Visions of the Future: "The Body" in 2057

"2057: The Body" had many good points.

It was fascinating to hear from a scientist engaging in actual, present day, research into creating flying cars. The speculation that such cars will eventually be in a price range such that up to 50% of cars 'on the road' (so to speak) will be able to fly is an exciting prospect. And even more likely is that these cars will be able to be in use by first responders, meaning that, when seconds count, they can get to emergencies quickly.

The program also interviewed several scientists making incredible advances in medical technology:

• One created an artificial blood that can (at least temporarily) replace the patient's blood and is more efficient at getting oxygen to tissues that have been deprived of oxygen, minimizing the risk of brain damage or other serious conditions. This substance is already being tested on trauma victims.
• There is great potential for a procedure called 'reversible death.' This would allow paramedics (or other medical staff) to quickly chill the body to the point where both the brain and heart stop functioning but with the ability to revive the person later. This allows more time to transport the patient or make treatment decisions.
• One scientist was already using brainwave monitors to get data input from a quadriplegic. It's projected that this could be coupled with a chip on the other side of a spinal-cord injury to allow wheelchair-bound patients to walk again.
• Really exciting was one scientist who is using printing technology (yes, the technology inkjet printers use to get ink on paper) to possibly create organs*. His current testing is allowing him to 'print' particular cells in patterns on a biological 'paper' without killing the cells. The next step would be to print multiple layers of the cells, so as to create a 3-dimensional pattern. While this is all very exciting (and has great potential), I am disappointed at the program's failure to mention the news story of the cloned bladders already implanted in patients,** but I suppose it's possible that the production of the program was completed before this happened.

And now, some of the 'bad' (unrealistic) things from the program:

• Intelligent clothes can monitor a person's respiration, heart-rate and other body-indicators as well as store information. These clothes (which have prototypes in the testing stages already) would be a boon to athletes, but I think it is unlikely that ordinary people would wear them on a regular basis. Would you want anyone in the room with the proper kind of scanner to get your personal body information? Also, the program suggested that clothes would have your medical history somehow attached to them. While some people with chronic medical conditions (e.g. diabetes) or severe allergies (e.g. penicillin) might want that information on their clothes (rather than, say, a medic alert bracelet), the idea that anyone would be comfortable with that much information easily available is far fetched, to say the least.
• In a hospital, there was a security device that checked people's eyes to confirm that they had sufficient clearance to be in that part of the building. Reasonable and likely. However the security device was randomly roaming the hallways and its snake-like neck shoved the scanner in the faces of passing doctors, rather than being a stationary device at all entrances. Probably ineffective at preventing unauthorized access and definitely dangerous (tripping doctors and nurses is not usually an efficient way to run a hospital).
• People got near-constant monitoring by their health-insurance companies. Even if I didn't think that monitoring multiple urine checks and breathalyzer toothbrushes (as well as other, implied, tests) was massively cost-inefficient (You're going to put testing devices in every toilet in every house? And you're going to check it all the time?), I have a hard time believing people would stand for that level of invasion of privacy (You're going to let other people's toilets monitor your urine?).

Now, the ugly.

As I mentioned in the previous post, the Discovery Channel likes to focus in on a sort of 'day in the life' of a typical person. The person they've chosen is an apparently single man who lives in a nice-looking apartment in a nice-looking building with a small, but appropriately futuristic-looking ground car. His house is highly programed and follows a number of instructions. And oh, by the way, the first thing we see him do is to commit insurance fraud.

We are told that he (and everyone else?) is given a remote physical every three days by his insurance company. They monitor everything about him from his blood alcohol content (which they get when he uses his toilet) to any developing issues with the mucus membrane in his mouth (which, by the way, the insurance company sends him a message about, suggesting he use a particular toothbrush). As I've already stated, I can't imagine this is cost-effective and, the things people will do on reality TV aside, I simply don't believe that people will allow these intrusions into their lives on a constant basis. But let's assume I am wrong.

