[lowem]

Is anyone here working in the healthcare industry, or who knows someone else who does? Healthcare professionals, nurses, doctors, pharmacists, biotech researchers perhaps, etc. I wonder what the future of healthcare might be like, taking peak oil and its ramifications into account.

Is it something that one might want to go into, for a career change? Seeing how things like tech, manufacturing and especially tourism are going to suffer mightily in an era of increasing oil prices and a collapsing economy.

What about as a user/patient? Are we going to rely on the healthcare system as it is?

Will society put considerable effort and resources into keeping people alive and healthy (hospitals, ambulances, staff of doctors and nurses, medicines, medical equipment and supplies - the list goes on), or will healthcare be in demand simply because, in a fast crash scenario, people start doing violence unto one another?

Are there people jumping into healthcare as a "good" industry to venture into, or are your plans simply to keep a 30-year supply of the particular medicines you need and sit tight, or maybe learn to plant some useful medicinal herbs or something of the sort?

What I can be sure of so far, is that healthcare may not likely be the high-tech, wasteful (throwaway plastic-based medical supplies), resource- and energy-intensive (X-rays, CT scans etc.) industry that it is today.

Any comments will be appreciated, thanks.

[UIUCstudent01]

Healthcare will probably change a lot in 25 years. I don't see it changing much within 10 years though, I see it as being one of the last things to go. Even if oil does get expensive as diamond, there is still all the existing technology and hospitals I think tend to take care of their equipment pretty well. Second, remember that electricity probably won't spike (someone proposed that it might spike because of an increased usage of electric vehicles and such, but I think powerplants (nuclear or coal) will be built to offset the price for as long as possible (until those peak)).
Although, we will see an economic recession/depression, and I don't know how everything is going to pan out, but I do see it being as it is today for quite some time.

80 years from now and taking into account that some new power source is not found/created, I see medicine/healthcare receding seeing that new antibiotics need to be found to combat disease. (Because what we are doing now is making a whole lot of diseases become resistant to current anti-biotics via selection... it's a worry in medical field that some kind of super disease that is resistant to every anti-biotic could sweep the world.)

So, the medical situation in future might be troublesome. R&D takes millions of dollars and infrastructure... and the use of only a few anti-biotics over a period of time creates resistant strains...


Edit: (BTW: My Dad is Doctor, my Aunt is a nurse, my brother got accepted to Doctor school, and I'm studying Biology (but that may change...) and have an aspiration to be a dentist although, that may change)

Also, the biotech industry probably has the best chance to mitigate the effects of Peak Oil and farming's dependency on oil. And they are making progress everyday, so if there is hope anywhere, it's there. Although, that still doesn't do away with the giant waste that is the suburbs and the transportation costs and the fact that plastic may be hard to find (even if they could make it from oranges... there's not going to be as much as there once was...)

[energyaddict]

Iowem,

I am in the Healthcare Industry, just changed there from the Chemical Industry. No - I am not a doctor, but working in the administration - that is not much different from the Chemical Industries admin...

If you decide to go into that industry depends to a certain extend on the expectations you have for future developments. If you are with the doom and gloom scenarios of PO, it might be the best choice to learn about bio-farming. If you do not believe in PO at all you should choose what ever you like most to do (aircraft engineer or something like that)...

If you are the soft landing type of PO believer, than I think the Healthcare Industry is worth looking at. Why: The aviation industry is the first to go - airtravel will become very expensive after PO. Only the wealthy will be able to travel by plane - as only 50 years ago. Also the use of cars must decline in future, the automotive industry will be affected sharply by that. There will be demand for energy efficient cars, but demand will be significantly below todays average. The middle class will regard cars as a precious good and will keep them much longer in good shape as today. But Healthcare is something the people need. People will travel to work by bike or bus rather than staying away from the doctor or hospital when ill...

Another job opportunity post PO might be to have a good skill as a craftsman. Thoose jobs where in very high demand before industrializing / globalizing set in. As replacements for goods will become expensive after PO their will be high demand for repair of goods - repair in the old way (not changing the engine but repair of the engine). Craftsmen will be soon in high demand...

