For the umpteenth time in recent history I have written a column attacking Donald Trump’s belief that free trade and immigration have wrecked American jobs.
But it is getting increasingly hard to ignore the fact that mobile technology is saving lives.
Given the assumption that medical care is expensive, and without work one will not be able to afford it, this is interesting.
If a patient needs to be taken to the hospital – or, let’s say, a long journey to a hospital from an outlying area – do they still need to get themselves there?
Well, certainly some patients do, although there are many times when just not having to arrange to travel in real time allows great savings in costs and travel time.
Particularly in rural America, a few days of emergency travel can be a major outlay. Why, then, doesn’t the health system respond to the fact that this technology exists?
Let’s go to the TV set, then, and imagine that the hospital has a choice between a mobile unit equipped with a CT scanner to be used in a hospital with big X-ray machines, and a conventional truck equipped with only an ordinary portable CT scanner.
Obviously, it would make more sense to have the mobile unit, whose principal users are medical students who would be much more likely to take it to a hard-to-reach area.
In rural areas, though, both options are fairly common and the mobile unit would be a better investment, with an estimated annual savings of $150,000. This is still quite a lot of money, but if the money can be spent at least half as efficiently as the truck, that’s quite an improvement.
Of course, both technologies have to be considered as a whole – the truck is almost certainly a much cheaper alternative to the mobile unit – but the $150,000 saving is pretty remarkable.
Unfortunately, this has all been lost on Medicare. The government health plan for the elderly and disabled pays for most hospitals, so Medicare represents a huge source of profit for the medical business, and thus more than 40% of the demand for ancillary equipment.
The lesson to be learned from this isn’t that the government should subsidize wireless-based transport for transportation, of course. Instead, the lesson is how much we don’t really understand about the economics of providing medical care.
If we can’t make it work, the result will be higher costs for everyone. (You can’t expand until there are more available systems.)
But this may change. We already have functioning parallel railroads in urban areas, and Amtrak has managed to get new trains running at a cost far below those of the costlier mainline systems.
There are also advanced cars on the roads, including trucks and buses, which could be used for big-bang driving once they were adapted to handle emergency situations.
All of this takes innovation, and almost certainly requires more collaboration than the United States has demonstrated over the past couple of decades.
Instead of fighting changes that are in the best interests of the people, our response would be to find ways to make them work.