Friday, February 19, 2010

Technology and medicine- future directions?

I couldn't pass up an opportunity to comment on a recent article in the latest issues of the Economist.  Basically there is a 3-D bio printer machine on the horizon that can be programmed to create cell lines and eventually whole organs.  Researchers are starting simply with skin, muscle and blood vasculature but hope to progress to larger patches of cells that are grown on artificial scaffolds in the shape of particular organs.  Researchers have created ex vivo bladders this way but not using a machine approach. My feeling is that a bladder is one thing, but a functioning organ such as a kidney will be a great deal more complex. Human biology being what it is, I think it unlikely that a machine primed with recipes for 'baking body parts' will become a reality any time soon, if ever.  I do applaud the effort however.  There is certainly no progress in any field without imagination.

It's obvious that our current healthcare system is unsustainable and this piece from the New York Times sums it up nicely. In addition to speculating on the future collapse of the system he talks about his son's recent wrestling injury which I must admit distracted me from the meat of the message, having a young wrestler myself (see pic).  Regardless, if you are thinking healthcare reform is unnecessary, you should take a look at what he has to say.  We spend the most but are way down the list when it comes to outcomes such as life expectancy and infant mortality.  For those worried about tax increases to pay for universal access, would you rather pay a few hundred more each month for health insurance with higher deductibles and more procedures not covered, or a bit more tax for higher coverage for all.  The the country as a whole, the latter makes so much more sense.

I don't hear much about this yet but it's eye opening how much 'high-tech' doctors are earning these days.  Even taking into consideration their malpractice insurance, these salaries are likely to come under scrutiny as health reform progresses (yes, it is progressing, albeit very slowly).   When physicians earn up to half a million per year and patients are going bankrupt to afford the services, something is out of balance.  Even for those who are adequately insured (a rapidly decreasing segment of the US population), increases in insurance premiums and decreases in covered services will bring the actual costs of medicine and everything it encompasses further under the microscope.  It's hard to figure how this will re-balance, given the costs of med school and malpractice, but re-balance it must.

This posts brings up a related question: High tech means high cost; how much technology in medicine is too much? And who makes that determination?  Ultimately, it must be you and I, the consumer.  Are we prepared?
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