[Doly]

My father was a doctor and he used to say 80% of modern medicine is quite cheap, it's the remaining 20% that requires sophisticated machines and expensive equipment.

I think some of the expensive medicine may become too expensive to be available for everyone. Things like transplants, difficult operations, some chronic diseases that require constant care to keep people alive. I think the current discussion about euthanasia is likely to disappear, because the circumstances where we wonder about euthanasia today will simply not exist any more.

However, that still leaves 80% of modern medicine functioning, so I wouldn't think that we will go back anywhere near Middle Ages standard.

[Elfstrom]

I currently work in IT, supporting medical scientists/researchers in the research department of a large teaching hospital in Canada.

In hospitals the major spending is on salaries and big equipment (MRI machines, for example). Post P.O. we'll see no new equipment bought, and a larger market in used and maintenance contracts. As the suppliers of equipment start going bankrupt, much the equipment will eventually become unusuable due to lack of parts. The big expensive equipment will go first.

This is similar to what has happened in Cuba. (See Cuba: Life After Oil - PDF) for insight. Health professionals will be one profession that will stick around, just like farmers and skilled tradespeople.

There will always be a need for the caring professions. Nursing, counselling, and general practitioners will be the most important. I'm thinking that a Naturopathic Doctor would be an ideal certification to obtain soon. A N.D. -- like a general practitioner M.D., doesn't need big equipment and large infrastructure. If a four-year program in naturopathic medicine is too daunting, becoming a certified herbalist would be a secondary choice.

I'm thining of either naturopathy (expensive!) or herbalist training (cheap), as I have a chronic inflammatory arthritis that limits my ability for manual skilled labour. Does anyone have thoughts about begining an intensive education in naturopathy at this time?

[DomusAlbion]

My wife and I have discussed this subject for several years now and it has been part of our long term plans years before we knew anything about Peak Oil. We've been planning to move to a rural location where I could start a cottage farm. The most important factor was for her to find the right location where she could continue to practice with a group and then gradually set up her own client base.

We decided that if things became very hard with the economy that she could even barter her skills with other farmers in the area and become a type of frontier medicine woman. Set a broken arm for a piglet or 2 bushels of wheat; that kind of idea.

Well the pieces are beginning to fall into place and two years ahead of our original schedule. She's currently negotiating two contracts in the west central part of Idaho. There are two small towns together there; one in Idaho and the other across the Snake River in Washington. We'll live some 16 miles out of town on an already establish small ranch.

One addition area of knowledge she wants to pursue is herbal medicine and I’ll be planting an extensive herb garden to support that goal. Standard pharmaceuticals could become scarce.

[JohnDenver]

One addition area of knowledge she wants to pursue is herbal medicine and I’ll be planting an extensive herb garden to support that goal. Standard pharmaceuticals could become scarce.

Don't forget the weeds, DA. I'm very interested in weeds and wild plants, and I know almost all the common weeds which grow in the Western states where I grew up (Colorado and Arizona). Many of them have useful properties. Lamb's quarter is a great spinach substitute. Don't bother growing spinach in the garden unless you're really good at it. Just let the weed grow where it likes and eat it. You'll save yourself a lot of hoe-ing time, and get a great yield. Purslane grows everywhere, even out of the cracks in the sidewalk, and it's a good vegetable. Thoreau himself talks about the satisfaction of eating a plate of purslane. You can also use it in soup as an okra substitute because it has a similar mucousy quality. Mallow is interesting. It's probably the most common vacant lot weed in the west, and I know from experience that pigs won't eat it. I thought it was completely useless, until I read that the Pythagoreans ate it, and valued it highly. Hemlock is also interesting. It's highly poisonous, but it grows all over the place in vacant lots and untended yards.

