Sunday, May 4, 2008

Costs - Health Care’s Split Screen – Costs and Technology

Viewing America’s health care resembles looking at a split screen. On the left screen, you see a people struggling with costs and coverage and saving money. On the right screen, you see a nation obsessed with technology and making money.

Nowhere is this split screen better shown than in two stories in today’s May 4, 2008 Sunday New York Times.

• On the front page, column right, the column reserved for the big news of the day, runs this piece, “Even the Insured Feel the Strain of Health Costs.” It reports even those with insurance are having a hard time getting care and paying for it. Combinations of high premiums, limited coverage, high deductibles and co-payments, and soaring food and gas prices, are causing people to avoid seeing the doctor and paying for that $50 co-payment. The Times reporters offer no solutions, instead content themselves with hard luck stories from across the land about people unable to pay and small businesses unable to provide benefits. This brings to mind Benjamin Franklin’s maxim, “For want of a nail the shoe was lost; for want of a shoe the horse was lost; for want of a horse, the rider was lost.” So much for the bad news, now for the good news.

• On the front page of the business section appears another story, more upbeat, even glowing, about using of robots to perform surgery. It’s entitled, “Prepping Robots to Perform Surgery.” The lead paragraph sets the tone, “What do you call a surgeon who operates without scalpels, stitching tools or a powerful headlight to light the patient’s insides? A better doctor, according to a growing number of surgeons who prefer to hand over much of the blood-and-guts portion of their work to medical robots controlled from computer consoles.” The article proceeds to describe a bustling $1 billion segment of the health care industry, its heroes, premier companies, and Wall Street’s love affair with medical robots, hospitals’ obsessions to have the latest and best, and diseases organs that lend themselves to robotic fixes. Theoretically, robots will erase differences between good and bad surgeons. There’s only one dissenting note. Winifred Hayes, CEO of Hayes, Inc, a company that evaluates medical technologies, says, “The real story is that this is a technology that has been disseminated fairly widely prematurely.” She might have added robotic surgery is expensive and does little to ease angst of those on the other side of the split screen.

A paradox, according to my dictionary, is a statement or proposition that contradicts itself. Health care's greatest paradox is that technology and progress go hand in hand but so technology and costs which makes progress difficult.

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