of the family's doctoring needs.

Once she takes over responsibility for the medical needs, it's easy to see why so many men/boyfriends are okay to abdicate responsibility for the necessary checkups etc.

Young people tend to be healthy, so it's not unusual for the guys to avoid doctors unless they get an injury....and since many young people do not see the years piling up, it's hard for them to give up their feeling of invincibility...until their wife/girlfriend reminds them

[HereSince1628]

61. I'm not sure that being married means more preventive care visits for men

It may be true.

[SoCalDem]

62. Every wife I have met has been the one who talked husbands into them

made the appointments and often made them go

[HereSince1628]

64. I have no doubt that is true...the question is does that enable a reasonably general inference?

Something above 1/4 and under 2/3s of men I've talked to in the diabetes clinic at the VA were married and said they hadn't been to a Dr in decades before they had a major cardiac or kidney crisis through which their diabetes was discovered

That's my experience, but I don't trust it to be representative or sufficent basis to be a reliable general inference about all men's healthcare seeking.

[SoCalDem]

65. Men are procrastinators, to be sure

Must be the macho gene

[HereSince1628]

66. It seems to be something.

[liberal_at_heart]

63. some women bug their husband until they go to the doctor. Sometimes it works, sometimes it

doesn't. I've never been that kind of wife. My husband has pretty major medical issues with his eyes so he has always gone to the doctor. He was overweight for a long time. I never bugged him about it. His doctor did. For years he did not listen. When he learned he was pre-diabetic he lost weight so that he would not make his eye issues worse. He made that decision on his own when he was ready.

[subterranean]

68. Why I don't go to the doctor for preventive care...

One reason is that I've been uninsured for the last 14 years. Most of the time I feel fine. Why should I pay several hundred dollars for a doctor to tell me that nothing is wrong?

When I do have a health problem, I try to take care of it myself and wait a few days to see if the condition improves. If it doesn't, then I relent and call up a doctor.

Maybe I'll change my ways next year when I finally obtain health insurance.

[Gidney N Cloyd]

69. As a man, I mainly don't like ceding control to the GP or primary care physician.

It's like taking my car into Firestone for an oil change instead of the corner Just Lubes-- all of a sudden they're telling me about all kinds of other problems they "found." You go to a pcp for a shoulder ache and all of a sudden you hear the snap of a plastic glove or you have to pee in a cup or something. HEY! MY SHOULDERS ARE UP HERE!

[HereSince1628]

73. My experience has been different, but that's the thing about personal experience.

The few times I showed up for an acute problem, they discouraged having the conversation turn to anything else.

I think the time-allotments to care-codes have contributed to such focus, but I'm sure that varies. HMO pcps I've seen have been rushed. V.A. docs seem to have more flexibility an spend more time on queries of 'how r u'.

[Xithras]

74. I'm a 39 year old man. Until recently, I could count all my adult doctor visits on one hand.

When you're young, healthy, and nothing hurts, why waste the time and money to have some overpaid schmuck tell you that you're young, healthy, and that nothing hurts?

The female reproductive system requires a bit of care and attention to keep everything healthy and working, so women are conditioned to see doctors regularly from puberty on. In fact, there is a standing recommendation from the AMA that women get a gynecological exam yearly. We men don't have those kinds of standing recommendations because the male reproductive system doesn't need to be checked with any regularity. In fact, the first AMA recommendations don't kick in until we hit 40 and the docs want to start checking our prostates.

[HereSince1628]

75. Yes, social conditioning almost is certainly involved

in the creation of the observed patterns of healthcare seeking for both sexes.

[Xithras]

84. Of course, it may not be a bad thing.

While I can understand the general point of the OP, the simple reality is that the cost of socially promoting annual healthcare checkups for young men would outweigh any cost savings by an order of magnitude. It's uncommon for older men to experience health issues that can be attributed to disease that began at a younger age, and which would have been caught during a routine examination. Most male health issues are a function of aging itself, and there is little to nothing that preventative checkups at a younger age can do about them.

So we would be adding a substantial cost and time burden to the healthcare system as a whole, and we would see very little benefit from it.

