In 2016 even Obama Care has not done much in stemming the rising healthcare costs in the United States – the highest healthcare per GDP than any other country. And still the United States is nowhere in the top ten in results: the U.S. has created the most expensive medical care in the world and not as effective as other leading countries’ healthcare systems. Premiums are escalating around 25% in most States. For a few, the premiums will jump even much higher. In the meantime, we know that technology can create savings, from robotics in car manufacture to process efficiencies in finance. We need to focus on the adoption of technologies for early diagnosis and environmental conditions which, in turn, can forestall most of these skyrocketing premiums.
Early detection reduces mortality and treatment costs, but screening is incomplete. Only 35% of the population receive colorectal cancer screening; 79% receive cervical cancer screening, and; 68% receive breast cancer screening. Cancer is responsible for $128.1 billion in lost productivity annually (ACS Cancer Facts and Figures 2007.) The NCQA report states that preventing these cancer cases would have resulted in healthcare savings of hundreds of millions of dollars, if not billions. Medical screening costs for early diagnosis are high for the uninsured or low insured populations or just simply unavailable. With tacit agreement to these numbers, the NIH now promotes preventive medicine, which emphatically includes “early diagnosis.”
So it behooves the healthcare industry to identify diseases at its earliest stage. But why isn’t done? One gastrointestinal oncological Chilean doctor, in revealing the rate of late stage cancers in Latin America, demonstrated that once the patient had lesions by stage 3 or 4, his chances of recovery were virtually non-existent. To identify stage 1 or 2, however, required yearly visual inspection with endoscopes of the gastro-intestinal linings that was not only expensive, but physically uncomfortable and time consuming for patients.
Another factor is cost. Lung cancers can be identified with CAT scans. However, the average cost is $800, below today’s deductibles. And, in many rural regions, such diagnosis is not easily accessible.
Illnesses and conditions caused by external factors from the environment are collectively called environmental diseases. Air pollution, pesticides, chemicals, radiation, and water pollution, are some of the manmade hazards that contribute to human illnesses. We all have heard of the Love Canal and, recently, Flint, Michigan. Apparently, human population clusters are exposed to environmental attacks from human activity. One recent NY Times article described how a small town in China has been exposed to fine graphite powder, a major component to lithium batteries. This graphite, produced by the local factory, is extremely fine, permeating throughout homes, food and clothing – a recipe for pulmonary diseases.
Water and air pollution have a notable health impact. Poor air quality precipitates asthma and more serious pulmonary diseases. Millions die every year from air pollution. We also know that world’s highest asthmatic incidence is found in China, with a rate of 11%, simply because of inferior air quality. The world’s incidence of asthma average is 8%, with some pockets being slightly higher, such as Africa, Latin America, and Middle East. Poor water quality produces gastro-intestinal problems, including cancers, found in Latin America. In the case of Flint, Michigan, we know well that lead contaminants can cause brain damage.
One recent presentation at this year’s Singularity Healthcare conference claimed that the environment causes about 24% of diseases. Essentially, about one of every four disease can be prevented by monitoring and managing environmental conditions.
Technologies can reduce healthcare costs and garner economic efficiencies. One technology that can monitor air quality is the sensor. Sensors can be designed to monitor every possible air borne contaminant from Ozone to CO2. The technology has advanced to the point of shrinking such devices into millimeters, and in some cases, nanometers. The costs to produce them, to communicate and to store the data have dropped tremendously and are affordable to every common household.
There are also sensors being developed that diagnose early stage lung cancer by identifying Volatile Organic Compounds from human breath. These sensors behave very much like trained canines capable of identifying cancers with over 90% accuracy without incurring $800 CAT scans or endoscopy.
There are other new technologies. In photonics, new infrared light technology can scan passively early stage lesions within the gastro-intestinal linings, as a cheaper, more accurate and better alternative to endoscopes that rely on visible light exploration. Water contaminants can also be identified and then treated inexpensively with the new technologies using the Raman effect and miniature lasers.
(Indirectly related: Recently, a retired woman related to me that to have her dental bridge replaced would cost $2,500, a huge sum for someone living off social security. 3D printing should be able to create that bridge for a fraction of that amount.)
Finally, there is telemedicine – remote diagnosis and treatment. Telecom and the smart phones can become the new doctor. No patient needs to drive for miles to visit a medical clinic for checkups and identify early symptoms. Technology can take blood samples, measure pulse rates, gauge body temperature — all effectively done with WiFi, cellphones, Bluetooth—as if the patient and doctor were facing each other. Fedex the tool and connect it with the phone.
There is deep chasm between the implementation of these technologies and healthcare costs – outdated regulations, medical insurance reimbursement, legacy systems and hesitant adoption. “Zero sum” economics would reveal that, by implementing these new technologies, overly paid CEOs of medical insurance processors would lose millions of dollars in salaries (one CEO earned over $1 billion); numerous medical labs would shut down; and others who thrive in this Byzantine system would be sitting on their hands. But isn’t the purpose of healthcare to improve a patient’s standard of living, not compensate individuals and organizations that leech off the system? It is this peculiar, economic imbalance that is responsible for the overly priced but inefficient healthcare system. I like to see technology that lowers the costs of medical care, not raise them. Hopefully, the bubble of rising healthcare costs in 2017 should burst and release these technologies to be adopted quickly in mainstream America. The key is to implement the right technologies for environmental prevention and early detection of diseases. Those technologies currently exist.