In Belgium, my general practitioner told me it used to be common practice to simple cross every box on the blood test selection sheet for a client's annual checkup.

Right now there is rightfully pushback against unnecessary testing. Over-medicalization by which people are subjected to treatment without suffering under symptoms is very much a problem. Also the socialized healthcare providers are not happy with this, as you can imagine.

Why conflate over/unnecessary treatment with availability and evaluation of markers? I guess if neither the patient nor the health care practitioner are uninterested in careful consideration of the data, then why bother I suppose. But then why bother at all with seat-belts, environmental laws, or dental visits if there's no value to prevention? We can just react after its too late, for everything.

/s in some of this, perhaps all

There's a multitude of reasons, touched upon in a metastudy of inappropriate lab testing in medicine [1,2]:

> “But, unexpectedly, on a per-test basis, we actually found that the main problem was tests being over-ordered during a patient’s initial examination, rather than during repeat tests. This indicates to us that ordering the right test during the initial evaluation may lead to fewer errors and better patient care,” he said.

a. Tests are not accurate, a false positive causes alarm and follow-up examination where none was present.

b. On the inverse: negative tests provide a false sense of security and good-health. [2] discusses this as the prime motivator for patient blood test requests.

c. Economic cost to the insurer or ultimately patient/taxpayer, not of the tests themselves but of the downstream examinations.

As a general rule in medicine: Don't treat a patient without signs or symptoms. When a persons feels healthy, they usually are healthy.

1. https://hms.harvard.edu/news/unnecessary-testing

2. https://journals.plos.org/plosone/article?id=10.1371/journal...

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769380/

I appreciate all those considerations but prevention of disease is all about identifying issues that may disrupt ones current feelings of and actual healthy state.

We cannot keep waiting for randomized experimental research to identify all the ways health may degrade over time. If we can regularly gather data en masse, we regularly over time can identify more predictors and risk factors for poor (and good) health, and evaluate efficacy of treatments received or effects from lack of treatment.

Again, why pay for seatbelts (and get tickets for not having them) in vehicles if I've have no history of accidents, or receive preventative dental care despite no serious current oral issues, etc.

Why do we have heat sensors in vehicles? The vehicles I've driven in life have never overheated.

Somehow we continue to excuse doctors who practice poorly by treating by markers alone rather than the whole picture (including the patients feelings and desires), or despite contraindications for the treatment being considered.

Somehow the only practical solution is to allow health degradation, and then rush to identify and treat and attempt reversal.

Some tests not only don’t benefit patients when done without reason, they actually harm them. medical interventions and procedures are often invasive and not without side effects, including pain, severe disability, and death. In many cases the studies you allude to us waiting for have arrived, and they show active harm for many cases where you’d think “why not add a test, what’s the harm”. Unfortunately medicine is still way too complex to reason about without the research to back it.

In my field of nutrition alone, there is tons more we could do to individualize and thus improve the targets for macro and micronutrients, as just one example. RDAs are only a rough starting point (when there is an RDA) as we understand more about individual genetics, food environment, etc. Why is all of medicine just invasive procedures and pharma? I'm not convinced that we somehow just need to sit and wait for some future time before we can jnvest and safely make use of markers over ones life to improve behaviors and health outcomes (for the benefit of an individual and others with similar medical characteristics).

Theres room to debate the degree and depth that we would utilize labs and other measures, but a complete non-starter mentality just leaves health outcomes to blind fate and promotes development of complex conditions much more difficult to unwind.

Not in my experience. I also lived in Sweden and UK. Blood tests are usually only a reactivate thing. You're sick you get blood tests. As prevention not as common I'm afraid.

The reason Sweden doesn't do regular health checks of the population is because there is no good scientific evidence that it has any effect. And that if a person feels healthy, they most likely are.

I think the similar reasoning is used in other countries.

If you can read swedish/use Google translate, this page explains it very clearly: https://www.1177.se/fragor--svar/nationellt/behandling--hjal...

> The reason Sweden doesn't do regular health checks of the population is because there is no good scientific evidence that it has any effect. And that if a person feels healthy, they most likely are.

I think this is naive: there are a number of reasons people in Sweden don't easily get health-checks, and among these are certainly cost-saving, where the healthcare representatives who you need to contact before speaking to a doctor or nurse act as gatekeepers to the system. This 'rationing' of resources can sometimes have dire consequences, as happened to a former colleague of mine, who was denied the in-person checks he needed and almost died as a consequence.

There's also an enormous amount of peer-pressure in Sweden to be skinny, fit and actively go to the gym several times each week. A fat person is an extreme rarity in Stockholm. Couple this with an ingrained cultural 'guilt-complex' instilled in everyone not to be a 'burden' on anyone else, and the health-service is suddenly transformed into an 'emergency-only' institution.

Naturally that may be seen as a positive - although for some people it may have bad outcomes. It certainly contrasts with my extended family in Spain, who have tests for every possible malady at all times. But otoh that seems to work pretty good too, as one of my uncles died last year at the age of 102.

"And that if a person feels healthy, they most likely are."

Uh, high blood pressure is a typical "silent" disease with major effect on health later.

You don't need a blood test to measure your blood pressure though.

The article says that you should check blood pressure and blood sugar every 5 years. And blood fats "some time". But that's very different from a regular check up.

I'm Irish and never heard of someone getting one unless they were checking for something specific. However, I do know that regular health checks are recommended once you hit 45 or so. Not sure if that includes blood tests.

We're currently ranked 16th in the world for longevity, so I doubt regular blood checks is that important - at least, I remember reading previously that there's no evidence regular blood checks are actually useful unless you have an ongoing condition.

Irish too, and I get bloods done every year because I noticed my health insurance covers me for an annual checkup. First time I got them done revealed I had very high cholesterol

I got a funny stare from the doctor in Germany when I wanted to check my cholesterol levels.

My wife OTOH got it done without an issue.

So yeah maybe they don't bother with males or foreigners.

Yep we only care about hot chics and Germans. But seriously, was it the same doctor? Then it would indeed be kinda weird, but otherwise there is a wide range of types of doctors, those who love checkups and prescribing stuff and sending you to a specialist whenever you report the slightest problem, and those that just send you home again no matter what, tell you to get some rest, work less, eat healthier, and maybe come back in two weeks if it doesn't fix itself. And then everything in between.

As an Indian I'll say that annual health check-ups are now normal amongst the privileged class. In my opinion it is a good thing considering how unhealthy our environment and lifestyle is along with a lot of predisposed conditions.

I feel in UK they are not that common unless you are ill. For company medicals / private health schemes and for certain age groups they do happen.