Technology and quality of life. Are we better or worse off?

I’m going to be all over the place in this blog entry, so try to stay with me…

For starters, I found the following Ancient Chinese Curse quite poignant for several reasons: “May you live in exciting times.” Individually, I feel inclined to a peaceful life—one that is not marked by long hours, competition, and high stress. However, I was born into an era where increasing technologies and globalization have made peace something to look forward to during retirement, rather than integrated into the daily lives of the general western population. We may live during exciting times, but do we live better lives because of it?

Admittedly, technologies have made the lives of individuals within the developed world abundantly more comfortable. However, with increasing access to the world around us, has our quality of life significantly increased? Undoubtedly yes… in some areas. BUT—I still find it incredibly ironic that 1) urbanization has placed so many people in such close proximity, 2) technologies have made it so that if we want to contact some one we have a plethora of resources at our disposal (call, text, e-mail, skype, facebook/myspace message, fax, etc, etc… or meet in person) and 3) we are marked as one of the loneliest cultures in history.

I guess what I’m saying is that I question some of the associations between increasing technologies and their effect on psychosocial behavior & well-being.

Nonetheless, the technological revolution offers considerable promise in the arena of public health. Particularly, gadgets can be used to monitor health status (or track disease maintenance) continually and thus provide a way for preventive medicine to enter into mainstream western medicine. Such breakthroughs offer the most immediate promise to those with chronic disease as well as aging populations. Continual health surveillance means that patients can be managed out of the hospital. When heart rate fluctuates abnormally, or cholesterol increases beyond a given value for example, steps can be taken to address the problem before there is a devastating (and expensive) medical emergency. As technological breakthroughs occur, methods to promote health, prevent disease and even treat disease will continue to change the medical infrastructure and the way that we perceive personal health. Such alterations also promise to change the way we live our lives…

Will the outcomes of such breakthroughs better or worsen our quality of life? Will we become like machines, fine-tuned to be healthy and to continuously compete in the international marketplace? Or can we find a balance—utilizing technologies to better health without being consumed by the impersonal matrix of technological advancement? (Human advancement???)

Will such trends further delineate the world’s rich and poor? There are just so many questions and such heavy baggage that this topic brings to the table. Nonetheless, we cannot avoid such questions because this topic will continue to define the world we live in. We must strive to use technologies—medical, informational, communication, etc.—as a tool, rather than as an end.

Public entities as consumer of high cost innovations

Both pharmaceuticals and technological innovations require high R&D expenditures, both offer novel ways of addressing healthcare concerns, and the patterns of adoption may be compared (although the channels of adoption may be somewhat different). A NYTimes article caused me to consider some of the financial considerations regarding innovations relating to healthcare. This article focuses on novel cancer drugs. While they provide new hope for the treatment of cancer, they do so at a high patient cost and at a high cost to society.

In a lecture with a physician and administrator for Los Angeles County healthcare, I became aware of some ethical concerns associated with these trends. In particular, the high cost of cancer drugs (and novel technologies) not only affects the patient/consumer and his/her insurance, but also the taxpayer. Expensive innovations are not only bought by private organizations, but by public ones as well. As such, issues of distributive justice arise. Should the uninsured have access to novel technologies even when this means less resources for other patients, or other hospital departments? Who should decide how the taxpayers money is spent on various innovations relating to healthcare? When the efficacy of these innovations is limited, but beneficial nonetheless, how does this effect what should be considered the appropriate degree of utilization by public entities?

For arguments sake: what if there was a new vaccine that could cure diabetes, but cost $100,000 per shot. Who should have access to the vaccine that can’t pay for it on his or her own? If the government can buy a certain amount, what is the ethical distribution? What if the vaccine is known to be 20% effective; how does that alter the utilization by publicly-funded hospitals?

As the cost of technological innovations increases, can public entities afford to be a major consumer to the detriment of other types of purchases?