The Single Biggest Problem in Healthcare

Someone I care deeply about has two relatively rare disease conditions: Thymoma (cancer of the thymus) and myelodysplastic syndromes (MDS — disorders that reduce the bone marrow’s ability to create normal blood cells.)

The treatment for the uncommon thymoma and MDS, together with her age, sex, other conditions, and her unique genetic profile, requires more than using an approved drug or drugs.

It requires finding a unique, specialized treatment, perhaps appropriate only to one person on earth.

Though today doctors generally prescribe a standard approved treatment for a common ailment — i.e. aspirin for a headache, chemotherapy for a cancer — each of us responds differently to every chemical and to every treatment, much to the frustration of doctors and their patients, who expect everyone to react the same.

Each of us is a unique human specimen as DNA searches reveal. At some time in the future, possibly every disease will be custom-treated for each individual.

Until then, it is the enormous differences in people multiplied by their infinite reactions to treatments, multiplied again by the immeasurable number of diseases and other afflictions, that makes the following excerpts germane.

18 DECEMBER 2019
How Artificial Intelligence Will Change Medicine
Claudia Wallis, Contributing Editor
(This report was produced independently by the editors of Scientific American, who take sole responsibility for the editorial content.)

The biomedical world is awash in data. We have terabytes of genomic information from mouse to human, troves of health metrics from clinical trials, and reams of so-called real-world data from insurance companies and pharmacies.

Using powerful computers, scientists have scrutinized this bounty with some fine results, but it has become clear that we can learn much more with an assist from artificial intelligence.

Over the next decade, deep-learning neural networks will likely transform how we look for patterns in data and how research is conducted and applied to human health.

Innovations In AI and Digital Health
Right now the biggest bets are being placed in the realm of drug discovery. And for good reason.

The average cost of bringing a new drug to market nearly doubled between 2003 and 2013 to $2.6 billion, and because nine out of 10 fail in the final two phases of clinical trials, most of the money goes to waste.

Every large pharma company is working with at least one AI-focused start-up to see if it can raise the return on investment.

Machine-learning algorithms can sift through millions of compounds, narrowing the options for a particular drug target.

Perhaps more exciting, AI systems—unconstrained by prevailing theories and biases—can identify entirely new targets by spotting subtle differences at the level of tissues, cells, genes or proteins between, say, a healthy brain and one marked by Parkinson’s—differences that might elude or even mystify a human scientist.

The pharmaceutical companies “waste” many billions of dollars searching for the one drug that works on enough similar people, who have a certain condition common enough that sales of the cure will be profitable.

If a company somehow discovered a drug that could cure the thymoma for just one woman, that drug would not be produced. Even if a drug could cure the MDS of a thousand people, it never would be brought to market.

The profit motive would prevent it.

And that takes us to the single biggest problem in health care. It is the biggest problem facing hospitals; the biggest problem facing doctors and nurses, etc. It is the biggest problem facing pharmaceutical companies. It is the biggest problem facing patients.

The single biggest problem in the entire realm of healthcare involves money.

And fortunately, we Americans own a solution to that problem. Our federal government has the unlimited ability to create money, specifically our sovereign currency, the U.S. dollar.

Our federal government, being Monetarily Sovereign, is not constrained by a profit motive. It wants no profits; it needs no income; it never can run short of dollars. Never.

Contrary to the disinformation by those who say America’s deficit spending is “unsustainable,” or harmful, federal deficits and debt are neither. They not only are beneficial, but absolutely necessary.

Without federal deficit spending, America would descend into a 3rd world depression unmatched in history. (Every depression in U.S. history has been introduced by federal surpluses).

The search for medical prevention and cures is constrained by money. For pharmaceutical companies, it is constrained by the need for profits. For universities, it is constrained by the need to pay for researchers, their research, and their equipment.

And all of it could be funded by the press of a federal computer, money-creation key.

Ben Bernanke: “The U.S. government has a technology, called a printing press (or, today, its electronic equivalent), that allows it to produce as many U.S. dollars as it wishes at essentially no cost.”

