Advances in technology are great, experts agree, but costs need to mimic the rest of the economy.
As Arizona enters its second century and health care costs soar, we can’t help but ask: Has the technology that helps us live longer become too costly? Are we living too long? And who will pay for the high-tech advances that keep us going?
Leading healthcare experts in the Valley say our lifespan has increased, but not as much as most people think, they say. Though they agree that residents may have to work longer, most believe that is because of problems with the economy overall, not from the increasing cost of healthcare.
Technology has improved, they say, but the changes will soon get more amazing. Some of this will be costly, but improved technology can also make healthcare more efficient and less expensive in the long run.
And none of these experts believe Arizona residents live too long.
“I suspect that people used to say that humans were living too long back when people lived 50 years or 60 years,” said Dr. Vishu Jhaveri, chief medical officer and senior vice president at Blue Cross Blue Shield of Arizona. “People may have the instinct to want to live longer, but what they really want is to live longer and healthier.”
Dr. Ed Staren, president and chief executive officer at Cancer Treatment Centers of America’s Western Regional Medical Center in Goodyear, agrees.
“I certainly don’t think people live too long,” says Dr. Ed Staren, president and chief executive officer at Cancer Treatment Centers of America’s Western Regional Medical Center in Goodyear. “I greatly value the chance to learn from those more experienced than we are. The purpose of medicine runs parallel to the right of an individual to a healthy life, to empower them to pursue life to the best of their abilities.”
The mission statement for Blue Cross Blue Shield, Jhaveri notes, “is to improve the quality of life for all Arizonans, not just our customers.”
Healthcare and its new technology are not the major factors in a long life, says Dr. John Hensing, executive vice president and chief medical officer of Banner Health. Genetics, diet and nutrition and exercise are what count the most, he says.
“Do you smoke? Do you get regular exercise? What do you eat? Do you take care of yourself?” Dr. Hensing asks. “Those factors contribute much more to longevity. That being said, of course, there are certain people alive today because of improvements made in medical technology. These are people who 100 years ago would not have survived. But technology is only a modest factor in longevity.”
We do, of course, live longer and longer, but in general our lifespan has increased fairly slowly. According to the U.S. Census, the average life expectancy for men and women combined in the United States was 78.3 years in 2010; it was 76.8 years in 2000.
So how will we pay for the health care that gives us extra years and stronger bodies?
“The new technology allows us to be more efficient in the cost of delivering care,” says Dr. Greg Mayer, senior vice president of the Hospice of the Valley.
Those cost-saving methods can include electronic transmission of medical records; video visits to the doctor for routine illnesses; or even robotic surgery with the robot controlled by a doctor who is hundreds or thousands of miles away from the operating room.
“Many areas of technology are very high in cost, and we’re all aware that the increases in these costs cannot be sustained in future,” Dr. Mayer says. “If we aren’t smarter and more efficient in our use of health care, it won’t be helpful. It will just be fancier care.”
In the drive to cut expenses, he says, patients will probably find that less complicated medical care will be delivered by highly qualified middle level personnel like nurse practitioners, rather than doctors. “There have to be changes because we can’t sustain the current system financially. There aren’t even enough physicians to meet all the needs,” Dr. Mayer says.
Of course, medical technology has brought on major changes in how serious diseases are treated, the doctors say. Cancer is a prime example.
When Dr. Staren of the Cancer Treatment Centers of America started practicing in the 1980s, the bulk of cancer diagnoses were based on just looking at the size and shape of a tumor or on what could be seen by analyzing cells under a microscope. Treatment was limited to drugs and chemotherapy that had not changed much in 25 years.
Now, doctors have electronic equipment to look at cancers on the molecular level and differentiate among individual tumors and types of cancer. Targeted therapies can use drugs to block the growth and spread of cancer by interfering with specific molecules involved in tumor growth. These targeted therapies may be more potent than chemotherapy and radiotherapy and less harmful to normal cells.
“Now, cancer is being treated as a chronic disease, much like diabetes,” Dr. Staren says. “There have been true paradigm shifts in treatment.”
It’s possible to treat tumors with minimal access to the body by delivering drugs through small pinholes in the abdomen, chest or brain. “This is process innovation that can result in lower costs and reimbursement,” Dr. Staren says.
“Right now, we’re going through transformation of our health care and how it’s paid for,” Dr. Hensing says. “We’re in a period of non-sustainable growth of costs. That has to change. The growth of costs must flatten out to a cost trend that looks like the rest of the U.S. economy – whether health care is paid for by employers or the government or both. We need a better way to deliver services, and they will be delivered in a more economical way. It will take the better part of a decade to do it.”
“There is unquestionably a much better prospect for better quality and quantity of life due to technology,” said Dr. Rafael Fonseca, deputy director of the Mayo Clinic Cancer Center. “But escalating costs remain a challenge.”
Costs are higher in the United States than around the world, he says, but that’s partly because the U.S. carries most of the cost of research and development. He sees room for containment of costs. “The notion that everything has to be managed by doctors must change,” Fonseca says. “Nurses can get a history and do a medical exam;. There can be electronic consultation. Nurses can deal with day-to-day problems with specialists handling individual cases.”
Here are the five things that Valley experts say will shape health care in Arizona as the state enters its second century:
More improvements, including less invasive surgery, targeted drugs and therapies.
More use of nurses and trained technicians to give care.
Training for technicians and nurses so they can administer more care.
Promotion of better nutrition and more exercise.
Growth of facilities
New clinics and hospitals in Arizona attracting patients from around the world.