Musings on scientific progress

For some time now I’ve been overwhelmed by the insoluble problem that is healthcare.  There’s so much that we COULD do to optimize peoples’ health.  But many of the things we do now are long-term therapies, which are costly.  The US is one of the wealthiest nations in the world, we spend over 15% of our GNP on healthcare, and we’re still failing to provide care to a frightening proportion of our population.  It seems impossible to do everything for everyone without bankrupting the nation – and the cost of care is an even bigger issue for the rest of the world, that doesn’t have our financial strength.

The “healthcare crisis” is driven by this disconnect between what we want done, and what we can (or choose to) pay for it.  For the last several decades, the system has been weakened by efforts to make the current system deliver more for less money.  From the POV of a healhcare provider, expectations for what we should do have steadily increased, while real wages have dropped and working hours have expanded.  That’s just a little piece of the overall complexity that is healthcare – I sure wouldn’t want anyone quoting this as an exhaustive summary of the healthcare crisis – but it is a piece that threatens to destroy the entire industry as talented providers abandon the profession in droves.

The knowledge-leaders and politicos discuss what will solve this dilemma.  Universal healthcare?  Healthcare rationing based on complicated cost-effectiveness models?  I’m increasingly convinced that none of it will work.  Our only hope, I suspect, is that some amazing revolutionary breakthroughs lead to astounding changes in what we can do with peoples’ bodies.  Permanent cures for common and expensive chronic diseases, for example, would free up enormous sums of money for treating other people and other problems.

What’s got me thinking of all this?  Two of the biggest news topics of the day:

1.  The presidential election:  After listening to various candidates talk about how they’d “fix” healthcare, I’m convinced none of their plans will do much good.  When it comes to fixing the healthcare crisis, the most important platform item may be how much the new president is willing to restore to the healthcare research infrastructure, which has been gutted after 2 terms of W’s administration.

2.  Stem cells from skin:  News items like this one make me feel so excited and hopeful for the future.  Could this be *it*? Could this be the technique that changes the world we live in? Or will it just turn out to be another disappointment, a fraud or a flawed result or an intriguing but ultimately not-very-useful footnote in the path of medical progress?

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