Badly needed wholesale change is coming to American medicine – Via Meadia has long predicted it – and the Washington Post’s Ezra Klein is also on the bandwagon. Between Robo-Doc prostate surgeons and ever-shrinking super computers, technology is changing how and who (or what) does medicine. Klein writes in the WaPo:
… Most doctors right now are thinking about robots built for diagnostics. They’re thinking about a version of IBM’s Watson that can cross-check symptoms with medications with a patient’s history and come up with an array of possible diagnoses ranked by likelihood. They’re thinking about that so much that, on Tuesday, the famed Cleveland Clinic is hosting an innovation conference in which clinicians will be competing against Watson.
There’s precedent for this. Librarians, for instance, now work with the public to find information on computers. Loan officers now speak with eager borrowers and plug their financial system into a computer program. Accountants now plug their client’s income information into tax-preparing software. There are plenty of professions that used to mix technical skills and conversational skills and now mix conversational skills and computers. Eventually, medicine will be one, too.
This is all encouraging news. America’s health care costs are completely out of hand and unless something changes they will literally bankrupt the country. In time we’ll either ration health care costs more aggressively or preferably find much more efficient ways to provide health care. Klein’s piece points to the good news: innovative technology is beginning to come on line. This needs to happen, fast, or no matter how we structure it or what laws we write, good quality American health care will soon be only for the rich.Not all doctors will like this. John Henry didn’t like his encounter with the steam drill. The Luddites didn’t like the mechanical looms. Blacksmiths hated the car.But using technology to cut costs in health care delivery isn’t an option; it’s a must. There is simply no other way to resolve this country’s health care mess. It is Dr. Steam Drill or Dr. Death Panel, and of those two physicians I think I can predict which one most Americans prefer.Better diagnostic software will mean that the entry point into the health care system for most people will be a less thoroughly trained (and much less expensive) human being with a ‘smart box’. Once we get individual health records fully online (with proper protections for individual privacy) many health problems could be dealt with by stopping off, say, at a McDoc booth in the local Walmart. Cases that the box and the booth can’t handle would move up the line to fully trained human physicians, but routine health care would be available at dramatically lower prices.However the American health care debate evolves in the coming months and years, much more needs to be done to promote innovative health care delivery models. Technology makes it possible to get better results at a lower cost; future efforts at health care reform in this country need to be aimed at creating a marketplace where producers and consumers have incentives and the freedom to innovate and experiment.Our poorly constructed and chaotically regulated health care system is a bit like JFK’s description of Washington DC: a city of northern charm and southern efficiency. American health care combines the high costs of the private sector with the low efficiency of government management. Partly as a result, health care is one of the few fields where progress in technology leads almost always to cost increases: expensive and elaborate new treatments come on line, creating new demand for government and insurance companies to pay for these treatments whatever the price.We need a system in which the cost-saving and efficiency-enhancing aspects of technology are as free to operate as the cost-increasing ones. In Via Meadia‘s view, this is the central challenge of health care today and it is one that both liberals and conservatives should leap to address. This is the only way to have a health care system that meets the needs of all Americans.Dr. Robot can’t come on line too fast for me.