Excellent topic.

Why is the cost of medical technology increasing at such a huge rate when virtually all other types of technology decrease in cost and increase in functionality every year. Think how much mobile phones, PCs and TVs cost a few years ago, and how much they cost now. As an engineer working in high tech product development I’d like to know how a mobile phone sized device can sell for $100,000 or a mechnical joint can sell for $20,000.

One problem with the medical industry is that it is generally not an open competitive one, but instead has layers of regulation, protection and entrenched interests which foster oligopolistic behaviour. In the name of safety we taxpayers pick up the bill for an inefficient anti-competitive industry which sometimes protects profits more than lives. If the providers of medical services, drugs, and devices are not reformed in the future we will most likely face the scenario which Kevin describes. The irony will be that people may die because the systems which were put into place to protect them ultimately ended up making specialised healthcare too expensive for them.

This post will of course draw predictable outcry from boomer and pre-boomer folks, but the question must be asked, if one is hypothetically well into retirement, can $20000 or more be justified if it will just give the person maybe an extra 2~5 or so years when the money spent on a younger person with workforce, family or other attachments will see the latter a very long and fulfilling life.

Of course with an ageing pop the boomers and pre-boomers are getting more clout. From a whole of society perspective, this may not be in whole society;s best interests.

AndrewM makes a good point; Medicine is in fact the only area of human endeavour that sees the introduction of technology drive costs up - rather than down. And Australian doctors have a reputation of being some of the fastes when it comes to technological update - and often in the face of no real evidence that the technology leads to improved outcomes.

Mr Pittman also uses hip prostheses as an example; the same prosthesis purchased by a volume consumer - say a busy orthpoaedic hospital - will be purchased at a premium by a factor of 5 in some cases by a smaller consumer - those expensive prices quoted by Mr Pittman are very arbitrary and do not reflect the real material costs of the item in many cases - they might be priced at $20K but really worth about 2.

As well as the rising cost of technology you can add changing methods af practice and fee for service arrangements. Consider the simple case of various forms of key hole surgery; where a surgeon might have worked for a couple of sessions doing maybe four medium length procedures - technology in some instances permits them to double their out put - that means double the disposable items, double the linen, double the equipment, increased use of sterilzing equipment and an increase in anesthetic drugs and double the cases the anesthetist can charge for and of course double the cases the surgeon charges for- everything escalates; the theatre staff, nurses and techicians get paid for the same 8 hours, the ward staff, cleaning and reception staff get paid for the same 8 hours whether they manage a thruogh put of 8 or 18 patients.

The only thing that goes up are the cost of consumables for the hospital and the fees attracted by the doctors.

There are other issues to address within the system before we start talking about rationing.

Good point Pete, when technology provides benefits they are usually pocketed by the specialists.

In April the Economist did a special report on the use of information technology in healthcare and found it to one of the most backward of all industries. It claimed that redundancy and inefficincy accounted for up to 40% of the cost of healthcare, and most of this could be eliminated though the use of IT. The article also found that "the inability and reluntance of doctors to use IT more widely is killing thousands of people".

There seems to be little incentive for the legions of senior health administrators and specialists to make their industry safer and more efficient; we taxpayers seem destined to fund them come what may. Perhaps when Kevin's scenario comes to pass and people are denied services becasue fo cost they will start to ask how their tax money was spent and realise they have been taken for a ride.

Unfortunately this forum seems to have fizzled out, it's a pity because it is more worthy of debate than other more popular topics. Anyway, if anyone out there is interested in saving lives and preserving our level of healthcare, you might like to read the following:
http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20050715-11123100-bc-us-medicalrecords1.xml

The following is an extract.
"Conservatively, when fully implemented an electronic healthcare system of medical records and communications could save $78 billion a year -- that's a conservative estimate -- of the $1.3 trillion U.S. healthcare costs," Rep. Patrick Kennedy, D-R.I. told United Press International. "Computerized medical records would save nearly 100,000 lives a year due to preventable medical errors…About 30 cents of every healthcare dollar is spent on redundant testing, copying, coding and filing, requiring an average of four attendants for every doctor, Kennedy said. “

The number of preventable medicial deaths in Australia, the US and the rest of the world is appalling, I am mystified as to why it is so little discussed compared to other causes of death which affect far fewer people and are virtually impossible to prevent.

Stop passing the buck on Health Care. Be it Australia or the world, we need to put a "human face" back into the systems of Health.

I believe it is true no matter where we go at present.. it needs to happen... and I believe; 'communities are justified in voicing a civic need to participate - in setting standards of care for the public health system'.

I don't understand in regional and remote areas of Far North Queensland for example, why the Health System doesn't promote innovative leadership from its staff, too engage with Community, as Pittman's article suggests Jim Bacon did, as Premier in Tasmania.

It is frustrating! It is not as if the information is not out there, it is a rank and file problem within the Health System itself, to use it's (gathered) IT knowledge data collected, to make a effective arguement, for real innovative change.

I do agree with anyone who may suggest that the Health System is dragging behind other industires.

I feel presently this statistic making.. is part of the problem. The information is not used for the open benefit of the public, to enforce more evidence for making productive policy, but rather supports the servicing role of health staff, by demanding and protecting the non-flexible comformity of their own interests, be they commercial, political or otherwise.

It is true, "No matter how much we argue for reallocation of resources from other areas of Government expenditure to health, there will always be a finite amount of resources. The issue is how should those finite resources be spent?"

Boost activities in Preventive Health, add-on "inclusion" of the whole community approach! "Wellbeing", has more to do with the ways we approach health as a factor of "life-quality" than anything - anywhere that the science of Western medicine is leading us at present.

This means allowing regional and local health staff to engage and initiate Preventive Health programs that help deal with the causes of ill-health, through education and awareness that supports communities through Community Health policy guidelines, at ground levels.

Maria Altmann
http://www.miacat.com