So then the question becomes what other daily device(s) could be made to do automatic health checks of certain specific indicators, which would give an early indication to the possible condition, thus improving life expectancy and quality of life, while lowering associated medical costs.
i.e. toothbrushes that detect cavities, sunglasses that check your pupils for certain symptoms, hats that monitor your EEG. These are obviously extreme examples, but you get the idea...
https://www.nytimes.com/2018/01/29/upshot/preventive-health-...
> Preventive Care Saves Money? Sorry, It’s Too Good to Be True
> The idea that spending more on preventive care will reduce overall health care spending is widely believed and often promoted as a reason to support reform. It’s thought that too many people with chronic illnesses wait until they are truly ill before seeking care, often in emergency rooms, where it costs more. It should follow then that treating diseases earlier, or screening for them before they become more serious, would wind up saving money in the long run.
> Unfortunately, almost none of this is true.
The byline is "Contrary to conventional wisdom, it tends to cost money, but it improves quality of life at a very reasonable price."
and the article closes with this
But money doesn’t have to be saved to make something worthwhile. Prevention improves outcomes. It makes people healthier. It improves quality of life. It often does so for a very reasonable price.
There are many good arguments for increasing our focus on prevention. Almost all have to do with improving quality, though, not reducing spending. We would do well to admit that and move forward.
Sometimes good things cost money.
I estimate I'm saving between $200k and $500k annually by doing things like eating right and getting enough exercise.
Well, TBF, that's really for two people eating right etc. I, personally, am probably saving only half that.
The nation of Germany?
No one would like this. It is an interesting idea.
The lady complains but I think she enjoins it. It's fun to complain and be heard, even if it seams minuscule annoyances to any observer.
Be careful with this. Look into the result of increase PSA testing:
> Although experts are somewhat split on the value of PSA tests as a screening tool, there is widespread agreement on two major points: overdiagnosis and overtreatment rates are far too high, and there is an urgent need to refine PSA testing to be a more effective screening tool. [1]
Or mammograms
> We conclude that the mammography FP rate in North America is in excess... [2]
Arguably, the issue is that we just lack good baseline data, but you have to consider all the false positives you'll get with more data collection.
[1]: https://www.health.harvard.edu/healthbeat/the-pros-and-cons-...
The Smart toilet idea has been parodied a lot though and none exist as far as I know. Maybe it’s just not feasible?
What other everyday objects could be utilized? What about my phone’s front facing camera to scan my face looking for muscle twitches or eye issues?
Does he feel car insurance and home insurance are useless since he didn't total his car last year and his house didn't burn down?
He knows this (as he mentions it obliquely) that he could lower his deductible but his costs would go up. Is he complaining that he is on the wrong part of that tradeoff curve? Or does he expect low-cost insurance with a low deductible that covers all of his routine medical expenses?
Even so, a $20k a year is peanuts compared to the out-of-pocket expenses of a serious medical emergency. Don’t fall into the trap of thinking insurance is not with it just because you haven’t had to use it yet.
With family members, they are all absolutely living in parallel and at the same time.
Just to add to the discussion, I've been self employed and on ACA plans for several years now (with my family). I'm grateful to have the option, and it's miles ahead of what we had prior to the ACA.
The whole health system in the US is horrible. Nobody should need to go through a middle-man (a.k.a. insurance) in the first place. No wonder prices for everything are absurdly high.
Edit: and I have an anecdote about this too. Last year I had an episode of AFib. I've been taking medication since then. So after almost 1 year taking a certain medication, my insurance rejected it, saying they wouldn't pay for it and that I had to switch to something else. Now, why is it OK for an insurance company to dictate what I can or cannot take, if my doctor prescribed me something? How on earth is it OK for insurance to dictate what treatments I can or cannot have? I feel like a piece of meat when I go to a clinic and they need to call my insurance to see if it is OK to give me a certain treatment. This is nuts.
