Translator: Zsuzsa Viola Reviewer: Lívia Sági
I'd like to introduce Béla.
Béla is a successful entrepreneur,
as we can see, he has a Rolex watch,
so he can even become a politician.
He spends a lot on himself, he takes care of himself.
Among other things, he buys a very expensive and safe car
So Béla would know immediately, in real time,
if there were any problems with his car.
For example, if the pressure is lower in one of the tires,
or the lambda probe got dirty.
Although there aren't sensors on Béla,
he leads a very healthy, conscious lifestyle.
He pays attention to his diet,
doesn't drink, doesn't smoke,
he makes an effort to exercise regularly.
He gets vaccinated.
In fact, three or four years ago,
he was even on a manager-screening test at a private clinic.
So if we were to ask Béla, "How are you, Béla?"
Béla would say, "I'm great, thanks."
But the truth is, unfortunately,
that Béla won't be among us for long.
Because his blood sugar level's been 12,
which is extremely high,
for at least two years.
In his eyes, kidneys, limbs,
the capillaries are irreversibly damaged.
In addition, he suffers from an extreme narrowing of arteries.
And he's got a genetic mutation as well,
which excessively increases the risk of thrombosis.
Moreover, Béla has atrial fibrillation,
which is an abnormal behavior of the heart,
that also forms thrombosis.
Unfortunately, it seems likely
that Béla will have an infarction in the near future.
But if our Béla still survived it,
then there's still that benign tumor,
which has been growing in his colon for 15 years,
and is beginning to transform into tumorous tissue.
It could be cut out now without any consequences
and our Béla could go home.
But by the time they recognize it,
it can be full of metastases, and then it'll be too late.
How is this possible?
Well, it's possible
because Béla has no symptoms.
And in Hungary someone can live without trouble
up to the age of 50
without ever getting an ECG,
without ever getting an ultrasound,
or without ever going for a blood test.
For many jobs,
even a compulsory medical examination doesn't contain a simple blood count.
And what about our socialization?
What does it mean if you have no symptoms?
It must mean I'm healthy.
But that's not true.
Many diseases have been developing for months, for years or for decades,
by the time they first cause symptoms.
Nature couldn't know that we would have doctors.
If something goes wrong in the body,
the organism tries to correct it, to fix it.
Then if it fails,
it'll try to delay the symptoms as much as possible
because the symptoms were evolutionary disadvantages.
Either the prehistoric man didn't catch up with his prey
or couldn't run away from the lion
or simply couldn't pass on his genes.
How many of our friends are proud of saying,
"I never go to see a doctor."
How many of them say,
"I'm not seeing the doc because they could find something."
As if normally if we didn't know about it,
that disorder wouldn't exist.
Sure, there are things that heal by themselves,
but there are a lot that don't.
For example, tumors rarely go away.
But let's admit it,
we all grew up with the notion, it's always in our minds,
that if there is nothing wrong with me, why should I see a doctor?
But if we consider
how many people die being fine
up until 10 minutes beforehand,
or at least thinking so,
it can be clearly deduced
that any one of us here and now
can die in 10 minutes even though they're fine now.
I can see horror on your faces.
But I have some good news: we can influence this.
It's up to us.
But our current systems aren't developed for this.
What we now call health care
is in fact sickness care.
A late-reacting, crisis-driven, reactive system,
where a specialist tries to treat
the isolated problems of patients who are usually at an advanced stage
with methods meant for the masses,
while the patient is a passive participant.
Yet, all diseases can be cured more effectively and cheaply
if we recognize them as soon as possible.
In fact, it's best not to let them develop.
During the onset of diabetes,
there is a 90% chance
that it can be reversed solely with lifestyle changes.
90% of the early diagnosed tumors can be cured,
while in late stages this is obviously much worse.
Still, more than 97% of our health expenditures
is devoted to healing,
and we spend less than 3% for prevention and screening.
So what are we doing?
We are waiting for someone to be very ill.
And when it happens,
we try to fix it with a heroic struggle
and huge costs.
And many times we do succeed.
And what are we doing afterward?
We let them go home.
And we usually wait, wait until they become ill again.
Also, the core of our doctors' training
is not to keep someone healthy for as long as possible
and to prevent illnesses.
Doctors learn for many, many years and through thousands of pages
how to fix something when it goes wrong.
And their material interest is also not in health
because nobody gets money if someone is healthy.