Will the inefficiencies of today’s electronic health records (EHRs) be addressed by smart systems that prevent prescribing errors and provide early warnings of disease?

Some of the world’s biggest tech giants are working on it.

More accurately, some of the world’s biggest tech giants are working on systems they can sell for a profit — which does not always correlate with the needs of patients.

By contrast, all phases of medical research could be federally funded, allowing for the goals to be prevention and cures rather than only profits.

The bigger concern is a shortage of people with both biomedical knowledge and algorithm-building proficiency.

The solution to the “shortage of people” problem is addressed in the Ten Steps to Prosperity, Step #4. Free education (including post-grad) for everyone, and Step #5. Salary for attending school, both of which the federal government easily could fund.

This brings us to a related article that appeared in the December 18, 2019 issue of Nature Magazine. Excerpts:

Hunting for New Drugs with AI
The $1-trillion global pharmaceutical industry has been in a drug development and productivity slide for at least two decades.

Pharmaceutical companies are spending more and more—the 10 largest ones now pay nearly $80 billion a year—to come up with fewer and fewer successful drugs.

Ten years ago every dollar invested in research and development saw a return of 10 cents; today it yields less than two cents.

In part, that is because the drugs that are easiest to find and that safely and effectively treat common disorders have all been found; what is left is hunting for drugs that address problems with complex and elusive solutions and that would treat disorders affecting only tiny portions of the population—and thus could return far less in revenue.

These same challenges have increased the lab-to-market time line to 12 years, with 90 percent of drugs washing out in one of the phases of human trials.

The private sector cannot afford endlessly to lose money, but the federal government can. Remember that since 1940 the federal government has lost more than $20 trillion, with no ill effects.

Alan Greenspan: “Central banks can issue currency, a non-interest-bearing claim on the government, effectively without limit. A government cannot become insolvent with respect to obligations in its own currency.”

In fact, the federal government easily could afford to lose double or triple that amount and the only effect would be for the economy to be strengthened and the populace to be enriched by the addition of dollars to their pockets.

And did we mention that finding new and better cures faster, would benefit everyone?

Step #10 of the Ten Steps to Prosperity reads: “Increase federal spending on the myriad initiatives that benefit America’s 99.9%”

I suggest that vastly increased federal funding for medical research and development be one of those “myriad initiatives.”

The federal government has the unlimited ability to fund personnel and equipment in the pharmaceutical industry and universities, and to provide financial incentives that encourage and enable faster and more complete searches for new prevention and cures.

It can be done. It should be done. It must be done, or development will continue to decline and we all will suffer.

The people who prevent this, by making false claims about “unsustainable” federal deficits and debt, are complicit in the suffering and too-early deaths of billions.

Disregard their deceptions. Demand more federal spending on projects vital to America.

Rodger Malcolm Mitchell
Monetary Sovereignty
Twitter: @rodgermitchell
Search #monetarysovereignty Facebook: Rodger Malcolm Mitchell

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The most important problems in economics involve:

1. Monetary Sovereignty describes money creation and destruction.
2. Gap Psychology describes the common desire to distance oneself from those “below” in any socio-economic ranking, and to come nearer those “above.” The socio-economic distance is referred to as “The Gap.”

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of Monetary Sovereignty and The Ten Steps To Prosperity can grow the economy and narrow the Gaps:

Ten Steps To Prosperity:

1. Eliminate FICA

2. Federally funded Medicare — parts A, B & D, plus long-term care — for everyone

3. Provide a monthly economic bonus to every man, woman and child in America (similar to social security for all)

4. Free education (including post-grad) for everyone

5. Salary for attending school

6. Eliminate federal taxes on business

7. Increase the standard income tax deduction, annually. 

8. Tax the very rich (the “.1%”) more, with higher progressive tax rates on all forms of income.

9. Federal ownership of all banks

10. Increase federal spending on the myriad initiatives that benefit America’s 99.9% 

The Ten Steps will grow the economy and narrow the income/wealth/power Gap between the rich and the rest.

MONETARY SOVEREIGNTY