Archive | February 2012

James Bond and the Proton Beam Device

James Bond slowly came to.  His head ached.  He could not move his arms.  Looking down, he saw his limbs were firmly attached to a large table. He was positioned beneath a huge, complex machine, from which a conical probe jutted straight at him.  Before he could make sense of his surroundings, his ears were filled with the booming voice of a familiar nemesis.

“Good morning Mr. Bond!  I trust you are well-rested?”

Bond:  “Professor Blocash!  I should have known.  What is this?”

Blocash:  “Why, you’re the first guest of my new Proton Beam Device.  There are only nine of them in America, and we control seven.  Your name is fitting.  You should have seen the size of the bond issue we had to float to finance this one.”

Bond:  “Do you expect me to talk?”

Blocash:  “Of course not.  But what I am going to do is demonstrate the device on your unsightly forearm mole.”

Bond:  “I thought this machine delivers precise energy to internal tumors without damaging surrounding tissue?”

Blocash:  “It does that, but we will eventually expand the indications.”

Bond:  “But this technology hasn’t been proven to be equivalent or superior to standard radiation!*”

Blocash:  “Mr. Bond, don’t you understand that doesn’t matter?  Medicare still pays for it.  It’s the same story with the DaVinci surgical robot and many other treatments.  Payments flow directly into my account.  And I don’t have to hire a single armed henchman!   This is far easier and more profitable than my other plans!”  [Rubs hands together menacingly]

Bond:  “But why would they pay you to provide expensive treatments that are of unproven value?”

Blocash:  [Pacing with hands clasped behind his back] “My organization donates generously to both American political parties, keeping them in a state of perpetual and profitable gridlock!  Even the simplest fixes could save their taxpayers a fortune.  Consider that for years Medicare continued to pay for outdated HIV infusion therapies.  Instead of writing a few lines of computer code, they didn’t react until a huge fraud ring in Miami stole millions billing those outdated codes!”

Bond:  “But if you build a Proton Beam Machine, other hospitals will have to do the same thing.  That leads to a hugely inefficient medical arms race.”

Blocash:  “We are not interested in an efficiently developed healthcare system.  Here the Byzantine regulations allow for far more creative options.  Also, patients don’t directly pay for the care they consume.  Skillful marketing can make them demand any technology we build!”

Bond:  “This can’t go on forever.  Patients do pay, just through increasing health costs borne by their employers.  They’ll stop you!”

Blocash:  “Perhaps, but not anytime soon.  Enough talk!  Engage the Proton Beam!”

Nurse:  “Professor we can’t do that.”

Blocash:  “Why not?”

Nurse:  “We haven’t completed the Time Out.”




* Author’s note:  The avoidance of damage to surrounding tissue may be one key indication for proton beam therapy, and this is not to suggest that the technology should never be used, only that it should be carefully studied before being implemented on a wide scale.