Access to Energy, published by the Oregon Institute of Science and Medicine, once predicted mass spectrometry would be used on bodily fluids to diagnose diseases long before symptoms emerge. Although advanced testing is becoming more common, I have heard nothing about using mass spec. Every year I get a complete blood count and wellness blood test from Walk-In Lab whether I seem my doctor or not. I also have urinalysis. Last year I paid about $300 for OneTest for Cancer, an early detection blood test that looks for biomarkers and DNA of cancer long before any symptoms appear. A few years back I paid $950 for a whole-body CT scan that looked for abnormalities and a few years before that I used Life Line Screening to assess my heart risk for ~$189.
I have probably spent $6,000 on various screening tests going back nearly 20 years. Doctors warn that most screening tests are a waste of money and sometimes lead to more harm than good. According to many experts, annual wellness visits and annual physicals are a waste of money in asymptomatic people. Standard blood tests may be the exception, but maybe not. Indeed, little came from my spending except peace of mind, but does that mean it was a waste of money?
Americans see their doctors about three times a year, on average. This average is heavily weighted by seniors who see their doctors more frequently for chronic conditions. Many people only see their doctors only when symptoms appear. Public health advocates argue that our health care system should be predicated on wellness and prevention, rather than waiting to treat sickness. The health care system’s emphasis on sickness is mostly due to how medical care is funded. Insurance does not tend to invest in prevention because it takes years for prevention to pay off. Nonetheless, discovering health conditions before disease develops is a worthy goal.
The Wall Street Journal reports on the future of health technology that aims to diagnose ailments long before the damage is done, saying:
In the near future, doctors may be able to predict the speed at which your individual organs are aging, and detect cancer, Alzheimer’s and other diseases long before you develop symptoms. GLP-1 drugs, now used for diabetes and weight loss, might be prescribed to protect your heart or brain or to treat a range of chronic conditions. And instead of a knee or hip replacement, you could get new bone and joint treatments designed to reverse physical decline entirely by regenerating tissue in damaged joints.
One caveat that is often misunderstood: prevention does not save money. Rather, it redirects funds that would have been spent treating disease to prevention. For example, the $6,000 I spent on medical screenings did not treat a single disease. Every screening test has a cost per life years saved. A 30-year-old paper explaining this was published in the journal Risk Analysis as well as a policy report by the National Center for Policy Analysis.
The WSJ provides some examples of futuristic screenings, but they sound more like science fiction than reality, saying:
Brain health. We’re close to a future when a simple blood draw may not only reveal your genetic risk for Alzheimer’s but will help predict exactly when the symptoms will appear.
Heart disease. To start, heart-risk screening is going to happen in some surprising places in the future.
Breast cancer. The future of breast-cancer care includes earlier detection of microscopic cancer recurrence, long before it would ever show up on a scan. New blood tests that measure circulating tumor DNA—tiny fragments of cancer DNA shed into the bloodstream—are already in limited use and offer a way to detect relapse months or even years sooner, when treatments should be more effective.
Gut health. Imagine going to the doctor for a colonoscopy and leaving with a complete view not just of your gut or colon-cancer risk, but of your overall health status. Over the next decade, the gut will emerge as a central hub to treat multiple diseases and protect organs across the body.
Knee arthritis. But a slate of research teams around the world are on an ambitious quest to cure arthritis, developing therapies that regrow cartilage and rebuild underlying bone to heal damaged joints.
Notice all these all reference the future, not what is currently available. The real key is how to pay for screenings that do not treat or cure a disease. One reason our health care system is predicated on treating disease rather than preventing it is because sickness is insurable, whereas prevention is not insurable. When individuals control their own funds, they have an incentive to invest in prevention.
Read more at WSJ: The Future of Health Technology