[JohnDenver]

Here's another great plant. If you live in a dry, hot climate it grows like a weed, and it's very nutritious. With beans it will give you a complete protein. It was the sacred plant of the Aztecs. They mixed its seeds with the blood of their human sacrifices. The plentiful seeds can be harvested by shaking the dry tassels in a paper bag. Be careful about rubbing the tassels with your hands, though, because there are stickers in there which will prick your fingers. Winnow out the debris by dropping the seeds in a very gentle breeze.

AMARANTH

[PonyBoy78]

Under the assumption that the decline will be on the softe/gradual end of the scale, I enrolled in school to get an associate's degree in the healthcare industry two years ago. With graduation upon me in three months, I'll be making enough money to pay off my debts and buy (with cash) a good size of acreage within two years. (building a working farm comes immediately after that)

In most emergency scenarios, I've seen that healthcare is of high priority as far as resource allocation goes, so I'm a bit more optimistic with the sector than most others. Should things hold-on for another decade (through recession/depression times), it will have been a good gamble for me.

As far as the shape of healthcare is concerned, I have no clue. The pessimist within tells me that treatment will begin to move towards the triage type of care within two decades.. and that the well-connected and wealthy will be the only ones able to afford care. I could be totally wrong though, and I really hope so.

[formandfile]

From what i understand, in Cuba (mentioned earlier, and probably the best dress rehearsal for PO) there has been a large focus on preventative medicine. I suspect we could learn a thing or two from the little island

[smallpoxgirl]

Modern medicine will disappear. And people will live longer as a result.

Link

[delphi319]

I live in a town that is HEAVILY dependent on the medical industry. I personally have no affiliation to the medical industry whatsoever, but living here has opened my eyes to it. I wonder what will happen to the medical industry in the forthcoming years. There is a common belief (fallacy?) that as the baby-boomers continue to age (and hence, become sicker), that the medical industry will continue to boom. Much like the tech sector in the late 90s, I also believe this market has been artifically inflated and certainly can't go on like this forever. Look at the costs of healthcare these days, just for a simple ailment. It's ridiculous! Increases in health costs have grown atrociously in the past 10 years, and, likewise, insurance costs and premiums have risen as well to absorb these costs.

Although we have the greatest healthcare in the nation, many Americans (something like 20%) don't have health insurance, and with changes in Medicare, our older generation is certainly not getting the care that they may require.

It's foolish to think that medical costs will continue to soar as energy and oil continue to rise and people's incomes become tightly crunched. However, as humans we have this fallcious belief that somehow life is sacred, and people will spend just about any amount of money to keep themself or loved ones alive.

I'm happy that I have a healthy genetic history in my family, with no serious ailments. I rarely go to the doctor and take good care of myself. Unfortunately, many people don't have this luxury.

As peak oil nears, what will we see happen to the healthcare industry? Will costs go down? Will alternative medicine become more popular? Will people live in pain and die instead of forking over expensive healthcare costs? Will the government subsidize costs? Will salaries of healthcare professionals go down to a more realistic level, thereby lowering costs? Or... will people, regardless of how hard they're hit financially, continue to fork over dollar after dollar to keep themselves alive?

[Doly]

I think there will be a certain decline in healthcare, especially for the most costly treatments. It will all be a matter of budgeting. Expensive machines will not be repaired, and therefore will stop being used. You can't ask your doctor to do a scanner if they don't have one, can you?

[KevO]

It's the dentistry or rather lack of that worries me.
In a post peak world, a tooth will have to be taken out Tom Hanks Castaway style.
ouch!

2.30

[Raxozanne]

It's the dentistry or rather lack of that worries me.
In a post peak world, a tooth will have to be taken out Tom Hanks Castaway style.
ouch!

19th century tooth extraction tools can be purchased on Ebay.

[Overlyhonest]

At some point suing doctors will not be on the table anymore. If a doctor purposely sets out to hurt people they will be arrested. Other than that though the results you get will be largely dependent on how good of a doctor you can pay for. All payments will be made in advance and after that you get what you get.

[MonteQuest]

As someone whose mother is dying of Alzhiemers Disease, I can tell you it is projected that this disease alone will bankrupt the health care system as the baby boomers age..sans peak oil.

