WASHINGTON, May 20 (UPI) -- The latest advances in medical technology may offer treatments and possible cures for a wide range of ailments, but these medical wonders come at such high cost they may be available only to the rich, advisers told United Press International.
New medications, for example, are attacking once-terminal diseases, such as cancer and AIDS, promising to turn them into chronic illnesses. Devices such as pacemakers keep weakened hearts going. Reproductive therapy offers new hope to infertile couples.
Such advances, however, come with hefty price tags -- not including the costs of the laboratory tests and doctor visits needed even to reach a diagnosis.
"By all predictions, it's going to be more expensive (to get medical care) in the future," Dr. Mark McClellan, a senior health care policy adviser to the White House appointed last year to President Bush's Council of Economic Advisers, told UPI.
The federal government will need to play a more active role to ensure low-income groups and the elderly are not left out in the cold, McClellan said. During the economic downturn last year, many Americans either lost health care coverage when they lost their jobs or skipped insurance coverage because of rising premiums.
U.S. Census Bureau data show more than 38 million people lack basic health care insurance, including 18.8 million Caucasians, 10.8 million Hispanics, 6.6 million African-Americans and 2 million Asians.
"Our policies need to recognize households and individuals differ in their abilities to pay for their medical needs," McClellan said. One problem is the government's health care policies tend to lag way behind medical science.
"You don't have to look any further than at Medicare being 30-plus years behind in covering (the latest) prescription drugs," he said.
Although nearly everyone agrees the current health care arrangement has problems, Americans tend to feel entitled to the most recent and top-of-the-line medical treatments yet rarely understand how much they cost, said Dr. Stuart Rosenberg, president and chief executive officer of the University of Texas Southwestern Health Systems in Dallas, the corporate arm of the university that oversees the business of clinical practice.
"You know the difference between a $100 pair of shoes and a $400 pair of shoes," Rosenberg told UPI. "When you go into health care, most people don't ask. The patient has to be put back into the economic equation ... but with protections for catastrophic care."
One possible solution is federally sponsored savings accounts for medical expenses. Also known as "Flex" accounts, they usually are offered through employer health insurance programs. Money is deducted from employee paychecks on a pre-tax basis and deposited into a special account separate from insurance premium deductions. The money can be withdrawn by employees to pay for a wide range of medical expenses not covered by insurance.
The bottom line, Rosenberg said, is as technology pushes medical treatment costs higher, patients may be challenged to find ways to foot the bill if insurance companies cannot or do not come through.
At present, however, fewer than 1 million Americans are taking advantage of the Flex accounts.
"This is a new concept," Rosenberg said. "How are we going to pay for 21st century technological advances?" The medical savings account approach is "being sold. It's being test-marketed. It exists."
Another example of a technological advance that will send medical costs skyrocketing, experts said, is the mapping of the human genome. It is expected to create a pool of sophisticated gene therapies to treat and potentially repair genetic defects that inhibit quality of life and claim lives too soon.
"Especially with the human genome project coming, we're going to have fantastic opportunities to improve the health of Americans," Dr. A. Mark Frenderick, a professor of internal medicine and health management and policy at the University of Michigan at Ann Arbor, told UPI. "(However,)innovative medical technology is a double edge sword when it comes to health and the health care of Americans."
Many agree innovations such as gene therapies will widen the gap between the haves and have nots.
"It's likely we'll see a greater divide to access to (the latest) medical intervention," Frenderick said.
One way to curb the growing gap, Frenderick said, and ease some of the financial burden is to make distinctions between those who really need medical intervention and those using the same intervention as preventive medicine.
For example, he explained, if two men take the same cholesterol-lowering drug, the man who has had a heart attack should pay less for the drug than a man who registers higher-than-normal cholesterol levels but has not suffered cardiovascular problems.
Whether such experimental approaches or encouraging Flex accounts will work remains to be seen. Although breakthrough medical care can be a luxury item for those who can afford it, David Cutler, an economics professor at Harvard University in Cambridge, Mass. said the forecast for the 21st century is not all gloom and doom as others have predicted.
"One can overstate the problem," Cutler said.
Federal government insurance and screenings programs, as well as charity clinics provide decent health care, he explained, to those who cannot afford state-of-the-art facilities and technology.
"The haves get a bit more care than the have nots," he conceded, "but the have nots also get some of the spiffy care. I think it's not as black and white as have and have not."
