How health care could lower health-care costs
I'm listening to Dr. Paul Ewald explain his theory that deadly diseases are caused by common infections. Take cancer. In recent years, we've tied a lot of cancers to fairly common infections (HPV leads to cervical cancer, the infection that leads to gastric reflux also increases the risk of esophageal cancer, etc.), and Ewald believes that's part of a much larger story: Cancer is usually caused by latent, low-grade infections that persist in the body by weakening cells, and these weakened and damaged cells are easier targets for cancer. To stop cancer, you have to focus on the infections that precede it.
I have no idea if this is true or not, of course. But if it's true, and if those infections can be solved through cheap interventions (hygienic efforts to reduce their spread, targeted medicines to run them out of the body), treating cancer could prove to be, well, quite cheap. These are the great unknowns of medicine going forward: If medicine gets much better because it comes up with extraordinarily expensive ways to treat illnesses, we're in some real trouble and will face some incredibly hard choices. The word for that world, I think, is "rationing." But if we figure out fairly cheap interventions, we could see costs trend down on their own: Being able to stop diabetes early can save hundreds of thousands of dollars over a patient's lifetime. Policy isn't everything.
Incidentally, here's Ewald presenting at TED:
July 8, 2010; 1:25 PM ET
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