The national budget is able to pay for only a finite number of these surgeries
and treatments. Don't call it rationing, but do call it reality.
Heredity is part of that equation and also doctors do make money in the process.
Many were active and shoulders are part of activity and jobs usually for men
required use of those parts of their bodies, routinely. Joints, tendons and
other parts just wear out depending on the person. Running does good things for
the heart, circulation and overall body care but the joints and results of
jarring also have effects on those that have hereditary problems and not just
the intake of bad substances or inactivity. Our brains have been
filled with much more than our parents had injected into their minds. Many of
them worked and exercised but just not in a gym. Fortunately, most of them were
Spartans that enjoyed that type of activity and they spent their time on the
welfare farms and their own farms using every muscle in their body all the time,
even after "retirement" as farming didn't stop except if they went
on a mission. People in some countries, due to their medical plans don't
get the option of being given a second chance as they end up on the list of
non-approval due to socialism.
If people were just more active all along, most wouldn't be needing joint
replacements or other orthopedic interventions. Simple lifestyle changes
followed early in life would prevent many of the surgeries people seek as they
age, lifestyle changes that take discipline in our eating habits and activity
levels, something few people seem to have.