Letters to the Editor
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Flooding
A very interesting story. However, the author says:
"In the near future this tsunami of nanomedical choices could literally drown our healthcare and insurance systems."
Is he saying that nanomedical choices will inundate hospitals and insurance companies with water?
The word "literally" does have an actual meaning, you know.
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That is literally irrelevant.
Don't be a twit, Joe Bergeron.
See:
http://itre.cis.upenn.edu/~myl/languagelog/archives/002611.html
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Nanomachines
"Not everyone believes that molecular assemblers will be viable"
That is a bit of an understatement. Personally, I will side with the guy who has a Nobel Prize in chemistry:
http://pubs.acs.org/cen/coverstory/8148/8148counterpoint.html
These nano-scare tactics are getting old. Remove every use of the prefix "nano" and this article still has the same relevance; it just isn't as sexy. The fact is that medical diagnostics are getting better. The information available in 10-15 years is going to raise more than a few issues. The idea that this is somehow the result of "nanotechnology" is misleading. "Nano" is just a buzzword used by scientists to get funding. Vilify it and they will simply stop using the term, but that won't change the underlying science.
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Flooding
Joe, don't forget that "[t]his work on breast cancer is, literally, just the tip of the iceberg."
Brr!
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Nanomedicine's brave new world
Very interesting discussion of how a technology could develop over the next couple of decades. The author's concern over access to the technology is strange in that he limits his discussion to the severely flawed US healthcare system and does not apparently anticipate any changes in that system over that same couple of decades. I hope he's wrong.
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You literally misused literally.
It's awfully pedantic of me, I know, but the application of nanomedicine to breast cancer is not actually "literally, just the tip of the iceberg," because it is not actually a jutting projection of a floating mass of ice.
Otherwise, an article which is of great interest to me, since I'm studying to become an R.N. and will probably encounter the (figurative) fallout from some of these issues in the foreseeable future.
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The other elephant in this particular room
The author does fail to address a rather important topic in all this, which is those unfortunate individuals afflicted with an inherited disease, or the ability of such technology to predict who will contract diseases such as MS, ALS, etc. Given the probable development path for this technology, the ability to predict such things will come before the ability to cure them. And isn't that information that a life or medical insurance company would love to have so they can deny coverage based on the expense of future illness? I know of individuals in this position now, so this isn't an issue only for the future.
I suppose the optimist would think that this prospect will make insurance companies exit the health insurance field in droves, leaving nationalized medicine as the only choice (as it is in most western countries except the US). The pessimist would think that this just means more of the same but progressively worse: the affluent can afford care, the rest can live with medical care not unlike that available to the common man in the early 1990's. Given the ability of large, wealthy corporations to direct public policy for their profit, I suspect that the pessimist will unfortunately be correct in their assessment.
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What world do you live in?
Mr. Goldstein writes: "Could we enter a world in which the rich live on and on, while the poor are denied even the knowledge of the disease that is inexorably killing them and whose prevention is at hand?" Um, sorry to break in on your upper middle class dreamstate, but WE ALREADY LIVE in that World !!! In never ceases to amaze me that, in this country where the minimum wage is $5 an hour, and millions of Americans recieve that wage, and NO BENEFITS OF ANY KIND, that writers and commemtators seem unaware of the OBVIOUS. Break out your calculator and DO THE MATH. To wit: millions of working Americans have NO ACCESS to healthcare of ANY KIND. Not even charity...because, you see, they are EMPLOYED. Even with a wage of a whopping $10 an hour, these working Americans cannot afford health insurance. Up at the TOP off the ladder aconomically, employers pay half or even all of the insurance premiums; at the bottom, insurance is not even offerred. Group rates aren't even offerred. To obtain health insurance, workers must buy INDIVIDUAL policies....which cost more than their entire salary !!!! This is not a situation where workers are too stupid or selfish to purchase health insurance....it is not even remotely possible for them to do so. When they get seriously ill, they are told to go home and die. This isn't a nightmare scenario from the future....it is here right now !!
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Can't encrypt genomic data?
Greetings,
As a nano-tech fan and computer science geek, I read the final paragraph of this excellent essay with a bit of surprise:
And by the way, the proliferation of unique molecular identifiers will make medical privacy an impossibility because, ultimately, these types of data cannot be encrypted. The medium is the message. Millions of people have your fasting-blood-sugar value, but no one else on earth has your gene sequence. Get the idea? Any single-molecule-based nanomedical procedure could identify you beyond a shadow of a doubt. Yet a fundamental principle of nanomedicine is that billions of single-molecule fingerprints from DNA, RNA and proteins will be routinely available for diagnostic and therapeutic strategies. Which is the same as saying farewell forever to anonymity for your health records.
While I quite agree that a full genome sequencing can identify someone beyond any reasonable doubt, I don't understand why the author chose to say that these types of information cannot be encrypted. Any string of data can be encrypted, whether it is your personal history in English or a series of base pairs. The challenge will be in setting up data processing systems that aren't required by the government (or parent companies) to monitor who is receiving what treatment. This may be where the lack of encryption comes into play, because you can't use encrypted genome strings to predict anything, they'd come up with total garbage results. So, the computing diagnostic machinery would have to have access to the unencrypted data, but not report the unencrypted data, just the treatment results to the provider of service, and no other third parties - this might be viewed as a kind of data escrow, encrypted raw genome data goes in and encrypted results come back (using public key cryptography, both directions could be secure from any interference or interception and decoding).