I estimate there is no greater intellectual in History than Friedrich Nietzsche (defined as original, impactful, durable, influential, stylistic). Since his tragic death in 1900 his phenomenal breadth and depth of aphoristic writings have rung more prescient with each passing decade,……it’s exhilarating and rather spooky.
Sometimes when reading him late at night I think “He is writing about 21st C healthcare, he is explicating our problems.” Very little of his books sold in a truncated lifetime, yet now he is unquestionably the most powerful philosopher of the past ~100 years,……perhaps ever.
One theme of his was anti-foundationalism which basically means that there is far, far more “untruth” than “truth” in our world,…….not necessarily lies or falsehoods, but “untruths”. Nietzsche persuasively argued that Mankind has wasted several millennia in the search for immutable “truths”. The cost of this unrequited desire for artificial stability and control has been oppression of 95% of the populace, violence, superstition, and arbitrary hierarchies. The tragedy of our grievous pursuit of non-existent foundations has been diversion from Mankind’s authentic meaning, journey, and fulfillment, i.e., self-mastery and self-creation.
We have not made progress toward the vaunted Triple Aim of healthcare (improved population health, better individual care, lower cost),……that is a data-driven, reasonable observation.
We cannot make progress toward the Triple Aim,……that is an “untruth”.
Obesity is the #1 healthcare problem in the USA that is organic and objective,……it exceeds just about every other upstream effector,……and it does have strategies that mitigate its devastating, long term consequences. Examples – first attachment is yet another study supporting the wisdom of preventing gestational diabetes. Whatever multi-prong strategy is proficient will pay for itself several times over. The second attachment demonstrates the skyrocketing incidence of obesity – 6% of “emerging adults” in 1976, to 33% in 2018.
RCTs could be designed with creative incentives of self-mastery and self-creation……
Joe Kaempf, MD
Oregon Representative
Portland, OR
Volume 13, Number 35