An Open Letter To The President

Dear Mr. President:

I have been troubled by the continued failure of medicine to effectively address chronic diseases, and with the resulting crushing economic burden. I graduated this year from New York University with a B.S. in Neural Science and a concentration in Molecular and Cellular Biology.

The enclosed outline of my proposal indicates how chronic diseases that are currently deemed incurable may be prevented. Economically, the proposal makes possible health-care savings of about one trillion dollars per year at the current level of expenditure. I am taking a year off from school and laying out my proposal in greater detail. I intend to send you a preliminary version of my proposal by the end of February 2012.

I believe that the enclosed proposal can make a difference. I hope that it will receive due consideration.

Respectfully,

Natasha Kharas

November 29, 2011

Enclosure: How Disease Prevention Can Save $1 Trillion Per Year

How Disease Prevention Can Save $1 Trillion Per Year

The steady and rapid growth of health-care cost as a percentage of GDP has become a crushing burden on the economy. The present focus on improved diagnosis and treatment cannot solve this economic problem. Incurable genetic, epigenetic and life-style diseases can be prevented. I propose that the transition be made from treatment to prevention. I believe that on inspection, the proposed transition to disease prevention would prove to be the only economically sustainable way to address public health.

I propose that a nationwide standard genetic test be introduced in 2014. This test should then be extended periodically. Initially, the test may include the 2% of the genome that codes for proteins. It should be then extended, first to include the whole genome, and then also to include heritable epigenetic factors. Such tests paired with counseling would provide prospective parents with the information and choice pre-conception about children that could have life-threatening diseases.

Saving: Instituting these tests would prevent the expression of the diseases, eliminating treatment costs of children for the diseases included in the tests. It would reduce indirect productivity losses of those that take care of affected children.

2.  Electronic Medical Records (EMRs)
The EMR is mandated to be in use by 2014. I propose that the results of the genetic/epigenetic tests be made a part of the EMR. The specifications for the EMR ought to be modified accordingly. The Social Security card should contain a semiconductor memory chip. Such a memory chip has the memory capacity to contain an essential minimum of the EMR data including encrypted genetic/epigenetic data in machine-readable form.

Saving: Currently data re-entry accounts for most of $1 billion a day spent on health care information processing. This need of repeatedly re-entering data would be eliminated once a Social Security card with a memory chip is introduced, resulting in saving half of this cost factor.

3.  Inducing Healthier Lifestyles  
Incentive-related guidelines should be issued to induce lifestyle changes including a healthy diet and an active lifestyle. Healthy lifestyle information ought to be part of curricula at all education levels.  Exercise regimen and healthier food should be encouraged in workplaces.

Saving: Instituting these changes would reduce obesity-related diseases such as diabetes and cardiac diseases. It would also reduce diseases linked to alcohol, nicotine and drug abuse. Lastly, it would reduce direct productivity losses, as less of the working population would fall ill.

1. Testing prospective parents would allow elimination of treatment costs of avoided diseases.
2. Introducing the new Social Security card would save half of the information processing cost.
3. Inducing a healthier lifestyle would further reduce cost of disease treatment.
4. Genetic testing and lifestyle changes combined would reduce direct and indirect productivity losses, which are greater than the health care treatment costs in most cases.

At the current level of health care expenditure, the implementation of the proposal would save an estimated $1 trillion per year.