I don't own a home. I drive an old (and thus, inexpensive to replace) car. To save money, I have the highest deductible offered by my insurance company. That ensures that when something small happens, unless it affects drivability, I'm not going to fix it.
The value I see that I get out of car insurance (besides the legal requirement) is its health insurance, e.g., if I get in a crash and need $50K for emergency surgery, or if I get in a wreck with another driver who was (illegally) driving without insurance and they needed surgery.
In other words, apart from the health insurance aspect (which should be single-payer anyway), yes, I think car insurance is pretty much useless for me.
I understand why governments institute requirements like this -- it's a systems-thinking solution which is probably better than not having it -- but pretty much by definition any private insurance system is going to be a financial loser for a lot of people.
I don't have to pay to insure my money -- the bank pays the FDIC from my capital. It seems weird to me that I have to pay for personal insurance at all. Why don't fuel taxes and license fees provide for auto insurance? Why doesn't federal income tax provide for health insurance? Various other countries do these and they seem to work fine. Yeah, I know: politics.
Australia generally has great "free" healthcare but even then it is complicated with rebates and gaps etc, its not completely "free" but there isn't exactly a limit on what you can have done under Medicare. If you have private medical insurance (an option not a requirement) then you can get a nicer hospital and not pay for the extra requirements.
In the UK you just get fixed and never see a bill in your life - everyones tax pays for it. Again not exactly "free" but you don't "pay" for it. Again, if you have private you can get a better hospital, choose your doctor etc.
The way I see it the US could 'have its cake and eat it' but there is significant opposition to anything that seems "Socialist" because the moguls who run these private health insurance companies are making too much money to change the system.
No, the Australian medicare system is not remotely close to being great. When a simple CT scan/MRI can take 4 months waiting time [1], I wouldn't jump up and defend such a failed system. It is not great, it is the complete opposite of that. Ever tried to do some dentals using that "free" healthcare you mentioned or ever tried 12-18 months elective surgery waiting time?
[1] https://www.2gb.com/hospital-waiting-times-for-crucial-surge...
with heart rate in 120 bpm? to me that is the pretty opposite of "excellent health".
It’s a weird case too because if she gets the care she needs she stands to live a long life, be of normal intelligence, she has a good chance of walking, etc. She’s so darned cute and gregarious, cooing and laughing, you’d never know she had all these problems if you saw her out and about.
So I guess my daughter is the reason insurance is so expensive. But after getting page after page of “100% covered $3000” pages for each day she’s spent in the hospital, I’m really glad to have the insurance I do, because a place where the government decides how much to spend on care would have given up on her months ago.
That seems insanely high
If you're worried about an elevated resting heart rate, go get an ECG done. Don't let random people on the internet talk you into health anxiety.
So for someone who is say 30, your maximum rate is ~187. But a rate over 90 when resting is considered outside normal levels.
If you have no history of cardiac disease and aren't taking any medications that would cause an increased rate, if your resting rate is 113-120, you need to be checked.
edit: just checked again and nope, that was pre-doctor visit. Something that high would certainly cause me to worry.
During a-fib, the electrical impulses are all off. The peaks and valleys are irregularly spaced and the amplitudes vary from cycle to cycle. This usually results in a rapid heart rate as a second order effect because, due to the "misfiring" not enough blood is pumping through and your heart is working harder to make up for the difference.
Although my case is infrequent enough that it is not thought of as a risk by the medical community, for peace of mind what I would really like to have is a link between a watch of some sort and a car capable of self driving. Should I be driving when I go unconscious, all the car would need to do is automatically kick in autopilot mode while gradually slowing down, until a heart rhythm is detected again.
The risk is small, if you consider the percentage of time I'm behind the wheel, but it would be good for peace of mind. It would also be helpful for others who do not yet know they have a heart condition, or those who are having a stroke or epileptic attack while at the wheel. There are others with worse conditions than mine who are basically advised not to drive, so it would help them as well.
