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Talented people undertake years of medical studies and training because they want to help. Must be a harsh awakening for them when they find themselves part of a U.S. healthcare System that charges fees-for-service regardless of whether they help the patient or not, benefitting the hospital systems above everyone else.
The United States…
Talented people undertake years of medical studies and training because they want to help. Must be a harsh awakening for them when they find themselves part of a U.S. healthcare System that charges fees-for-service regardless of whether they help the patient or not, benefitting the hospital systems above everyone else.
The United States spends more per capital on healthcare than any other advanced economy, and is the vanguard of scientific innovation, yet Americans see less benefit, have much lower heath status, and life expectancy is actually declining for the first time in history--See Robert Johnson's recent book, "The Customer Revolution in Healthcare". Dr. Prasad is unusual because he's willing to drive through the broken system to make sure he gets things done for patients.
The Nixon Administration launched the War on Cancer over fifty years ago. So why is the system still waiting until chronic symptoms like tumors can be seen on scans and felt by doctors? Why is the "standard of care" for most cancers still surgery followed by toxic chemotherapies and radiation that so often cause the patient all kinds of "treatment effects" before too-often failing (the highest risk cohort for cancer is previous cancer patients)? Maybe because there's less profit at the moment in prevention.
President Biden's recently re-launched the "Cancer Moonshot" is easily assumed to be looking for scientific innovation. Yet, we might already have nearly all the science we need. In recent decades since the de-coding of the human genome, scientists have come to understand human biology and the mechanisms by which genetic mutation leads to a cascade of other molecular problems affecting proteins, metabolism and and other biological systems, essentially evading or overwhelming our immune systems.
Other advanced nations (ex. England, Canada, Israel) with single-payor systems are starting to use a systems biology approach, monitoring peoples' biological condition longitudinally; examining how molecular, lifestyle and environmental factors create problems; and investigating methods of intercepting these problems before they cascade into end-stage symptoms (tumors in cancer, mis-folded proteins in neuro-degenerative conditions). These single payor national health systems can and are easily deciding to pay for the testing that will enable early disease interception. Where are U.S. Medicare and Medicaid on this? Private health insurers?
Healthcare should be about staying healthy for longer. If we need a "Moonshot", it's in seeing and addressing the problem differently, as one of Institutional Innovation. Dr. Prasad and his colleagues will surely be gratified when they're able to stop cancer before it becomes life-threatening. Fewer scans, radiation and drugs might be less lucrative for the hospitals, but no doubt they'll be plenty of profit in observing and managing outcomes longitudinal biology too.
https://www.project-syndicate.org/commentary/new-cancer-moonshot-genetic-knowledge-by-daniel-j-arbess-2022-02?utm_term=&utm_campaign=&utm_source=adwords&utm_medium=ppc&hsa_acc=1220154768&hsa_cam=12374283753&hsa_grp=117511853986&hsa_ad=499567080222&hsa_src=g&hsa_tgt=aud-1249316000797%3Adsa-19959388920&hsa_kw=&hsa_mt=&hsa_net=adwords&hsa_ver=3