The Corpus Callosum

One thing about hospitals, is that they 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 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 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 happen to be the most expensive medical devices on the planet.  

Michigan 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 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."

It did not go over too well.

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, obviously.

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 expected.