The Corpus Callosum

One thing about hospitals, is that they href="http://www.energybulletin.net/43514.html">use an awful
lot of
electricity.  We already know about some of the
challenges
that will occur in health care in the post-peak-oil era; I wrote about
that in href="http://scienceblogs.com/corpuscallosum/2007/10/peak_oil_and_health_care_chall.php">October
2007.  

…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 href="http://en.wikipedia.org/wiki/Proton_therapy" rel="tag">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 href="http://www.jsonline.com/story/index.aspx?id=733327">controversial.
 The reason they are controversial, is that devices used
happen
to be the most expensive medical devices on the planet.  


Michigan href="http://www.nytimes.com/2008/05/01/technology/01proton.html?ref=business">recently
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
will
go.

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
unproven.  

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 href="http://www.medgadget.com/archives/2007/06/in_the_works_compact_lowcost_proton_therapy_system.html">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 href="http://www.whitehouse.gov/government/thompson-bio.html"
rel="tag">Tommy Thompson?  He was the
Secretary for Health and Human Services during 2001-2005.  He href="http://www.haaretz.com/hasen/spages/849062.html">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.”

It href="http://scienceblogs.com/mikethemadbiologist/2007/04/my_hook_nose_is_swelling_with.php">did
href="http://scienceblogs.com/tfk/2007/04/tell_us_about_the_big_noses_to.php">not
go over too well.

By the way, according to href="http://www.opensecrets.org/pfds/candlook.php?CID=N99999985">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,
obviously.

Given his background at HHS, he was hoping to make his expertise on
health care policy a big point in his campaign.  He href="http://www.ontheissues.org/Tommy_Thompson.htm">claimed
that he would reduce costs by emphasizing preventative care.  

So what is he doing now, to “earn money?”  He’s the href="http://www.procurecenters.com/board.htm">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
expected.  

Comments

  1. #1 Mark P
    May 8, 2008

    This seems to be a good example of where cost-benefit analysis is really needed. I suspect that spending that money on other things could result in a far higher return in terms of saving lives. Trauma centers, maybe?

  2. #2 Alex
    May 8, 2008

    Wouldn’t one of those use electricity, rather than oil? It’s a very different problem.

  3. #3 Mark P
    May 8, 2008

    The cost of electricity and the cost of petroleum are related. If all electricity came from sources other than fossil fuels, and if there were an existing abundant supply, it might be a different story. But the cost of virtually everything depends on the cost of transportation, and that is almost exclusively provided by petroleum-based fuels. New generating plants require huge transportation expenditures for material and construction. Existing coal-fired plants require large quantities of coal that are transported by petroleum-fueled transportation.

  4. #4 Gingerbaker
    May 10, 2008

    Earlier this year, MIT scientists published a large position paper on the feasibility of using heat mining as a viable source of energy.

    Their report was very positive, and said that by 2050 10 % of US energy requirements could be generated using this technology, based upon an expense of only one billion dollars. One wonders what we could do with an expenditure of $100 B?

    According to Dr Tester at MIT, the amount of energy potentially available through heat mining is 100 million units. The entire globe currently uses 400 units of energy.

    The other positive attributes of this technology is that it has minimal environmental impact, and the plants can be located virtually anywhere.

    Damn the electric bills, full speed ahead?

    http://www.businessweek.com/investor/content/aug2007/pi20070824_021169.htm

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