Technology's role in preventive medicine

"Why can't medicine scale the way computers do?" asks Andy Kessler, a former Wall Street financial analyst.

In information technology everything can be reduced to chips, which keep getting smaller and cheaper, making costs go down. In medicine, everything works in the opposite way. Costs keep going up. Why?

Mr. Kessler looks for the answer in places like Stanford and Harvard, and he wrote about this journey and his conclusions in a book titled "The End of Medicine." He comes to the same conclusion as many others: costs keep rising because our healthcare system(s) focuses on treatment over prevention.

Everybody from legislators and insurers to doctors and researchers are vested in the current system, so instead of fixing it they find ways to exploit it. Other players are no different. "A complicated system of mutual dependency distorts the incentives. 'The FDA is like the FCC and Big Pharma is like the regional Bells' is what Mr. Kessler hears from Don Listwin, a former Cisco executive who now heads the Canary Foundation, a Silicon Valley-based effort to promote preventive medicine."

Why an innovative "device with a wide, preventive usefulness" would stall in the regulatory process as opposed to a one-in-10,000 compound that cures or treats a select few would get the fast track is explained in paraphrase by the writer of the book review in the WSJ (sub req'd). But the book isn't an expose or written in the whistle-blower tradition. And it's not just another assault on our current system that pushes the single-payer universal healthcare or on the other end of the spectrum HSAs, or lambasts academics for putting money into esoteric research. Instead, it's visionary, and touts how technology will be transformational.

In one hilarious sequence, Mr. Kessler recounts trying to draw his own blood sample, in the hope of checking his cholesterol. But clinics won't draw blood without a doctor's orders. Drugstores think you want the syringe to shoot heroin. Unless you want to just gouge your own finger, you're in the clutches of organized medicine. Imagine how tightly it grips something a bit more sophisticated.

Yet diagnostic technology is taking off -- and that's the crux of Mr. Kessler's book. Tomography -- that is, three-dimensional imaging -- is slicing and dicing the human body (figuratively speaking) almost down to the cellular level. Exploring the inside of someone's carotid arteries is like playing a video game. In one amazing scene in "The End of Medicine" -- it still doesn't quite seem real -- Mr. Kessler describes a "face off" between five rival 3-D modeling systems at the seventh annual Multi-Detector Row Computed Tomography Symposium in San Francisco.

What is the overall vision of this book? Well, here's a stab at it by the WSJ reviewer.

Mr. Kessler's ultimate vision is that of a brave new world where hundreds of antibodies attached to carbon nanotubes monitor our blood every day -- every minute? -- for early signs of artery clogging or cancer. Then, if need be, 3-D imaging can zero-in on offending cells, holding them in the target for destruction by radiation or other proteins. People won't live forever, but they will be much healthier and happier as they get older.