If falling asleep can be detected by any biological signals, that would also be a useful autopilot trigger while waking the driver up, for the general population.
Currently most cars require manually activating the autopilot mode; what I'm proposing is a vital sign monitor to automatically begin self-driving if the human is incapacitated.
If the human doesn't wake up within a half a minute or so, the car could also self-drive itself to a hospital. I think we're far enough with self-driving tech that that saved life would far outweigh the risks of the self-driving system having any issues en route.
I think you're onto a good idea, except for the above quote. It would be a much better idea to have the car automatically pull over to the shoulder, stop, engage the flashers, and call 911. Paramedics can keep you alive en route to the hospital with drugs, cardioversion, and CPR. Your car cannot.
I'm also thought to be under control via medications now, and also am scheduled for an ablation procedure which may cure it altogether. The bad news about medications, and that procedure, is that it's hard to know whether it cured it, considering how infrequently they happen. I could go another 10 years without incident and then it happens again -- or I could go my entire life and it never happens -- nobody knows. So the best I can do at the moment is to just carry on with life.
That said though, I would still feel emotionally safer if the car drove itself, or at least could detect such things. Not only for myself, but for the sake of those people who have incurable frequent instances of incapacitation -- they actually are not advised to never drive -- as well as the entire rest of the population that is over-stressed and under-slept.
Also, I feel what has happened to me could happen to anyone. Doctors haven't been able to diagnose any particular cause, but I have been under extreme work stress over the years, and the connection between that and heart failure among other things is really not well understood. Extreme electrolyte loss is another way any otherwise normal person could go into ventricular fibrillation as well, and that's not something everyone is educated about.
I bike most of the time, and drive only occasionally, by the way. If you look at that in isolation, yes, I'm more likely to die being incapacitated on a bike than in a car. But if you look at the problem holistically, biking is more likely to improve my cardiac condition over time via much needed exercise, as well as the reduction in stress by doing stuff I enjoy doing. For all we know, living a life of abstaining from everything could be far more likely to pile on stress that could potentially make things worse.
What if the self-driving tech kills both you and someone else on the route?
The reason is I would suggest the watch is their ECG is tuned quite well.
My dad is a triple bypass heart patient. ECG and stress tests did diddly squat to detect it, until it was too late and it was diagnosed by a CT Angiogram. I now get CT Angiogram with contrasts every few years just to be safe because of family history.
[1]https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atr...
There are 329 million people in the US. 1 in 122 (329/2.7) people is not "very rare". 1 in 55 (329/6) people is even less so.
Original: I don't think they enable the ECG feature for anyone outside the US. It's locked based on the point of sale last I checked. Very frustrating to buy something so expensive to find out it's been region-locked!
On the other hand, of course it's great to save lives and help you detect possibly harmful conditions. The thing that makes me uneasy is not the idea of a heart tracker watch per se, but the possibility that maybe one day the facebook app wants access or chrome because of WebHeartBeat API or whatever. This trend of constantly increasing amounts of data sources sent to the cloud is sick.
Heart rate information, like all health information gathered by Apple Watch, stays on your device unless you choose to back it up to iCloud. In this case it is end-to-end encrypted.
Thanks to an Apple Watch w/ ECG, I now have a cardiologist, too. My A-fib burden is only 4% and at my age without diabetes my increased stroke risk is minimal, so my Dr. basically asked why I was bothering to wear this thing if it was just worrying me unnecessarily.
I mostly agree. It is nice to finally know what's going on because I've been having irregular heartbeat when exercising for over 5 years & a stress test (ECG on a treadmill) didn't show anything. Now I've had 2 weeks of monitoring with an iRhythm Zio & an echocardiogram so I know I'm reasonably safe to continue exercising.
