The American medical system is in crisis mode. Many worry that cost escalations fueled by medical, pharmaceutical and genetic advances - coupled with an aging population - will implode the industry.

Health care expenditures exceeded $1.7 trillion - or 15 percent of our gross domestic product - in 2004. That's 4.3 times the amount spent on national defense.

No country in the history of the world has ever allocated so much of its economic activity to health care. And the future is cloudy as the development and availability of new technology is clinically and economically linked to greater use of the technology and to higher costs.

For example, new cardiac diagnostic imaging equipment and expanded heart care facilities have resulted in more cardiac procedures and a dramatic increase in costs. Another example frequently stated by health economists is that the greater the magnetic resonance imaging (MRI) availability there is, the more often CT scans are used. That is, they're used as complements, not replacements.

Yet, advances in medical technology provide a ray of hope, not only in stemming the rising costs but also in redefining the very concept of health and well-being.

Is there a solution?

Some experts believe the answer is to reinvent the industry - moving from a medical focus (responding to disease once it's been diagnosed) to a preventive or predictive health system. This approach anticipates the use of developing technology to stop or limit disease.

This paradigm shift was the focus of a recent two-day seminar sponsored by Emory University and the Georgia Institute of Technology. At the seminar, the institutions announced a new project, the Predictive Health Initiative, which seeks to boost advances in genetics, nanotechnology and new medical approaches. The model promotes discovery and treatment of disease during the very early stages of illness and, in a truly revolutionary advancement, may provide a means to prevent disease from developing in the first place.

The plan has the potential to dramatically change the health care industry. As reported in the Atlanta Journal-Constitution, Michael Johns, M.D., Emory's executive vice president for health affairs, believes the new initiative would flip the traditional medical paradigm of treating disease. Johns says the time has come to use newly developed tools to predict an individual's chance of developing a disease.

The new health model, still in its infancy and without an official title, has been called predictive, personalized, preventive or pre-emptive care. The initiative is based on the unraveling of the human genome and the discovery of body changes that occur at the microscopic level. The approach calls upon subspecialties of proteomics, epigenetics, bioinformatics and computational biology to develop a medical standard of care that acts upon early clues that portend the development of disease.

The new philosophy hinges on the concept that disease is the result of either outside forces, such as infectious agents or environmental toxins, or defective genes. These vectors disrupt the natural biological networks in the body and cause the body to produce proteins. The unnatural proteins, called biomarkers, are secreted into the blood or other body fluids, creating a molecular fingerprint that can be tracked or monitored.

Although the science is in its infancy, the concept has influenced medical care as physicians use C-reactive protein (CRP) to predict vulnerability to heart attack and monitor prostate-specific antigen (PSA) to detect prostate cancer.

Some visionaries foresee a practice of preventive medicine whereby every individual's unique genome is tracked or monitored to allow early detection of abnormal biomarkers. If a disturbance in the body's natural network is discovered, then tailored or individually created pharmaceuticals could be administered before the disease fully develops and even presents symptoms. Potentially, intervention could influence and impede the development of disease.

"Imagine if we could say to a woman, 'You have an 80-percent chance of having ovarian cancer by the time you are 60, but if you begin taking this pill when you are 40, your eventual chance of cancer will be 2 percent,' " Lee Hood, M.D., Ph.D., co-founder of the Institute for Systems Biology in Seattle, said in the Atlanta Journal-Constitution article.

Proceed with caution.

The new paradigm does have risks. Fundamental to the process is the collection, storage and manipulation of large amounts of personal data - information that could be used to discriminate against a person when it comes to employment or obtainment of health insurance.

Kenneth Brigham, M.D., a pulmonologist and acting director of the Emory-Georgia Tech initiative, is aware of the ethical implications. He views the need to redefine privacy as an essential component of the new health care model. To address this task, the new collaborative will include faculty experts in public policy, anthropology and behavioral science, as well as medical and public health specialists from Emory and mathematicians and bioengineers from Georgia Tech.

Paradoxically, some researchers fear the greatest barrier to implementation of a predictive health philosophy is the potential success in limiting disease. Ralph Snyderman, M.D., chancellor emeritus for health affairs at Duke University, told the Journal-Constitution that "the reimbursement system for health care not only doesn't reward this type of approach, it actually punishes it."

"The greatest payments physicians or hospitals get are for intervention after something has occurred," Snyderman said.

This Article is from MyDNA.com

© 2006 mydna.com