Saturday, October 3, 2009

Man's New Best Friend? A Cockroach-Based Healthcare Cost Crash?

Have we been wrong about the humble and not-so-lovable cockroach all these years? Could it be that a secret of better health for humans has been lurking within its tiny three-part body all along?

Rhys Blakeley of The Times of London, reports that an Indian scientist, Sujoy Guha, has looked to the cockroach heart for mechanical inspiration for humans. Guha began with the fact that cockroach hearts distribute the blood-pumping effort among thirteen separate chambers; if one chamber fails, for any reason, the hardy roach has 12 left. (There's a reason why roaches have been around for 300 million or so years,an evolutionary achievement that makes humans look like parvenus.)

By contrast, Blakeley explains, "The human heart has four chambers, but only the left ventricle is responsible for building the pressure that moves blood around the body. Depending on one chamber to do the hard work places this part of an artificial heart under enormous strain." And can in turn damage blood cells and blood vessels.

Proving, yet again, that innovation is the key to useful cost reduction, Guha projects that such artificial hearts can be produced for about $2400, compared to the current cost of around $50,000 per cardio unit.

And this could be a game-changer--a curve-bender, to use the popular wonk parlance. Blakeley further explains:

The development of a robust, affordable and safe synthetic heart remains one of the holy grails of biomedical engineering amid a shortage of donated organs and rising levels of heart disease.

In Britain, critically ill adults wait an average of 103 days and children 143 days for a donated heart, according to the NHS.

In India, heart disease will end more lives per year than all infectious illnesses combined, including diarrhoea, tuberculosis and malaria, by 2015, World Health Organisation figures suggest, as Western lifestyle diseases take a grip.

Guha hopes to make his heart available to humans in about 18 months. And if Guha's math holds--if he can produce hearts for $2400, down more than 95 percent from the current $50,000--then that will enormously good news for the peoples of the world.

Good news, that is, for everyone but healthcare central planners, of the sort that tend to collect in Washington DC. Those folks, such as Peter Orszag, now the director of the Office of Management and Budget for Barack Obama, have staked their careers on the proposition that the only way to deal with health care is rationing and price controls. If we had rationing and price controls, it's a safe bet that we would never see this sort of innovation. And in fact, we haven't seen exactly this sort of innovation in the US--Guha lives in India. Who knows how much medical activity and entrepreneurship has already been pushed offshore?

But wherever the next medical invention comes from, it's a safe bet that it will flummox the best efforts of healthcare central planners to calculate future costs. But as Joseph Califano, the Secretary of the old Department of Health, Education, and Welfare back in the 70s, observed recently to Elizabeth Drew in The New York Review of Books, the whole idea of planning out costs is folly. Says Califano:

It's preposterous to project ten-year costs. When we passed Medicare no one foresaw MRIs, CT scans, transplants, or the explosion of life expectancy. And now we're on the verge of a revolution in neurology and in genetics, stem cell research, and multiple transplants.

Exactly. Central-planning the future cost of health care in a technologically dynamic environment is folly and hubris compounded. But the rest of us should beware, because the only way to make such central-plans "work" is by snuffing out technological dynamism. Which seems to be what the central planners have in mind.

1 comment:

  1. Excellent points and ones that Obama and his folks will never admit to either about medicine or the economy as a whole. The costs or overall spending can't be said to be too high or too low in the abstract because the benefits and relative alternative things to spend the money on are constantly changing.

    To make matters worse (for them) you can't even say these things about different people at the same time. For some (say, with needs for heart transplants) a particular breakthrough might offer better results for less money. For others (say, AIDs patients) a new treatment that improves their health and life expectancy might cost more than current treatments but be well worth it. For still others (say, rich people) a million dollar treatment that makes them 10% less likely to have a heart attack might make good sense, while for someone making $25K/year this would mean sacrificing everything he earns just to get this benefit...hardly a desirable trade-off.

    Socialism removes all of these choices and crushes the cultural institutions that generate this dynamic improvement and facilitates people acquiring them in all in the pursuit of uniformity in society where nobody gets anything that someone else can't have, which to my way of looking at things isn't a desirable outcome at all even if it could come for free.

    None of this is just about Medicine of course. The same principles apply to banking, automobiles, electricity generation, and every other thing the government seeks to "help" with. The reason people are so agitated about it in medicine is that while the government screwing up our cars will make it harder to get one and less convenient to drive them, crushing the remnants of free market medicine is going to get us killed, probably in large numbers. No wonder people are so up in arms over it.