The key passage in the post at RealClearHealth by Marshall S. Runge, “The Wonders of Modern Medicine Come at a Cost” is this one:
Medicine is not like other aspects of our technological age, where everything from cell phones to PCs inevitably get better and cheaper. One reason is that therapies like CAR-T represent the trend in medical innovation toward targeting smaller groups of patients with relatively rare conditions. This is the exact opposite of the newest gadget aimed at a mass market. And in most cases, expensive, novel therapies are adopted earlier and to a greater extent in the United States than in many countries. In essence, we are taking the economic risk to implement medical breakthroughs when costs are highest.
That caused me to think of a couple of other articles I’d read recently, the first predicting that by 2040 life expectancies in the U. S. will have increased less than 1% from now, the other than by 2040 real health care spending in the U. S. will have doubled.
The greatest wonder of modern medicine is that we continue to be so complacent with paying so much for such meager results.
“The greatest wonder of modern medicine is that we continue to be so complacent with paying so much for such meager results.”
Odd phrasing and not many people use estimates of future life expectancy as a metric. I look at as a poor ROI vs the rest of the world.
Steve
What metric do you like? I mean other than median/average wages in the health care sector? We’re #1 there.
If you are going to use life expectancy, use current numbers in comparison with other countries. I have no confidence in those kind of predictions 22 years out. In general I prefer outcomes and cost per each outcome. Return to functional status is also one I dont think is followed as closely as it should be.
Steve
Is that really the right metric? IMO it’s better to use trends rather than current figures, i.e. the change in life expectancy rather than life expectancy and the change in costs per person rather than the costs per person. I don’t think we look particularly good whatever metric one selects.
Yes, was in a rush, but follow the trends up to the current numbers. Dontr rely too heavily on any one number. A lot of our outcome numbers are pretty good, it just costs a lot to achieve it.
Steve
I am not sure CAR-T is a good example of the point being made.
There are a lot of people researching how to apply the principles of CAR-T to more cancers (esp solid cancers) and / or lower the cost by making it amenable to mass manufacturing techniques.
CAR-T is really more a POC in the technology adoption curve. The first computers in the 50’s were also extremely niche applications and expensive – but once it moved along the technology adoption curve everything changed
Meager results, you can thank the AMA , and FDA controls for the serious lack of progress in this field, which should naturally attract thousands of entrepreneurs due to the unlimited profitability of cures for what ails us.
We do more of the medical research and pioneering than other countries do — that’s why we have things like CAR-T that are (currently) very expensive.
We also do not get a good price on our tried and true medical procedures, or provide health care to our entire population.
These are two distinct, but overlapping issues. If we were to switch to Totally Socialized Healthcare, we might cut the research a lot, and stop the advances. It’s an issue.
I wonder how much the decrease in life expectancy has to do with medical technology vs lifestyle. There’s ample evidence that the US lifestyle and food consumption patterns are unhealthy.
Don’t forget the drug deaths as a cause of decreased life expectancy.
Steve