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Carrie C's avatar

Ok, as a subscriber from the beginning, I love Sensible Medicine. It’s one of my three favorite Substacks, the others being Racket News (Taibbi & Kirn) and of course, Vinay’s Observations. But I really have to push back on you here, Adam.

I live in West Virginia. Moved there from northern California 25 years ago. I used to work in a largely government subsidized health clinic before I switched specialties. I grocery shop weekly myself, in a very working class WV grocery store and every week for years I’ve see what the people Adam described buy and feed their families and themselves.

When you have a box of Kellogg’s Something Cereal for $7, frozen Chicken Tenders for $15, the big bag of Doritos for $8.99, Soda for $5.99, 4 hamburger buns cost $5.00 and you believe vegetables are carrots, corn and potatoes,that’s a problem. These are typical ingredients of the shopping carts I see. These foods are government subsidized, too. I see the SNAP cards used.

I don’t buy that stuff, nor was I raised in my blue collar family to eat that way. My mother clipped coupons, didn’t buy convenience foods. My mother worked full time but she still cooked, and we kids learned to as well. Lots of times we cooked ahead of time and prepped meals to eat later in the week, or we refroze our leftovers. We made it work with the time we had when we had it. Healthier meal prep and avoiding eating crap can be done if you are poor.

Why do so many doctors and white collar workers automatically believe the working class can’t feed themselves in a healthier manner?

How about our system start addressing the root cause of America’s chronic disease epidemic? Why is it always the excuse- oh that poor worker, she can’t afford nutritious food or fix it. So it’s ok if she and her kids are morbidly obese, the doctor can help with their diabetes and hypertension.

I think it’s a cop out on the part of medicine to neglect teaching our kids and their parents that a pill or shot is not the way to make things better.

The widespread belief that workers are helpless due to circumstances creates more dependency on the medical system and doesn’t treat workers as part of their own health care team, which is empowering.

This is my hope for MAHA. Teach and influence those who lack knowledge, right the nutrition ship, and don’t teach that medicine is the basis for improved health.

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TiredMedStudent's avatar

This seems a bit like a strawman. I don’t think there are many people who sincerely believe no harm will come to them if they eat well, sleep well, exercise, and so on. Perhaps you’re more exposed to the extremes of opinions because your job requires you to be very active online, but I have yet to meet anyone who has the mindset you’ve described in your essay. I think the point of RFK is to focus on the large, low hanging fruit that impacts everyone’s lives instead of pouring billions into the next drug with marginal improvements in EF for heart failure. Last point in my mini rant: I really hope there’s an essay coming soon where you point out the specific things you disagree with RFK on, that would be more interesting and helpful!

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