One thing about hospitals, is that they use an awful
electricity. We already know about some of the
that will occur in health care in the post-peak-oil era; I wrote about
that in October
…Petroleum scarcity will affect the health system
in at least 4 ways:
through effects on medical supplies and equipment, transportation,
energy generation, and food production…
One way this will affect medical care is that it will change the
relative costs of certain kinds of care. Everything will cost
more, of course. More interestingly, the costs for some
things will rise much faster than for others. For example,
the cost for ICU care — already staggeringly expensive — will rise
faster than less intensive kinds of care.
I was thinking about this when I was reading up on proton
therapy. Proton therapy is a kind of
radiation treatment, usually used to kill tumors. There are
only a few proton therapy facilities in the world (five in the USA).
More are being planned, but it is controversial.
The reason they are controversial, is that devices used
to be the most expensive medical devices on the planet.
imposed a rule that will allow only one proton therapy center
in the entire State. The rule was imposed by a commission
that tries to limit the cost of health care by regulating the
construction of expensive new facilities. Beaumont Hospitals
had a plan to build one at a cost of $159 million. Now they
have to join a group that will plan jointly where the single facility
The facilities are the size of a football field. They have to
contain a cyclotron, which weighs over 200 tons. Yes, the are
efforts to reduce the size and expense of the devices, but they are
In fact, in most cases, the advantages of proton therapy over
conventional radiation therapy are unproven. There are
theoretical reasons to believe it is better: protons penetrate tissue
for a certain distance before releasing any energy. The
distance is determined by how much energy they have. The
amount of energy can be varied; it is possible to calculate how to
focus the beam, and how much energy to give it, so that the great
majority of the energy is delivered to the tumor. This leaves
surrounding tissue relatively unaffected.
Anyway, this is exactly the kind of thing that is going to be impacted
by energy costs. Proton therapy already is controversial
because of the expense. Whatever the benefits, we have to wonder
whether it makes sense to go around building these things, when the
cost to operate them may very well be prohibitive in the near future.
Yes, those in the know will say that there are promising efforts under
way to develop cheaper
proton therapy devices, using new technology.
(Using dielectric-wall accelerators instead of cyclotrons)
That might help, but there is a limit to how much you can
reduce the energy requirements and still have an effective device.
Oh, and of course there is a political wrinkle to this story.
Remember Tommy Thompson? He was the
Secretary for Health and Human Services during 2001-2005. He gained
notoriety when he spoke at at the Religious Action Center of
Reform Judaism, and commented…
“I’m in the private sector and for the first time in
my life I’m earning money. You know that’s sort of part of the Jewish
tradition and I do not find anything wrong with that.”
By the way, according to Open
Secrets, Thompson was already doing rather well financially,
when he worked for Bush. He could have retired in 2005, and
never had to worry.
Thompson made the comment while he was preparing his ill-advised
presidential campaign. That never got off the ground,
Given his background at HHS, he was hoping to make his expertise on
health care policy a big point in his campaign. He claimed
that he would reduce costs by emphasizing preventative care.
So what is he doing now, to “earn money?” He’s the director of
the Board at Procure, a company that makes proton therapy
centers. Yes, the guy who was going to moderate the cost of
health care, is now hawking the most expensive medical devices in the
solar system. Devices that we might not even be able to use,
when the cost of energy becomes prohibitive, and that could become
obsolete, if the dielectric-wall accelerator works as