Brian Greenspun is editor of the Las Vegas Sun.
THE FUTURE is finally here. How can we not afford it?
A large number of Americans were not alive when "Star Trek" made its debut in living rooms across the country. Gene Roddenberry's vision of tomorrowland, so ably captained by William Shatner aka James Kirk and crew, brought outer-space travel to our consciousness and made the possibilities of life in other solar systems seem likely. People with pointy ears and curmudgeonly engineers filled out the cast of an incredible ride through space.
One of the characters who always fascinated me, though, was Dr. McCoy. They called him Bones and, as best I can recall, he rarely lost a patient to sickness or disease once he got them into his sick bay. He had this little gadget that he'd scan the body with and it would instantly diagnose the problem and in many instances determine the cure. Way back then I used to think that such a tool would not only be useful but would change the way we think about medicine.
I saw one of those machines Monday. The technology has been around for a couple of years or so, but this was the first time that I had the opportunity to visit the Steinberg Diagnostic Center to get an up close and personal look at the PET scan. For certain, it isn't yet handheld like the one Bones used, and it probably still costs a good deal more, too. If I am not mistaken, a set-up like the one they have at Steinberg could run well over $1 million, while the portable one yet to be built would probably cost substantially less. But regardless of the size and cost, the remarkable thing is this: What I used to think would one day happen many years hence is in the here and now.
PET stands for Positron Emission Tomography, which is a very fancy way of describing a machine that takes pictures of the inner self in such a way that doctors can see what is happening from stem to stern in the human body. It is designed, simply, to detect disease and does it in a way that has heretofore been unavailable to physicians. PET scans can uncover abnormalities that might otherwise go undetected for years, and it does it in a virtually risk-free manner with the only pain coming from a pin prick used to draw the smallest drop of blood.
Just think about it. As much as we might not like to know, wouldn't it be helpful to see the formation of malignancies long before a clinical test would otherwise alert our doctors, giving them and us an opportunity to treat them before it is too late? And what about the onset of Alzheimer's and other forms of dementia? The PET scan can detect them one or two years before symptoms might alert a skilled doctor, giving the newly invented drug therapies a chance to forestall the effects of the debilitating disease.
Just think about what this machine can do today. It can detect cancer, coronary artery disease, Parkinson's disease, epilepsy and Alzheimer's in patients after only an hour or two on the table --- long before the symptoms give themselves away -- perhaps saving people years of misery as well as backbreaking financial costs. All we have to do is be able to avail ourselves of a PET scan and whatever else is coming down the pike.
Ah, there's the rub.
I didn't mention that the PET scan is not covered by insurance unless, of course, you already have fallen victim to the diseases the machine is designed to detect. And the cost, while not prohibitive, is well beyond the resources of most average Americans. So what does that mean? Do people who can't afford the cost have to suffer the ravages of disease that might otherwise have been detected and treated earlier, less expensively and far more successfully because of the PET scan?
That, my friends, is the $64,000 question. Adjusted for inflation, we could be dealing with a multibillion-dollar question, but the answer seems self-evident. Why on Earth would the insurance companies -- which are so concerned with keeping people healthy longer, thereby keeping costs of treatment down and perhaps out -- oppose the regular use of technology like PET?
That's the same question the country asked a few years ago when mammography tests were elective and fully uncovered by the insurance carriers who shortsightedly saw dollar signs impacting their quarterly results, masking the long-term benefits to health care and health costs. Today women routinely get mammograms, which positively impact the detection and treatment of breast cancer.
The same is true of blood tests for prostate cancer, colonoscopies and chest X-rays, which at one time were seen as uneccessary and too costly to make available to the average American. Time has proved that early detection has not only saved lives but hundreds of billions of dollars in medical care that would otherwise have broken the health insurance industry years ago. I predict the same good sense will overtake reluctant insurance companies that so far are slow-playing the acceptance of PET scans as routine diagnostic tools of preventive medicine.
And here's a bonus. The sooner machines like the PET scan become widely accepted and paid for as part of a preventive medical plan, the sooner the prices come down for the machines and the tests, making them more affordable which, in turn, makes them more available. And the sooner that happens, the more likely it is that science will invent more and better machines until one day that little detection device I saw on "Star Trek" a generation ago will be commonplace in doctors' offices around the country.
That's when medicine will reach a potential that only space dreamers could have imagined just a few years ago. And that is when people may be spared the misery of diseases that we should have known about but didn't, only because the tools available were out of reach and out of sight.
If you can afford it, get a PET scan. If you can't, start putting pressure on your insurance carriers until they see the wisdom and make it available. This is the kind of tool that can save your life and keep many of us around long enough to see the Starship Enterprise do its thing for real.
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