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commentary

(Zócalo Public Square)

August 31, 2012

What Will Change Most About Our Routine Physicals Over the Next Decade?

by Arthur L. Kellermann

This is a response to a Zócalo Public Square discussion, "Cough Into Your Droid, Please — What Will Change Most About Our Routine Physicals Over the Next Decade?"

We'll get our care online—but fancy technology comes with new costs

The healthcare systems of most developed countries are organized to provide all the care you need, whether or not you can afford it. America's healthcare system is aligned to provide all the healthcare you can afford, whether or not you need it. As a result, Americans pay more for their healthcare than anyone else on earth. No other country comes close.

Americans can be justifiably proud of their prowess in biomedical research, but this knowledge has to be applied carefully. Otherwise, the "promise" of biomedicine could prove to be a curse. Rather than getting a routine physical in 10 years, much of our preventive care will be accomplished online. Will preventive care in the future also include an analysis of each person's genetic code? I hope not.

We hear a lot about the benefits of genomics but very little about its risks. These include: false-positive test results that trigger needless worry and costly diagnostic workups; the detection of a gene that might (but probably won't) cause problems later in life; labeling otherwise healthy people "high risk," potentially rendering them uninsurable and possibly unemployable, and the prospect of consigning hundreds of thousands—perhaps millions—to an interminable series of doctor visits, follow-up tests, and treatments to prevent disease in a few.

In a nation long fearful of healthcare rationing, we are just beginning to come to grips with the opposite problem—the enormous costs and grievous harm that come from excessive testing and needless treatments. Don't forget—an American's odds of living a long and healthy life still depend more on his zip code than his genetic code. That won't change until we make healthcare more affordable.

This article was originally published at Zócalo Public Square.


Dr. Arthur Kellermann, an emergency physician, holds the Paul-O'Neill-Alcoa Chair in Policy Analysis at the nonprofit, nonpartisan RAND Corporation.

This commentary appeared on Zócalo Public Square on August 31, 2012