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This week, in a special episode of Healthcare Triage, Aaron and John Green answer your questions! Learn answers to burning questions about handwashing, life expectancy, and stuff.


Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=68657

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

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J: Hi I'm John Green!

A: I'm Aaron Carroll.

J: And we're here today to do Healthcare Triage Q&A. I'm gonna ask your questions of Dr. Carroll. I'm also might ask some of my questions, uh, most of which will revolve around my own mortality. Aaron, am I gonna die?

A: nnnnnnn...yes.

J: Damn it!

A: Some day! Some day! Not now. 

J: (Sigh) What's my chances next five years?

A: Very, very low. Really low.

J: Yeah but not nil, not zero. 

A: Yeah, not zero. Really low. 

Q1....
J: We're going to start with a question from Little Lionflower: "How long does it take to process food into stored fat or muscle energy? If I eat fewer calories today, will I see the difference tomorrow or the next day?" 

A: Not in terms of fat. Um, so there's no chance that if you eat fewer calories today is going to reduce in fat reduction tomorrow. But there will be changes in your water weight, and eating less salt or less certain nutrients may make you diurese, or pee off some of the water so that it would not be immediate weight reduction. But it would be a fat reduction that would be consistent. 

J: So if I'm looking to lose 13 pounds in the next 24 hours what would you recommend?

A: I don't know if there's any way, short of amputating a leg (laughter), that you could probably pull that off. Or have a baby! Women could do that - have a baby. 

J: so I just need to have a baby

A: Have a baby! Tomorrow
 
J: (laughs more)


Q2....
J: Sakowski asks: "Do you think there are specific health benefits to weight training? Metabolic, cognitive, or hormones?"

A: Well certainly if it gets you to exercise it would be, yes, because of course, if you, in fact, some of the recommendations for exercise are always 150 minutes a week or five days a week at 30 [minutes] or moderate, or vigorous for two 30-minute periods and I think three periods of weight training instead. So, if you want to figure it out so that you're still getting the recommended amount, weight training is perfectly fine. Some people also argue too that if you put on more muscle mass that that helps you increase your metabolic rate or how many calories you're burning and that it could help with long-term management. Iiiiii'm not totally convinced of that. 

J: What are the supposed cognitive benefits of weight training?

A: So again, I think that's more exercise than it is weight training. So there are definitely cognitive benefits with respect to anxiety and depression, everything else that I've- we even did this discussion in an episode of exercise. But I don't think that would specifically be weight training. 

J: So I'm good to continue with my, uh, 30 minutes a day of jogging?

A: Yeah.

J: Slash fast-walking.

A: That's perfectly... you see 30 to 35 minutes a day is the weekly recommended amount. You have done the recommended amount. 

Q3:
J: James asks: "My parents are saying Obamacare has caused their premiums to rise, but I'm not convinced that's the reason (they're in TX). What causes premiums to rise? How can I help them find better rates/plans?" Can I answer this question first?

A: Sure! Go ahead.

J: ...and then you tell me if I'm right.

A: Yeah. 

J: No, Obamacare has not caused your parents' premiums to go up. And the way to find them better rates or plans is to have a drastic overhaul of our healthcare system so that we have one that is more like countries in Europe. 

A: Okay, so since that's NOT gonna happen, I'm going to give you realistic advice. So first of all, it's healthcare premiums that rise when healthcare spending goes up. I mean, you know as much as we demonize health insurance companies, their profit margins are on the thin-side, so what happens is that each year they have to guess how much they're going to spend on healthcare. If they wind up spending more on their risk pool than they thought, then the next year, they raise the premiums in order to sort-of compensate for that. So, the reason the premiums likely went up for your parents is that that health insurance company wound up spending more money than they did the year before. The way to fix it is if they're getting a plan from the exchanges, go shop for a cheaper plan. It's very likely that if that plan went up, then other plans may be cheaper because they weren't covering such a sick pool. So you need to shop around every year. And it is easy or common these days to scapegoat Obamacare and just blame it for every little problem. Healthcare spending and premiums have been rising really fast since forever, and in fact they have been in the past few years rising so much more slowly than ever before. You can also credit that to Obamacare, but nobody does. But you know these days it's just like anything: "Did you hear the new drugs have side-effects? Now it's because of Obamacare!" It's just... It's not all Obamacare's fault.

J: Is there any truth to the talk that Obamacare is in a sort of death spiral, where the pools are getting sicker and sicker?

A: No. So what they've seen is that some of the co-ops have gone under and those are some