This man has entered into an agreement with his insurance company that his premiums will be kept at a particular level if he submits to a particular level of scrutiny to ensure that he is not doing anything dangerous and, if he is doing something like drinking, his premiums will go up. So, to avoid that, this guy has his house programed to warn him if his alcohol level is too high so he can give his toilet a fake urine sample. Not only did he commit fraud, he planned to commit fraud. Sleazy.

Then he trips and falls out a three-story window.

His insurance company and the doctors they provide do everything right: their monitoring of his vital signs indicates the problem, they send an ambulance immediately, the paramedics use reversible death to give him more time, the doctors fix his most pressing injuries and then use a chip to get past his spinal cord injury, they start his rehab, they catch an unrelated heart problem and immediately start growing a new organ to fix the problem.

And then they catch his fraud.

After confirming that he had been committing fraud, he immediately loses his insurance coverage. So, he now has to pay for his care out of his own pocket, right? Assuming the care is expensive, he uses his savings or agrees to an installment plan or sells his car or mortgages his house or takes out a bank loan or borrows from friends or family. He also probably accepts a different level of care: he moves out of a private room and plans for outpatient rehab rather than inpatient care. Right?

Wrong. In this world of 2057, he is immediately moved to the NI (Not Insured) ward. He is in a room with dozens of other people and the beds are right smack next to each other (um, ever hear of communicable diseases or infections? That many sick people that close to each other is incredibly dangerous). Also, his life-saving surgery is immediately cancelled.

I realize that right people believe that the only way to pay for health care is through health insurance,*** but this is only an artifact of wage controls in WWII in which employers could not attempt to attract workers with higher wages and so offered the benefit of health insurance. We can and, I think, should go to other, more efficient ways of paying for health care.

But I digress.

Instead of the man taking responsibility for himself, he just goes off to, presumably, die. His doctor wants to help him but, instead of suggesting other ways he could pay for the surgery, she gives up as well. Until another patient of hers, one with good insurance, dies. Then she decides hide his death, switch the two men's insurance chips, fraudulently report that the dead man needs surgery, perform the surgery, switch the chips back and then make it look like the dead man died during surgery.

Just as a side thought, if everyone is committing insurance fraud, no wonder health care in this future world is so expensive.

She, of course, is the hero for saving the patient. She lies to her colleagues, falsifies medical records, steals from the dead man and the insurance company (and, when you steal from an insurance company, you are really stealing from all of the customers), and misrepresents the time and manner of death for someone who can't speak for himself. I wonder how his family would feel.

Somehow, I didn't find this ending to be as inspirational as it was supposed to be.

*19 people die on the organ transplant waiting list every single day (see http://www.organdonor.gov/). The lives we could save and the suffering we could prevent makes the idea of artificial creation of organs, to me at least, the single most exciting potential advance.
**See Researchers Transplant Lab-Grown Bladders Into Patient Successfully
***For why this is NOT the best way to pay for health care, read What Hunger Insurance Could Teach Us About Health Insurance

Visions of the Future: Reviewing 2057

The Discovery Channel had a special recently: 3 shows about different aspects of what the year 2057 might look like. These hour-long programs examined "The Body" (flying cars, medical advances and health care), "The City" (holograms, robots, self-driving cars, and how cities could be run), and "The World" (warfare, space travel, alternative energy sources and geopolitics).

Similar to other Discovery Channel programs that involve projections (either of the distant future, the distant past, a distant planet or foreseeable natural disasters), these programs showed how one family, or small group of people, might navigate their way through this new environment. I think this might just be why these shows are so successful: they don't only show cold scientific projections, they show how normal people (or anthropomorphized non-people) live in these strange new worlds. Since we can relate to these people, we can more easily imagine ourselves using their technologies (or lack thereof) and confronting their problems and thus get a greater understanding of the science involved.

And the science, as always, is fascinating. If I had to point out one thing that the Discovery Channel does incredibly well, it is presenting good science in an interesting way.

Of course, if I had to point out one thing they do badly, it is presenting economics, politics and government in a realistic way. And that is what this (short) series of posts will be about. Because, while I was learning about scientific breakthroughs that could extend lives, I was also seeing completely unrealistic mechanisms for getting them to real people. Oh, and I had no sympathy for the main character.

So, to be continued in the next post...The Body.