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About that "World's Best Healthcare System" the U.S. is supposed to have...

2&2 Slider To Leyritz said:
In this instance, we really don't have any. We materially draw genetically from all over the world, so you'd really need to average everywhere else in the world to start.
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So since we're a special little snowflake, we can't be expected to have fewer infants die than the average of the entire world, which includes countries with incredibly high rates of poverty? There is no way we can move higher on this list of infant mortality rate?

Iceland
Luxembourg
Singapore
Japan
Finland
Andorra
Sweden
Norway
Slovenia
Cyprus
San Marino
Portugal
Monaco
Denmark
Czech Republic
Italy
Estonia
Germany
Ireland
Korea, Rep.
Austria
Israel
France
Netherlands
Belgium
Switzerland
Australia
Spain
Greece
United Kingdom
Croatia
Belarus
Canada
Poland
Lithuania
New Zealand
Cuba
Malta
Hungary
Montenegro
United States
Bahrain
Bosnia and Herzegovina
Serbia
Slovak Republic

(In the interest of full disclosure, I used a five year average.)
 
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TownieDeac said:
I've yet to hear the actual argument for it. What is it again? That genetic diversity in the United States leads to worse, more expensive health care?
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Basically, yes. If you have a more genetically diverse population, then you have many more potential mutations to screen for and/or treat. That is going to cost more and the treatment is going to be less effective because of the need for more knowledgeable specialists. A generally genetically homogenous population is going to have less possible mutations to screen for and/or treat. That is going to cost less and the treatment is going be more effective. It is pretty basic common sense.
 
Think of it this way. If you are an auto mechanic, and all you work on all day every day is Hondas, then you are going to get pretty damn good at diagnosing and fixing Honda's problems. But if you are that same mechanic but now you also have to fix Chevys and BMWs and Saabs and Toyotas, then your results are not going to be as good and it is going to cost your customers more because of all the different equipment you have to buy to diagnose and fix those makes as well.
 
2&2 Slider To Leyritz said:
Basically, yes. If you have a more genetically diverse population, then you have many more potential mutations to screen for and/or treat. That is going to cost more and the treatment is going to be less effective because of the need for more knowledgeable specialists. A generally genetically homogenous population is going to have less possible mutations to screen for and/or treat. That is going to cost less and the treatment is going be more effective. It is pretty basic common sense.
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No, it's not common sense. It's complete and utter hokey horse shit. What in the fuck are you even talking about?
 
2&2 Slider To Leyritz said:
Basically, yes. If you have a more genetically diverse population, then you have many more potential mutations to screen for and/or treat. That is going to cost more and the treatment is going to be less effective because of the need for more knowledgeable specialists. A generally genetically homogenous population is going to have less possible mutations to screen for and/or treat. That is going to cost less and the treatment is going be more effective. It is pretty basic common sense.
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I mean it's basic common sense for anyone that has taken a biology class that the exact opposite of this is true.
 
TownieDeac said:
I'll try my best not to use numbers.

Without genetic heterogeneity, biomedical research on genomics would collapse. You can't build gene expression profiles (transcriptomics) without diversity; you need tens of thousands of diverse gene arrays. But even with a homogeneous population, proteomics (studying genetics by studying proteins) is absurdly diverse. Proteins are the ultimate product of the human genome, and there are perhaps 90-100,000 different proteins making up the proteome, some 4-5 times the number of genes within the genome. Access to a single human's genome is a necessary but insufficient understanding for genomic medicine. You absolutely need a diverse population to advance biomedical research in genomics/genetics.
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No shit, but that has absolutely nothing to do with this discussion.
 
2&2 sometimes makes good arguments that get ridiculed because they go against the board's left leaning conventional wisdom.

This isn't one of those times.
 
2&2 Slider To Leyritz said:
Basically, yes. If you have a more genetically diverse population, then you have many more potential mutations to screen for and/or treat. That is going to cost more and the treatment is going to be less effective because of the need for more knowledgeable specialists. A generally genetically homogenous population is going to have less possible mutations to screen for and/or treat. That is going to cost less and the treatment is going be more effective. It is pretty basic common sense.
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Oh man. I haven't been screened for mutations lately. I better go get my special uncertain-ethnic-background-generic-southern-white-male mutation screening, STAT. Anybody else due for their mutation screen?

514px-Xmen90s.jpg
 
TownieDeac said:
Except none of this is how personalized medicine or even basic Mendelian genetics works. Take this, the first country-scale meta-study of population genetics. Even within remarkably homogeneous populations like native populations in Mexico, there's a "stunning amount of genetic diversity". Which is why we don't focus on population genetics when we apply personalized medicine. That's so unbelievably basic I didn't realize it was the argument you were making in the first place. Population genetics are important for understanding epidemiological trends, responses to treatment, etc., but to quote the article:
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I would just like to point out that while I do not refute what Townie posted, population genetics do matter in genetics and especially genetic diagnosis. There is a reason why every genetic testing form asks for your ethnicity. Certain mutations are pathogenic in one population and benign in another.
 
