Son,

I was just watching the History Channel. The program was on ‘dangerous cargoes.’ One of the cargoes they showcased was ‘radioactive pharmaceuticals.’ Well, I guess that would qualify as dangerous. But the costs and benefits caught my attention.

These radioactive pharmaceuticals are central to the ability to diagnose and treat a variety of cancers. The History Channel reported that 14,000,000 doses of this medication is used by Americans every year. That is 14,000,000 opportunities for better health care than was offered forty years ago.

The radioactive pharmaceuticals described in this program have a half life of 110 minutes. That means that every 110 minutes, less than two hours, they lose half of their potency, half of their effectiveness. These drugs are manufactured on demand and shipped immediately by special jet planes around the country as needed. The flight crew is trained to move quickly and safely to deliver the drugs within a two hour time frame – sometimes many states away from the site of manufacture. I was watching this and marveling at the cost of that drug.

The quality control and protection from radiation for pharmaceutical and transport workers is astounding – but we have to have it to insure safety. Special jets darting around the country delivering timely supplies cannot be cheap.

I was working for a health care system in Northwest Missouri in the 1980’s when we obtained the first lithrotripsy machine. The machine could pulverized stones accumulating in the kidney, bladder, and gallbladder. I remember it was an outpatient procedure and cost like $5,000. People raised holy heck about the cost of an outpatient procedure – but the comparative cost was remarkably less than inpatient invasive surgery. Outpatient cost – $5,000 and a day off work. Inpatient cost – $20,000, painful recovery, and two weeks off work. These are numbers from twenty years ago.

Health care costs seem to be rising rapidly. In some cases the cost has dramatically reduced with the shift to outpatient or ambulatory treatments. In 1980 my town had about 600 occupied inpatient beds per day, today we have about 220 occupied inpatient beds. This reduction is attributed to improved ambulatory treatments and to a hard line by insurance companies around frivolous hospital stays.

The point of this post is to note that while cost are rising, the benefit is rising proportionately. I would much rather live in today’s health care world than the health care world of 1975.

Dad