[HereSince1628]

86. I'm not really sure about that.

You seem to be saying saying preventive health care for men is a snakeoil. THeir problems are all about the untreatable nature of senescence.

So things like control of blood pressure and high blood sugar are medical scams and do nothing to reduce other risks and future costs of things like vascular disease, renal disease and/or amputations?

If so, I'd say we have more serious problems in healthcare than its funding.

[Xithras]

90. High blood pressure among young men is uncommon.

The problem here is threefold:

1) Health problems that actually afflict young men already cause them to seek medical attention, because they generally have other symptoms that would be recognized and addressed. The numbers show that young men DO already seek treatment when they have a medical issue, but simply avoid checkups when they don't. Because routine checkups aren't going to catch things like cancer anyway, the health issues that they WOULD catch are primarily issues that are already being caught under the current model.

2) Problems like high cholesterol and high blood pressure are far less common in young men than older men. While there would unquestionably be some young men diagnosed who are currently slipping through the cracks, the cost savings from treating them would be trivial in contrast to the costs required to scan the vast majority of other young men who would have absolutely no problems.

3) Any doctor will tell you that young men generally don't follow treatment plans for non-acute medical conditions anyway. If a doctor tells a 25 year old that he needs to stop eating cheeseburgers and start taking blood pressure medications in order to avoid health problems at 40, the odds are virtually certain that he will fail to follow the doctors advice and treatment plan. I know that, if my doctor had told me to quit eating cheeseburgers at 25, I'd have done little more than laugh. Doctors aren't generally seen as authority figures.

And 40 seemed like a lifetime away.

[HereSince1628]

94. I see, it's about the way you see fair-sharing personal risk

risks that vary across age, occupation, recreation, housing density, environmental quality, quality of diet, etc, as well as sex.

And if this were about something like medicare, rather than a change to the assignment of costs in a 'personal' insurance policy...would you object to younger men paying for more than their personal care?

I do think there is a muddling of social and personal issues in the approach used in the ACA. It really does seem to me to be an attempt to get away from the notion of healthcare financing from a strictly personal point of view, but very confusingly using as the vehicle to reach that goal...personal private insurance policies.

As I said up in the OP, the ACA requires a new view to be adopted about financing healthcare. We are now mandated to be in it together with respect to covering the overall costs.

Economically being in it together, means we all have an interest in curbing costs through efficiencies and I would argue, the cost benefits of preventive care.

Everything I've read suggests not seek preventive care means disproportionately higher costs than would occur under "prevention".

I don't disagree that young men think in terms of invincibility and distance from consequences...that's why the US military preferred drafting kids, and why they still send recruiters into elementary and secondary schools.

[bettyellen]

99. so, you are defending not taking care of your health basically. well for one thing,

guys shld be getting screened for STDs more frequently. My mind has been blown by how many men want to go unprotected without bothering to do that. Some of this lack of SIMPLE self care is just lazy and foolish. Anyway, 90% of the purpose for everyone who is young is protect you in case of incidents and accidents that send you to the hospital, and that happens more frequently to men. It's not like our annual Paps take more than 10 min during a regular exam. And if we need to get STD tests, like pregnancy- a man bears some involvement in that too. Guys have a stake in all that.

[AngryAmish]

88. Proof of that?

Hand waving don't count.

[liberal N proud]

77. Girls are start visits to the doctor early in life

There are things that can and need to be checked.

Boys, not so much. Until the last couple of years, I had not gone to a doctor on a routine basis. I was little overweight, but everything else was good. I had a bout with ulcers when I was 24, but nothing after that that needed a doctor. What was I going to do when I got there?

When health screening first started, the only thing they would get me for was my BMI, Blood pressure was good, cholesterol was good. I am now on a routine doctors visits (got one in 45 minutes) and have seen the doctor more in the last 2 years than in the 20 years prior.

Why now, my blood pressure has crept up a bit, found through health screenings at work, medication is working and now I just go in for routine monitoring.

[HereSince1628]

80. Really? My visits started at age 9 and happened annually

because they were a required part of participating in organized athletics.