Sgt Hulka said:
I would just like to point out that while I do not refute what Townie posted, population genetics do matter in genetics and especially genetic diagnosis. There is a reason why every genetic testing form asks for your ethnicity. Certain mutations are pathogenic in one population and benign in another.
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Exactly, which is my point. The permutations of possible mutations are much greater in the US population than the Finnish population. Therefore, there is more to screen for and treat, which goes directly to effectiveness and cost.
 
Again, why? You just said yourself that it is a necessary component. Are you arguing that more tests don't cost more?
 
Is there any basis to say that we are significantly more ethnically diverse than the peer group we are looking at?
 
2&2 Slider To Leyritz said:
Exactly, which is my point. The permutations of possible mutations are much greater in the US population than the Finnish population. Therefore, there is more to screen for and treat, which goes directly to effectiveness and cost.
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Seriously, what in the fuck are you talking about? I mean, you are literally just making shit up at this point*










*well, even more than usual
 
I was mostly being snarky, but a few quick points (and I'm by no means a geneticist).

1. In general terms, genetic homogeneity is a bad thing and increases susceptibility to disease. That is why you may hear about certain endogamous populations having high rates of certain diseases (Ashkenazi Jews and tay-sachs disease is a classic example).

2. The diseases that fall into this category (with specific driver mutations that are highly represented in certain sub-populations) are incredibly rare. It's not like working all day every day on a Honda. It's like working all day every day on lime green 1970 Dodge Coronet Convertibles. Screening and treating these diseases aren't even a rounding error when discussing health care expenditures.

3. A place like Austria, while less "diverse" than the US, still has an incredible amount of genetic diversity, and we share the common diseases that drive health care spending. In other words, the breadth of diseases that dominate health care dollars is no different. Our doctors are fixing the same Hondas, Toyotas and Fords, and there's no biologic reason we should need more specialists to do so. The driver for specialization in our country is economic, not biologic.
 
Again, I want to know who is getting all this genetic mutation screening and treatment that 2&2 is on about. if the mutants look like this I vote for more, not less.

4087109-phoenix_five_flats_trinitymathews_vic55b__colors_by_vic55b-d67n2ps-1577285182.jpg
 
TownieDeac said:
It's the exact opposite. You run organ, tissue, or gene specific tests on people to test for risk factors. Diversity has absolutely nothing to do with the amount of tests that have to be run. On the contrary, they can help algorithmic medicine. You fit these genetic parameters, you get these tests done because you're at risk. It cuts down on the diagnostic work that needs to be done.
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None of what you posted from that article is relevant to this discussion. We're talking about infant mortality, not looking for long-range risk factors. I know it is #anecdotal, but that is not the way it happens. The child is born (usually in these cases premature), the child doesn't do so well, and the child dies. During the period while the child is alive, they run a shit-ton of tests to try to narrow down what the problem could be. That has nothing to do with a genetic predisposition to certain long-term risk factors like you are addressing, it has to do with short term mutations and afflictions.

However, the bolded part of your post is relevant. If the hospital knows with a good degree of certainty the genetic parameters, then it has a better idea of what test to run. However, if it is a crapshoot what genetic parameters are present, then the spectrum of tests is wide open. Which is my point.
 
There's a whole lotta wrong talking down to 2&2 who happens to be right going on in this thread.

And LOL @ townie w/ his big words. just so utterly wrong, but keep usin' dem big words.
 
tiltdeac said:
I was mostly being snarky, but a few quick points (and I'm by no means a geneticist).

1. In general terms, genetic homogeneity is a bad thing and increases susceptibility to disease. That is why you may hear about certain endogamous populations having high rates of certain diseases (Ashkenazi Jews and tay-sachs disease is a classic example). Right. So certain countries don't have any Ashkenazi Jews, so they are not looking for that. We do, so that is another thing for the US to screen for.

2. The diseases that fall into this category (with specific driver mutations that are highly represented in certain sub-populations) are incredibly rare. It's not like working all day every day on a Honda. It's like working all day every day on lime green 1970 Dodge Coronet Convertibles. Screening and treating these diseases aren't even a rounding error when discussing health care expenditures. But the US doctors still need to be able to recognize those drivers and be able to run those tests if they encounter a potential patient, right? So that need for knowledge and the test adds to the cost.

3. A place like Austria, while less "diverse" than the US, still has an incredible amount of genetic diversity, and we share the common diseases that drive health care spending. In other words, the breadth of diseases that dominate health care dollars is no different. Our doctors are fixing the same Hondas, Toyotas and Fords, and there's no biologic reason we should need more specialists to do so. The driver for specialization in our country is economic, not biologic. But we're not also just treating Austria's common diseases, we are sharing every other country's common diseases as well.
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Basically we have to be able to diagnose and respond to all of the potential diseases that impact pretty much every single other country, so it compounds everything.
 
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