About 20 years ago, I wrote a column about new technology in health care.

I was looking at some old papers and found it. I think it applies just as well today as it did back then. I have not changed one word of what you will read below. I don’t have to, it still applies.

Amazing, isn’t it?

I’m writing this today. By tomorrow, new technology not available today will be available to further help in the diagnosis and treatment of illness. Sometimes we get so smug that we think we know it all and have discovered everything and there will be nothing new to learn. Then something even more extraordinary develops.

The ultimate medical goal is to put ourselves out of business. We have come a long way. We can cure many diseases and prevent many others. The problem is, just as soon as we cure one disease, a new one appears to take its place. But that’s one of the exciting parts of being in the medical business. The “problems” (read that “opportunities,”) are always present.

Nevertheless, the things we are doing now were unheard of just a few years ago. We can now do surgery without making long, and painful, incisions. In just a few years many different types of surgical procedures are being done using instruments and video cameras and it may be that in the near future almost all surgery will be done this way.

The diagnostic testing that can be done is also exciting. Computers, lasers, magnets, radioactive materials, and a host of other technologies allow evaluation that can tell us all about you, your organs, your cells and even what goes on inside your cells.

But all of this is not possible without a price. And the price is money, money, money. The research and development cost of this technology is very expensive and the machinery itself is also expensive. And the issue we face is simply: Is the cost worth it?

The new technology will prolong life. It will even save lives. But our taxes will go up. Our insurance costs will rise. Our out of pocket expenses will increase.

The alternative is to ration the expensive tests and treatments. But, the problem is deciding who should get the expensive tests and treatments and who should not. Moreover, who should make the decisions?

Of course, we could establish the national policy that halts or at least slows down the development of new technology, but that’s very difficult, if not impossible to achieve.

Much of the development is a spinoff of other uses. Space exploration, for example, has provided much in the way of health care technology. So that even if we wanted to stop health care technology much of it would appear anyway. Once available, not using it is virtually impossible.

You, the patient, need to be grateful for all of this development and thankful if it helps in your medical care, but you also have to play a role in the ethical debates that will arise about their appropriate use.

Dr. Michael M. Warren is Ashbel Smith professor of surgery at University of Texas Medical Branch Division of Urology. Write him at michael.warren@galvnews.com.

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