Mr. Freidman discounts a little too quickly the incredible changes and advances in technology in the past 60 years. If you consider per capita technology spending in the last 60 years, I suspect there might be a suprising correlation to health care spending.
In 1946, oxygen administration was considered "advanced". Penicillin and sulfa antibiotics were just begining regular use in World War II. Before that people died from infections like pneumonia very frequently. Diseases like polio, smallpox, measles, tetanus, mumps, were devastating and crippling diseases. We rarely see those any more. Advances in microbioligy and pharmacology have greatly reduced morbidity and mortality. It's harder than it used to be to die from an infectuous disease in a country with modern healthcare.
But, people in the US now have a cultural expectation that medicine can dramatically fix or cure a lot of diseases, like we did with microbial diseases. But, the diseases that we are left with tend to be chronic and a lot harder to cure: heart disease, diabetes, cancer. Low hanging fruit are easiest to pick.
15 years ago, when I started my nursing career the state of the art in emergency heart attack treatment was a $1000 single dose of a clot busting medication. 1 out of 20 people bled to death from that cure. So, $300,000 emergency heart catheterization and angioplasty was developed to limit the 5% mortality rate.
One of the big focuses in the US medicine is technological innovation and critical care, because that's what our insurance pays for. The focus in many other developed nations is primary care, prevention and cost effective treatments.
Also, other areas of technological innovation benefit from exponential decrease in costs because of Moore's law. Medical and biological technology have the inherit limitation of the human body. That's going to influence cost structures dramatically in comparison to other technologies.
In 1946, oxygen administration was considered "advanced". Penicillin and sulfa antibiotics were just begining regular use in World War II. Before that people died from infections like pneumonia very frequently. Diseases like polio, smallpox, measles, tetanus, mumps, were devastating and crippling diseases. We rarely see those any more. Advances in microbioligy and pharmacology have greatly reduced morbidity and mortality. It's harder than it used to be to die from an infectuous disease in a country with modern healthcare.
But, people in the US now have a cultural expectation that medicine can dramatically fix or cure a lot of diseases, like we did with microbial diseases. But, the diseases that we are left with tend to be chronic and a lot harder to cure: heart disease, diabetes, cancer. Low hanging fruit are easiest to pick.
15 years ago, when I started my nursing career the state of the art in emergency heart attack treatment was a $1000 single dose of a clot busting medication. 1 out of 20 people bled to death from that cure. So, $300,000 emergency heart catheterization and angioplasty was developed to limit the 5% mortality rate.
One of the big focuses in the US medicine is technological innovation and critical care, because that's what our insurance pays for. The focus in many other developed nations is primary care, prevention and cost effective treatments.
Also, other areas of technological innovation benefit from exponential decrease in costs because of Moore's law. Medical and biological technology have the inherit limitation of the human body. That's going to influence cost structures dramatically in comparison to other technologies.