It’s hard to believe how different health care is than normal technology. When we are dealing with computers, automobiles or other technology, things get cheaper and more efficient with time. In health care, new innovations either make things possible- sometimes at lower costs, but just as often these developments just cost more money. Which is why health care comprises some 20% of our GDP.
One of the interesting components of Obamacare is the requirement for determining what medicine and medical procedures work and what doesn’t. The budget for this program will be on the order of $ 650 million- but that does not mean some lobbyist won’t divert its attentions or intentions. Especially since Congress has stipulated that cost-benefits are NOT among the purviews of this program. (Um… You DO know that five of the biggest lobbying groups- among the top 7- are all health care driven, right?)
Our concept of health insurance is going to change that practice, though. Nowadays, if we have insurance- all we want to know is if something is covered and are the doctors/clinics/hospitals part of our program. Moreover, if we want to be diligent and know the true costs, we have to call and ask our insurer- and that doesn’t get us what we want. It takes forever to get an answer. Because the insurance company wants to know your plan, your doctor, your hospital, etc. It’s not like buying an airline ticket. (Although buying those items has become more complicated- but still definable- with their a la carte pricing models.) But, with the adoption of bronze/silver/gold/platinum insurance programs (as stipulated by Obamacare)- those metals denote plans that cover 60%, 70%, 80%, and 90% of the health costs- there will be a greater awareness of the costs involved in these operations.
Drs. A. Chandra and J. Skinner have been examining the health care cost spiral in the US. (One such report is Technology Growth and Expenditure Growth in Health Care, 2012). They divided the healthcare improvements into three categories. Category I involved highly cost-effective, “home-run” innovations that are rarely overused (they used anti-retroviral therapy for HIV, aspirin and beta blockers for heart attacks as their example for this category; I would add my developments of Colyte and Bicarbolyte to this category). Category II included therapies and treatments that were highly effective for some- but not all- patients (they used angioplasty stents, which are only effective in the first 12 hours after a heart attack; I would add Kalydeco for some Cystic Fibrosis patients- except that the price being charged for that therapy is outrageous). And, then, there’s Category III, which they termed “grey area” therapies. These have uncertain clinical value (ICU stays for chronically ill patients, spinal fusion for back pain).
They, not surprisingly, found that countries which adopted Category I and II therapies had the greatest improvements in citizen health; those adopting categories II and III incurred the most rapid cost increases for health care. Of course, you also know that the US covers all (or almost all) technological advances regardless of their economic value. It doesn’t help that most physicians have no clue as to the costs of their prescribed therapy.
And, part of our problem is our regulatory processes. For example, EyeNetra (developed by V. Pamplona, while he was studying at MIT) has developed a smartphone app (with a clip-on device) that measures one’s eyesight- the refractive error. This $ 5 device (it may be down to $ 2 by the time you read this) can tell almost anyone what kind of eyeglasses you need.
It basically replaces a $ 5000 medical device- that needs a doctor or optometrist to interpret the results. So, EyeNetra will only be sold outside the US, unless and until we change the regulations that stipulate who can improve our eyesight. Which is why the FDA has not reviewed the device, either. (Maybe now I should remind you that doctor’s fees comprise MORE than 20% of our healthcare costs- or 3% of the US GDP.)
I am not saying that the doctors that examine your eyes don’t do something this device can’t- like determine the health of your eye or solve complex problems. But, for most of us, the simple exam is all we need- not that $ 150 eye exam at FourEyes- or whatever name they are using today.
Especially, if we want to control our healthcare costs!
Fascinating stuff, as usual, Roy. Unfortunately, my diagnosis of keratoconus would probably be one those complex problems the app wouldn’t help. 😉 I have found it frustrating that all our amazing advances that save lives are often part of the problem in our outrageously high health care costs. Damned if you do, damned if you don’t?
Absolutely true, Cathy… I wish it weren’t….
We still have no great solutions for keratoconus… but we can hope something is developed soon. And, the costs seem to have no upper limits…
I like http://t.co/lYNCdLfSOm They have apps for everything – See the latest 😉
Great information and indeed something that should be better managed but as long as big business controls congress we can not expect any such improvement. I will look around down here and see if I can find Eyenetra but it might not be in Mexico yet.
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I think Eyenetra has been keeping to Africa for now, Chef William…
But, there are lots of other improvements that are finding their way to Mexico!
What a great ap and hopefully we can see more of the like AND have access to them. Great post!
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I love these little apps, too, Alessa…
Thanks for the approbations.
Healthcare Cost Spiral – what drives it? http://t.co/j4zku2dywX
Interesting post, Roy. I didn’t know that five of the biggest lobbying groups are health related. That explains a lot. What a shame that these simple, inexpensive alternatives can’t be used in the US.
I’m with you, Suerae. Yes, these lobbying groups and the Koch front (ALEC) really do wonders upon the rest of America…
The whole issue of medical care has miffed me for years (yes, miffed does contain a letter of what I really mean). Once I had a surgery in a hospital approved by my insurance only to find out later that some of the people working on me were not. And when I called to complain, I learned that there was a rotation for this procedure and so it was a case of Russian roulette whether I would get someone covered or not.
And I am not going to into my rant about the price of some cod liver oil pills I was just put on.
Some of these people should feel the pinch the everyday person does. Then maybe they would fix the problem instead of make it worse.
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The cost of medical care and the cost of devices and drugs are related- but only up to a point, Ann. To replace one’s hip may cost $ 30000- but the device itself is a small, small part of that cost.
Now, getting to the second part of your statement- that seems to me to be a function (or lack thereof) of your physician. We generally agree (sic) to an operation with our doctor, who has privileges at hospital X. Your doctor should have infomred you that while you thought you were buying a Buick- with Buick parts- you probably were getting an Oldsmobile engine.
Cod liver oil? Really? That is not even covered by insurance- and the value is questionable at best…
Great information, Roy! I think that we are not using the potential of apps and smartphones as far as healthcare is concerned, and you are right, there are huge savings to be made. That said, some illnesses are chronic, and/or complicated, and their treatment will always be expensive.
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Well, let’s not get too taken away with those apps. Too many of them are questionable- and are about to find out what regulations will require of them. (Many of them are simply spying apps, to boot!). But, with the proper oversight, those apps can be very useful- ubiquitous- and will make health care more affordable- and more transportable.
And, you are also right that some therapies will always be expensive- but the trick is to try the less costly ones first. Our goal has to be to provide the best care to the most people at a reasonable cost. Too often, we opt for the highest profit (which may or may not be the highest cost) alternative.