There’s been lots of talk about how to better pay for medical costs. Sadly there’s been little advancement on controlling the costs save for financial tricks and rationing systems of one form or another.

Technologies have been advancing in many fields and making many aspects of modern life better and more affordable. Medicine has not added the efficiencies that would make medical care more widespread and cheaper.

from TCS Daily - Rebooting Your Doctor, by Glenn Reynolds

Andy Kessler has worked in Silicon Valley for a long time. He’s seen the way that improving technology can lower costs and increase capabilities in all sorts of areas, and now he says that it’s time for silicon to do for medicine what it’s done for so many other fields.

“Doctors hold the expertise. It’s imbedded in their brains. … But in other industries, the expertise is increasingly embedded elsewhere — in software, in silicon, in routers, in cell phones, in iPods, in Xboxes, in search engines. That’s what made Silicon Valley what it is today. You can take intellectual property and embed it on a chip — to handle telephone calls, move email around, display 3-D graphics for video games and on and on. A dozen guys with no life design the chip and then workerless factories in Taiwan stamp them out by the millions to be shipped in products you and I can buy for under $100. That’s scale. … Yet here is R2. Cancer-identifying expertise is embedded in an algorithm you can buy for $29. Well, you can’t buy it. Some weird system of service and reimbursements pays for it. But it’s the first crack in the armor.”

It’s these “certificates of need” that keep any cancer treatment facility from opening up here in the Rockland area. It’s rough to travel to Brunswick time and again for chemotherapy. Especially when you need to get someone to drive you all those times. The time and expense of such travel rarely comes into the discussion. There are health care costs as real as any other.

Maybe there isn’t enough “need” for a local cancer treatment center, but If someone is willing to take a chance on trying to put one together, they should be able to go for it.

Admittably my information on this example may be out of date. Its based on my memory of articles about the Bob Gagnon Cancer Fund. (I did a quick google search, but didn’t find helpful information)

Hospitals outside of Portland have very little competition that would encourage some degree of cost cutting. True, hospitals have a hard time of it financially, but being short on cash leads to asking for more money. If there was competition for services the pressure would be on to be at least as efficient as the “other guy” or better in some way.

One would hope that computerization would make matters better, as suggested in the above linked article. Certainly the paperwork could be improved. Every doctor’s office has incredibly huge sets of files and hospitals even more so. Certainly the paperwork of medicine can be made less bureaucratic. Unfortunatly the deep levels of government involvement in medicine and the finances of medicine complicate matters.

I’ve also wondered why so much of medicine is a nine to five business. There needs to be some innovations that would allow people to get help for a wider number of services beyond the “business hours” when many people are working. Maybe more doctors working on odder schedules could help. One wonders if the problem of people overusing emergency rooms is due to the that medical needs don’t happen on a schedule.

If you can buy a carton of milk 24-7 why can’t medical help be easier to get after 5 or on the weekend?

True, you pay a premium to get that milk at 2 A.M. and the selection is less, so I’m sure that there will be trade offs with odd-hours medical practices too. But I’m sure that better could be done with a little innovation.

Mind you, that’s all just thoughts off the top of my head. Maybe developments are being made, and I just don’t know of them.

Technorati Tags: Medicine, Technology