SENS5 Video: Questions of Resource Allocation

Resources in research and medical development seems to be the unifying topic here for the past week or so. It is interesting to these accidental thematic collections of content come and go in passing, all without any deliberate intent; a reminder that we take small samples from a much broader, many-threaded conversation of millions of people, one that spans all media and has its tides and fashions at every timescale. So continuing the theme, here is a newly processed and posted video from the SENS5 conference:

Since rejuvenation therapies will ultimately offer many more years of life than traditional life-saving interventions, a problem emerges for existing principles of medical decision-making. Justice demands that all patients are due an equal standard of medical care. But if we measure medical care in terms of the amount of life it saves, or in terms of its cost relative to its effectiveness, or even in terms of its ability to save identified individuals rather than reduce statistical risk in groups, rejuvenation will eventually be far more valuable than life-saving. More broadly, effective rejuvenation medicines will effectively erode the boundary between curative and prophylactic medicines, as well as the boundary between treatment and enhancement.

The quote above is the more reasonable part of the abstract, which concurs with the sensible view that the dominant strategies in medicine must change: what happens today largely takes the form of trying to patch over late stage consequences without addressing root causes, and will thus always be expensive and ultimately unsuccessful. It is poor value in comparison to a strategy of consistently repairing low-level biological damage and thus effecting rejuvenation.

That said, I should note that the whole is a viewpoint I cannot agree with. The presentation builds upon an idealized, and already incorrect, view of the British governmental heath monolith on the one hand, and the meaning of "justice" that roughly translates to "equality maintained through theft, coercion, and destruction of progress is better than honestly earned inequality" on the other. The end result is just moving deckchairs on the Titanic, painting a poisonous, failing system a different color. It'll all come to the same in the end. All systems, like the government health services in Western nations, that divorce themselves from price signaling and patient accountability for costs incurred ultimately create shortages, enforce rationing, and stagnate. They turn relationships between patient and provider from mutually beneficial trade to hostile engagement at arms length, then remove the market incentives for participants to develop and offer better services and technologies, and later the incentives that cause people to offer any form of service at all. Finally, you reach the unhappy truth about other people's money: it runs out.

While they last, the current incarnation of government-run health systems will continue to greatly harm the progression of medical technology - the pace of development, the cost-effectiveness, and the directions taken. The effects of the FDA on research directions - such as the institutional discouragement of work on therapies for aging - are but one facet of this problem. The laws that remove freedom of choice in funding research and development, freedom to practice medicine, and the freedom to try new medical technologies are but another.

These systems are rotten to the core, and the best thing we can do is find practical ways to work around their constraints: engaging them, trying to change them by working within the system, will only prop up these corroded, toxic hulks for that little while longer. We will all be better off when the current regime of regulation and centralized control collapses.


"...Finally, you reach the unhappy truth about other people's money: it runs out. ..."

yeah !right ! can we remember what’s the cause of most personal bankrupcies in the US ?

Posted by: sinbad1 at February 20th, 2012 7:36 AM

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