Technological advances in medicine are and have been astounding. This includes pharmaceuticals, surgical techniques, diagnostic equipment, various implants from stents to joint replacements, and a whole onslaught of therapies that can only amaze. Medicine today looks very different than the medicine of the 1970’s let’s say. The amount of life saved, diseases cured, and hope given to those who have benefited from such advances is remarkable and practically immeasurable. We are blessed to live in a time filled with the miraculous wonder of medicine today.
So what’s the issue, you ask?
You know me too well. It’s the other side of that sword. Advances cost money. Even advances that save money cost money. For example, various new heart procedures save money per procedure, but since they are also less invasive, have fewer side-effects, and are cheaper, more and more people are having them performed. Overall, the costs are higher. It’s all about: Costs = Price X Quantity. Often when the price drops the quantity rises and this more than offsets the price reduction. But surely the overall cost is worth all the benefits? I would argue that it is.
But what if the therapy isn’t really proven (at least not yet)? What if the costs per procedure are higher and the benefit small or not known? Is that advance still a positive thing for society?
Imagine that a company invests millions of dollars into a new treatment and it’s proven to be safe. The company will obviously market the new technology to everybody and anybody to recoup its huge investment. The company will tout its new proton, laser-guided, micro-fabulous device that has such great promise to treat <insert disease of your choice>. The company will discuss why this therapy is the next thing. The company will talk about how the protons are better than the x-ray or how the laser is more powerful than its predecessor. Maybe it is. The theory could be sound, but as of yet its effectiveness is unproven (how much health does it provide?). Meanwhile, the marketing campaign by the company is a smashing success, and hospitals are building new wings for such devices. Millions more pour into this device. Hospitals buy in and the company turns a profit. Hospitals now need to create demand so they can recoup their investments. Before the science is in, the device is deemed effective by professionals. It’s too late now to turn back. The investment needs to be recouped. The fancy new device is a go and there is no turning back.
This scenario does happen. Is it a bad thing? Is this how progress is made? Or is this responsible for our rising health care bill? Question one is difficult. The answer to question two is a firm YES.