The doctor gets money for healing; the insurer pays for sickness.
Not for health.
If we think it over like this, how could such a system have developed?
Actually, it's very simple.
Because apart from the recent past, for thousands of years,
doctors had only two ways to learn
whether the patient had any problems:
either the patient had visible signs on themselves,
or they said,
"I have something wrong with me."
There weren't any other possibilities. Nothing.
But it's not the case today.
Not only have doctors other tools, but we do too.
Nowadays anyone can choose to have a genetic screening test
for a few tens of thousands of forints.
Not only for themselves, but even for their entire intestinal flora
of which a lot of illnesses can be predicted.
For a few tens of thousands of forints, anyone can buy portable devices
that measure their pulse or ECG throughout the day,
or their blood oxygen levels, breathing, brain functions, sleep cycles,
or they measure the exact blood pressure just by touching them to the forehead.
Anyone can buy a smart toilet, that analyzes end-products,
and sends the results to their mobile phone.
We will soon test blood sugar and other blood components without pricking.
What kind of screening I go for is solely my decision.
Yeah, but I hear from some of my smart doctor friends:
"It's not so good because a lot of screenings aren't accurate enough."
And they're absolutely right.
We have some tests which aren't accurate enough,
especially if we study the test results, separately, in themselves.
One hundred years ago it was super dangerous to fly.
However, we didn't choose the option to travel to America by boat,
but we made air travel safer.
That is to say our methods will become more accurate,
but until then we can do more tests,
from which we get much more accurate results.
My doctor friends say about this:
"Not all screening tests are worth it."
Namely, a colon examination -
that our poor Béla would need too -
costs 6,000 forints, at least the institutions get that much for it,
and no more than a few tens of thousands of forints privately.
This must be contrasted, let's say,
with treatment of a colon tumor recognized at a late stage,
which can cost from 10 to 20 million forints.
Obviously, it's also worth it on a social level.
But many tests aren't worth it on the population level.
But I'm not the population.
My mother, my brother or my child aren't the population either.
What is worth it for the insurer and what I choose
are two completely different questions.
Currently, the most sensitive way to recognize early-stage tumors
is the so-called PET CT scan.
It's a very expensive test.
It's totally unsuitable for testing on a societal level, that's for sure.
A couple of years ago, an elderly couple decided
that they would pay for such a test for each other for Christmas
from their saved money.
The results were shocking.
Both turned out to have tumors.
In addition, they had different but aggressive tumors with poor prognoses.
Since being recognized early and managed in time,
both were cured and are still healthy today.
If they'd started to treat them when the first symptoms occurred,
it's sure neither of them would have survived.
What we're doing now
is a bit like if we had developed a supercar with tremendous effort,
driven by a very professional driver at night without any lights.
And when the obstacles come,
we would try to avoid them with incredible feats
or at least minimize the losses,
instead of turning on the headlights,
so that we could see the obstacles as they come and avoid them.
We would go much farther, with much less damage.
We have to transform this system not just because of the development of technology
but because it's untenable.
In all developed countries of the world,
health expenditures increase about 2-3% faster than the GDP.
In addition, patients want to participate more actively in their own health care.
Science, our tools, our sensors, and the development of artificial intelligence
combined with the explosive growth
of genetic and other biological information
will soon enable us to always drive with our headlights on.
Health will be more about health,
disease prevention,
and it'll be a proactive, not a reactive system.
And when necessary, healing will be personalized
with individual treatment,
the patient won't be treated with methods for the masses.
They'll be an active participant in the process.
In addition, our health care, especially diagnostics,
will move into our homes very soon.
I know it sounds a bit futuristic,
but think about it this way: it wasn't so long ago,
when the computer was a roomful of equipment.
Nobody would have thought that such a thing would ever be in our apartments.
And nowadays we carry the knowledge of 100,000 such devices
in our pockets or even our watches,
which are the perfect devices
to collect and process information about our health.
Fortunately, the culture of screenings and prevention
is starting to integrate into our lives in Hungary.
But, in truth, we aren't ready for it yet
either in terms of instrumentation or personnel.
We still need to redesign our financial system,
supply system, education, but most of all our thinking.
But until these changes happen,
we can decide if we want to be passive participants in sick-care,
and see if we survive the next obstacle,
or if we take our health and the health of our loved ones into our own hands.
Thank you.
(Applause)