Is it worth the $$$ insurance paid for all of it? I'm really not sure about that. I kind of wish the Dr. had told me "lose some weight or you'll drop dead" because I would have listened. I'm also not sure what I would have done if I hadn't been able to figure out what was happening. Probably just continue to keep my rate under 150 as it's a high rate that usually correlates with irregular beats.
The heart is pretty complex for being 'just a pump'. Things can and do go wrong in ~100% of the population. Whether or not that's a problem that should be monitored, medicated or operated on, depends on many factors. It isn't as clearcut as saying "you've got afib and we need to fix that".
Now it's a questionnaire instead. I think the new system works better here since it's one less hurdle to get over before you can sign up for a gym and work out.
Just asking... Because if the value prop is that they can detect, then they should have some accountability for non-detected positives, no?
The device has been given a class II clearance by the FDA, which means it has to “ provide reasonable assurance of safety and effectiveness “.
False negative rates are definitely one of the things that are considered in getting this. That doesn’t mean false negatives aren’t possible.
Are people be better off without the watch altogether if it does not have perfect detection?
Don't let perfection be the enemy of good. I don't think we should hold Apple/the watch accountable for type II errors for similar reasons as to why we have Good Samaritan laws.
This is just basic medical stuff.
It takes the form of a combination of very high output training (BJJ) coupled with regular, sustained aerobic training at a high percentage of my aerobic capacity (running and plyometrics).
It sounds like I'm being flip, or worse, self-satisfied - but I am quite serious.
If my heart started behaving strangely, or weakened in some way, I would notice immediately. It would be quite marked. Things that I partake in, and think about, and feel, would suddenly be off.
Or to put it more technically, I am running my body at a much lower set of tolerances where defects are immediately identifiable.[1]
I have a suspicion that my cardiologist is actually better than the apple one, since I could feel some differences that might not yet manifest themselves in some kind of measurable heart output.
The downside to all of this, in the faraway future (I am currently 42 years old) is that "heart trouble" might manifest itself during exercise in a sudden and acute fashion that leaves me dead. On the other hand, the exercise makes that, statistically, less likely.
I also enjoy it very much, so there's that.
[1] https://www.keyence.com/ss/products/measure/measurement_libr...
Actually depending on your condition and your activities, it’s entirely possible that the first warning you’d have is dropping dead. I’m also not being flip or self-satisfied, and I also have an anecdote to share. A good friend of mine who was a serious tennis players, and later an equally serious swimmer and runner got his “warning” about two years ago. He was at a conference and complained of feeling a bit ill. Then he experienced sudden cardiac arrest and despite an AED on premises he died.
He wasn’t much older than you, was in perfect shape and ate well his whole life, saw his doctor and had good lab numbers. The “far future” you imagine is hopefully just that, far in the future, but it might not be. Like a lawyer as their own client, don’t be a fool and pretend to be your own cardiologist.
Yes, that's exactly what I said.
This is looking at it backwards. How many serious health problems have similar rates of affliction? If there are 50 different potential health problems then he has a 2 in 3 chance of having at least one of those.
So if you're a doctor it's really unlikely that you patient has either of those. But start adding up all of those rare syndromes and it starts getting scary.
One had better be okay with it, because if you don't consent, they'll take the money from you by force.
Grandfather discovers heart condition thanks to children’s museum exhibit
https://kdvr.com/2019/02/21/grandfather-discovers-heart-cond...
I don't think I submitted it to HN. I felt it would be viewed as fluff.
But we have incredible and constantly increasing opportunities to casually check biometrics that previously required serious medical exams and lab work, etc. It's absolutely changing things.
Tangential question, related to the above: I am currently paying for COBRA, and the amount paid is outragerous. Anyone has suggestions for a cheaper, good enough alternative?
Yeah that should have been a red flag in itself
Also remember that while it will give "true positive" results, there will be a lot of borderline or non-worrying alarms that will need to be checked.
> resting heart rate being in the 113-120 bpm range
with such readings, I guess one would just go to see a doc?
