``...So should those patients for whom it is determined that the major cause is heredity (80%? 90%) be judged not at fault for their condition, and be treated, while those who got sick because of an unhealthy life-style be left to die...'' JJ
No of course not. The point is the capitalism kills twice over.
``..To some extent. But it's not unversally true that medicine is trending to less expensive procedures and equipment...''
Actually what I was trying to illustrate was the transformation of skilled labor into devices and proceedures that require less labor, and therefore less dependence on that labor---and therefore more easily extracted profits or efficiencies by other means, and not necessarily less `cost'. All the same sorts of processes and wars of advance capitalism are carried out inside the medical world, just as they are outside.
``Who is going to demand that it [waste] be wrung out of the system? (I'm asking this as a genuine question -- I don't know the answer.)''
Again the point was to illustrate various kinds of transformations that are installed under progress and efficiencies, but these are progress and efficiency in the narrow business sense, rather than in the larger social and medical sense. Waste is obviously in the eye of the beholder.
``should we go back to the older type of hospital? (Again, a genuine question.)''
No probably not all the way--but real kitchens and shops would be nice. Maybe there is a place for that kind of operation in poorer areas, areas under served, etc.. One of my early jobs was working in an old fashion hospital as an orderly. Maybe its just worker nostalgia. There was something (wholesome?) about bringing in real breakfasts made downstairs, making beds with fresh laundered sheets, taking carts of paper wrapped sterile instruments up to the surgery floor.
Since most diseases and conditions are not new, there are whole histories of methods to deal with them. One thing about advanced western medicine is its emphasis on acute conditions and a relatively disinterest in the chronic conditions. This is almost the reverse emphasis of various non-western traditional medicine practices which tend to treat chronic conditions and more or less flounder on acute cases like infections, severe wounds, and so forth.
On the other hand, most of the world would probably be able to provide more care for less if they followed older western systems, since these are more labor intensive and don't require the high and continuing cost of disposables. However a lot these older systems depend on the kind of industrialization that many areas lack, so they go immediately to imported disposables since they don't have the underlying infrastructure to develop and build the older versions. Still it seems to me to make more sense to import large autoclaves and other equipment than get trapped into buying the more immediately useful disposables.
CG