The Future of Medicine Is Exciting — but Troubling

It’s no space-age fantasy: today’s doctors and other medical professionals know they’re living in exciting times. Anxious times, too.

When we asked some of the area’s foremost medical experts for their thoughts on what the next 15 or so years will bring to the health care landscape, they had no shortage of ideas.

They spoke about the promise of stem cells, and the possibility that scientists might hone their potential to replace tissue and even grow new organs for patients in need — an idea that would have seemed like science fiction not too long ago.

They talked about how robotics, laparoscopy, and other surgical advances are helping doctors operate with a minimum of trauma or scarring, and turning what used to be week-long hospital stays into outpatient visits.

The breakthroughs keep piling up — research on gene therapy to reverse the effects of heart disease and prevent it from recurring. Imaging technology that is giving doctors quicker, more accurate pictures of health problems. Computer advances that are starting to help doctors diagnose and treat homebound patients remotely.

The list goes on, and it speaks not only to the boundless ingenuity of medicine and science, but also to the impressive quality of health care in Western Mass., where many of the latest technologies are being put into practice every day.

So, there’s clearly no shortage of optimism when it comes to innovation. But there’s also a nagging worry that’s beginning to loom ever-larger for those who are paying attention.

It’s simply this: how are we going to pay for it all?

Let’s face it — Americans are accustomed to expecting the best, and our attitude toward health care is no exception. If there’s a breakthough in treatment, people want to partake of it, and they want it now. That’s our culture.

But doctors and policy experts are starting to ask some sobering questions. With health care already costing about $2 trillion per year, with each new high-tech medical solution arriving with a hefty price tag, and with the plentiful Baby Boomers expected to live longer — often managing serious, chronic health issues — than past generations, many are starting to wonder whether our current health care infrastructure is even sustainable.

In some cases, they’re flatly saying that it’s not.

Although debate will rage over the details, many expect that some sort of universal health care in the U.S. is inevitable, which will strain the system further. Long waits for non-essential treatment might become commonplace. Federal regulators might have to decide which products make it to market and which are deemed, well, not cost-effective.

Some would gasp at the very thought. But, again, we’re Americans, and we’re used to having options. The idea of our health care choices being severely reduced is a scary thought — but it’s one that many are openly talking about.

There’s a clear dichotomy in play; science is performing miracles on a daily basis, but will we reach a point where even those efforts must be slowed due to financial restraints?

“We’re developing all this great stuff,” Dr. Jeffrey Leppo told us when he was interviewed for the “Vision 2025” story (see page 34). “We can maybe cure diseases, but we’re still decades away in some cases, and in the meantime we’re pouring tons of money into it without any control.”

It’s not clear right now that anyone has the answer for a cost problem that, by the direst estimates, could crash the system within 10 years. Efforts to streamline health care through electronic record-keeping and other efficiencies play around the edges, but don’t tackle the core of the problem, which is simply a growing lack of money to pay for everything we want.

And we want everything. Which, in the end, may turn out to be the biggest fantasy of all.