Cant' say what is required now or what fraction of boys played in the past.

But I would think those that do are getting physicals.

[liberal N proud]

96. Our atletic physicals were done in school by a retired osteopath.

[HereSince1628]

97. Do you know if such physicals are still required for kids?

I've been out of that loop for decades

[liberal N proud]

98. They are required now

And it must be a doctor now, our kids had to in high school even for marching band.

[lumberjack_jeff]

83. Maybe this will inspire them to take advantage of their coverage

http://money.cnn.com/2013/05/14/news/economy/obamacare-premiums/index.html

Gender: Currently insurers can charge premiums based on gender. Men usually pay less than women, since they typically visit the doctor less frequently. The Affordable Care Act, however, doesn't allow insurers to charge different rates to men and women.
Taken together, men ages 25 to 36 could see rate increases greater than 50%, according to Milliman's O'Connor, but women of the same age will only see their premiums creep up 4%. Meanwhile, men age 60 to 64 could see their premiums drop by 12%.

[Rex]

93. Average persons insurance plan - don't get sick.

Now no longer will our health and our job be integral parts of each other!

[bettyellen]

100. Such a relief to break the employment for insurance chains!!

[Manifestor_of_Light]

95. Conservatives think illness is a moral failing. It's not just macho.

Note stories that the woman who fainted at a recent Obama speech was "faking it", Hillary's head bump was "faking it", "trying to get attention", etc.


I was once married to a man like that. When I was curled up in bed with agonizing menstrual cramps, he was convinced that I was "doing it to get attention", and so he went to the other side of the house so as not to "encourage me". It never occurred to him that his presence did not affect my disabling cramps every 28 days. I was in so much pain that I didn't even notice if he was in the room. For some reason, doing something "to get attention" like singing or dancing, for example, is BAD among rednecks.


Eventually he put me under so much stress with his constant nagging, refusal to provide emotional support or affection, that I physically collapsed and was in and out of the hospital and ER with pneumonia and bronchitis for eight or nine YEARS. When we were separated he told the baby sitter that I was "faking the whole thing" and "she's bribing her doctor to put her in the hospital, because she wants sympathy." He said he was "embarrassed at work" because I cost his insurance so much money, when he was the one abusing me with mental cruelty.

My doctor suctioned my lungs out so I would not die (drown in lungs full of pus) four times in five years.

When I had our child, my husband thought I was supposed to go to the neighborhood hospital and just drop the baby like a peasant woman. Because his mother had an Indian midwife in California when he was born.

I insisted on going to the Medical Center to a very experienced obstetrician because I knew I had to have a C-section. I'm a small person. After delivery, he was in the far corner of my hospital room telling me "you're lazy" for not getting up after being sliced open from one hip to the other!! Major abdominal surgery, spinal anesthesia, and you are forbidden from getting up for two days!!

My mother was crying tears of joy and relief that the baby and I were both healthy and safe.


He was so mean to me that I think he married me for money, thought I would be rich after I graduated from law school. That didn't happen.


Ex-hubby is such a genius that he tried to bicycle from Houston to Wyoming and ended up in a hospital in Colorado getting his hemorrhoids removed. (Insert perfect asshole joke here.)


Greg Abbott is going to run for Governor of Texas. He's in a wheelchair because he was out jogging in West University Place (a neighborhood near Rice University in Houston) and a tree fell on him; he sued the property owner. But he's against injured plaintiffs suing those who injure them, and putting caps on damages, all known as "tort reform". Okay for him to sue, but not for other people. He is also against the Americans With Disabilities Act. So I guess he's gonna crawl up the steps of the Governor's Mansion if he wins????

Conservatives think it's your fault if you're sick and you brought it upon yourself, so they don't want people to get reliable health care. They don't understand that being sick is usually not a choice.

It's like pro-lifers who say "the only good abortion is MY abortion." A bunch of goddamn hypocrites.

[lumberjack_jeff]

101. "Social burden"? Maybe. Is the fact that they're dying also a consideration? n/t

[gopiscrap]

102. I didn't go for many years

because it was expensive and I also didn't want to take the time