U.S. healthcare spending is astronomical.
In 2019, it was $3.8 trillion or $11,582 per person.
That accounts for 17.7%
of the nation's gross domestic product.
Much of the recent progress in medicine
has involved high-tech diagnostic tests and therapies.
Many of these innovations are spectacular,
but if we focus on them at the expense of cheaper
and possibly more cost-effective interventions
to diagnose and prevent illness.
The huge cost in our healthcare system come
from a variety of sources.
Routine diagnostic tests can be incredibly expensive.
A magnetic resonance imaging or MRI machine
can cost anywhere from 1 million to $3 million.
And the cost of a single scan can be $400 to $10,000,
depending on the area of the body that needs to be examined.
Some of the more revolutionary treatments
such as gene therapies to cure
or alleviate rare and deadly childhood diseases
are staggeringly expensive.
In 2019, the FDA approved a cellular therapy
called Zolgensma for a rare genetic disease,
spinal muscular atrophy caused by a defect in a single gene.
The illnesses affects about 400 babies
in the United States annually
and kills those with the most common form of the disease,
in the first few years of life.
The Zolgensma therapy cost just over $2 million
for a single dose.
A more common, very expensive therapy
is a drug called Sovaldi.
A course, of which to treat hepatitis C costs $84,000.
Although innovations like these are amazing and save lives,
they also drive up the total cost of healthcare.
Sometimes as simple tool or device can provide
a necessary clinical diagnosis.
One example was the handheld direct Ophthalmoscope,
which allows a medical practitioner to look into
the back of the eye to gauge the health of the retina,
optic nerve, vasculature and vitreous humor.
The liquid inside the eyeball.
Invented in 1851, it costs less than $200.
Similarly are dermatoscope, a simple handheld
visual aid device dermatologists use to examine
and diagnose skin lesions such as melanomas,
is cheap and very effective.
Tooth decay is one of the most common chronic conditions
in the United States.
Decay not only causes pain and tooth loss,
but has also been associated with cardiovascular risk
and complications in pregnancy.
Researchers found that adding fluoride
to the drinking water in communities
has decreased overall tooth decay,
which in turn has decreased the need
for costly dental procedures.
And it's easy to do.
And yet the centers for disease control and prevention
estimates that nearly 100 million Americans
are without access to fluoridated water.
The high-tech miracles will continue to garner headlines,
but to advance public health simpler
and relatively inexpensive innovations are also essential.
Thus, we need to find ways to balance the developments
of cutting edge technology
and clever inexpensive interventions.
Decisions about where our research dollars should go
are critical, but not easy.