Hope for Cures, Despair from Costs

While the Hill labors over which health care interventions to cover and who must pay the tab, medical researchers continue with remarkable progress in understanding and treatments. Each year, there are breakthroughs that can save lives, restore failed organs or cure diseases. Medical progress is reported tentatively at first based on effectiveness in mice or apes. Gradually human trials confirm success and the earliest approved treatments are priced at sky-high levels. It is unclear how well the architects of national health care schemes will capture taxes and premiums to fund the stratospheric costs of health care that are on their way. Some treatments are experimental or so new that cost estimates are unavailable.

An unfortunate consequence of wars in the Middle East has been the harm to military personnel. Some return with damaged limbs or organs and some with posttraumatic stress. The inflow of military patients has prompted advances in prosthetics. Conventional prosthetics are actuated by the patient’s own muscles. In advanced cases, implanted electrodes can allow paralyzed people to move robotic arms with their thoughts. Conventional prosthetics cost between $5,000 and $50,000 and will need to be replaced each 3-5 years as the patient’s body adjusts. The advanced equipment costs far more.

Victims of fires, automobile wrecks, and other grisly damage to flesh can in many cases be repaired through 3-D printed organs such as ears and noses. But 3-D printing has also been successful creating 3-D bio-printed heart valves made from living tissue. A printed heart valve can grow with the patient, but non-living prosthetics cannot. The 3-D printer is relative cheap, but the live cell “ink” may be costly.

Neuro-prosthetics such as cochlear brain implants can restore hearing to some who are deaf. Cochlear implants cost about $40,000 for the equipment, surgery, and other medical costs. For Parkinson patients, there is a brain implant that “reduces or even eliminates the tremors and rigid movement typical for Parkinson’s patients.” The implant does not cure Parkinson’s however.

No longer reserved for replicants in Blade Runner, memory implants for humans may be near at hand. “Conscious memories have been implanted into the minds of mice while the sleep.” The technique may be used to change human memories. For example, positive thoughts could be attached to negative memories to stop people having nightmares or dwelling on upsetting events. Despite an obvious breakthrough for PTSD treatment, ethicists warn that altering memories may cause a change in personality. That change may produce antisocial or immoral behavior. No cost estimate is available yet for memory implants.

Gene therapy can replace defective or mutated DNA that causes disease or can replace a gene that is functioning improperly, or can introduce a new gene that can fight a disease. Gene therapy is a promising treatment option for inherited disorders, some types of cancer and certain viral infections. However, the National Institutes of Health regards gene therapy as appropriate only for diseases that cannot otherwise be treated. The first gene therapy was approved in the EU for a price tag of $1.4 million per treatment.

Stem Cell therapy “regenerates” damaged or failing tissues and organs by using the patient’s own cells and healing abilities. Wake Forest Institute for Regenerative Medicine has successful experience with human stem cell implants, including knee cartilage, skin, blood vessels, urethras, windpipes (trachea) and bladders. The medical costs for stem cell therapy varies but many cost $30,000-$50,000.

The near-miracle treatments under development are impressive and can bring hope to many awaiting effective treatments. Those of us aware of government’s health care overpromising already know who will be stuck with the tab, again.

On a more prosaic note, the 2015 cost for a year’s stay a nursing home averages $80,000. The same year spent in an assisted living facility costs $43,000. That means the 40 million US people over the age of 65 today will soon be looking for assisted living or for skilled nursing, and will expect government to pay their share of the $2.4 trillion annual tab. That total is before the miracle cures are added to the mix.

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