As a practicing obstetrician gynecologist, I face barriers and inefficiencies in our health care system on a daily basis that interfere with my ability to adequately care for my patients. All too often, these difficulties are unnecessary, brought about by an incoherent system of provision and reimbursement. But I have hope in our country’s history of finding innovative ways out of these types of difficulties.
Health care is in critical need of technological innovation as we face increasing demand for services from an expanding and aging population that expects more out of medicine. In many ways, the strain on our health system is a product of medicine’s success. Simply put, a patient in the 19th century saw a doctor to try to combat death and disease. Now, in the 21st century, patients can seek previously unimaginable treatments like changing their genes or the physical body they were born with. As medicine’s capabilities increase, so does demand.
Given the challenges of meeting this increasing demand and adequately supplying health care to people who truly need it, technological innovation is becoming all the more critical. Fortunately, some amazing approaches are around the corner. Rather than fear them, we need to make them workable and put them to good use.
Telemedicine, springing from NASA research, removes geographic barriers through electronic communication, bringing patients in contact with the right providers at lower costs.
Bioelectronics interfaces human nervous and biological systems, and may someday achieve something as intricate as replacing a damaged optic nerve with electronic technology that restores vision.
Bioinformatics compiles the detailed molecular profile of an individual so that a “finger prick” analysis done at home might enable routine and personalized health monitoring. Ultimately, many tasks that are routine, standardized, and repeatable in medicine will be automated, bringing the cost of medicine down as processes are codified.
There are, however, strong obstacles threatening the successful development of health care technology, which is often viewed with suspicion as a cost driver to an overburdened system.
Public trust in the health care system and its providers has eroded through scandals of fraud, malpractice, waste, and abuse. This loss of confidence results in increased regulatory activity and a robust “precautionary principle” that forbids the development of any innovation until an activity or product is proven safe, regardless of the length of time or financial viability required to gather such evidence.
This, in turn, promotes regulations that divert venture-capital away from productive research. Ultimately, potential life-saving innovations are strangled at an early stage of development. We have already seen this problem acknowledged in the “right to try” movement.
Policy makers must remove obstacles to medical innovation. One possible approach is the creation of “safe harbors,” which protect innovators who comply with published standards or procedures of safety based on empirical evidence—while preventing retroactive liability, should norms become more restrictive.
Ultimately a thoughtful application of law is critically important. While many fear a freer market in health care, if innovators cannot compete with each other and develop new and better ways to provide care, the result is the status quo, and that’s not good enough. More collaboration is needed between those who craft policies and those who do innovative research.
The benefits of greater innovation in health care are too great—and too close to becoming reality—to ignore, and the costs of missing out are too high. Prolonging the delay between discovery and practice is directly linked to human suffering and loss of life. Despite genuinely good intentions, the pessimism of the “scarcity mindset” by definition rations limited health care resources—ultimately favoring, in one way or another, those who are youngest or have the best prognosis.
But innovation in health care has the potential to expand supply for everyone who needs it, rather than simply dividing up existing resources. That’s way we must do all that we can to support our innovators.