The health care of the future will be what it always should have been, diet and exercise.

[EnergySpin]

I have been wondering about that my self (and I am a health care professional). Couple of clarifications on current health care cost/organization of the US health care system and how it might be affected or not affected by PO:
1) What you pay for any service is not equal to what the health care provider gets. For example an MRI scan is prized ca $2000-$2500 across the Midwest (statistics from the following hospitals Indiana University/ Univ of Chicago/ Nortwestern/ Univ of Illinois in Chicago/Ohio State/ Univ Cincinniti/ Univ Kentucky/ Wright State) BUT the combined fee to the doctor and technician who will do the test is at best 20%. Evertyhing else is for "technical fee" i.e. a euphymism for management/insurance companies/litigation cost/ risk management and all that crap. The same test in European systems using the same scanners is anywhere from 50% to 85% less depending on the complexity of the system crap that stands between patient and the healthcare provider (MD or non-MD). In fact, these countries can have a much smaller cost in spite of a lower scanner per capita number. This monstrous overhead IS what makes the healthcare industry big in this country since money can be allocated to support other unrelated jobs in the industry (in reality, it all goes to the companies that run the hospitals). However that means that there is potential to cut back and decrease cost but no one is willing to do that (John Kenneth Galbraith wrote about the self expanding nature of beaurocracy in "The Cultrue of Contentment"). So as lay-offs start, prices might actually go down
2) Even by reducing the number of scanners and other high tech gizmos to 1/10th of what they currently are in North America, you could still deliver good (21st century) care. Why? The quality of medical care across this planet SUCKS and it is not due to any resource scarcities. The current medical education system has proved to be unable to incorporate major research and shape the way we teach medicine to our students. In reality the majority of patient cases can be handled without access to multimillion dollar machines for scanning or gazillions of blood tests. All it takes is to talk to the patient for more than the allocated 15 minutes to gather an idea of what is going on, do very simple ,if any, tests and start them on simple medications or non pharmacological (not alternative medicine crap). Instead, we destroyed basic medical skills (i.e. history taking, examination skills) and never really advanced the cause for decision support tools in medical education and health care. Hence we do a lot of unnecessary stuff and even if PO takes out 90% of current technology infrastructure deployed in NA it would make absolutely no difference ... because it does not really contribute or advance health care (it just consumes more energy). Is there any evidence that doing away with technology is not all that bad ? At a personal level I have practised in high -tech and low tech settings both in the US and Europe. The UK NHS (even though totally fucked by Thatcher/Blair) can deliver much better care in "benchmark" diseases i.e. hypertension, diabetes and deliver better outcomes inspite of the chronic underfunding. They do that in the expense of Vaginal Rejuvenation SurgiCenters or Booboplastie Operating tables ... but it is only in the US that access to these things is equated with better health care. By the way, by far the system with the potential to be the BEST in the whole world is the Veterans Affairs here in the US even though it suffers from chronic underfunding, has absolutely the sickest patient basis and an outdated physical infrastructure.
3) Disease Treatments: the greatest achievements of 20th century medicine WAS NOT antibiotics or other oil based stuff (contrary to what is commonly assumed). It was the public health movement which ensured basic hygiene, vaccinations sanitation and running (and clear water i.e. by boiling). So even though it is commonly assumed that modern medicine "enabled the weak to survive" , it was actually these simple interventions I alluded to. Practising again what exists in our mainstream (not alternative) medicine textbooks can help with preventing a fair number of common diseases thus doing away with the need for expensive intervention. However even if intervention is needed in a PO world there are good and bad news ( I will use examples of high profile diseases, because they are the ones of concern for the majority of us):
- antibiotics for common infections are actually products of microorganisms or simple chemical modifications of them that do not require chemical Mcfactories to synthesize.
- bugs that cause common antibiotics have become resistant which means that a % of those infections cannot be treated regardless of what we use. However this is irrelevant to PO (since we have nothing to use even now). As with many other stuff ... discontinuation of inappropriate use of antibiotics can bring back the easily killed bugs (i.e. the superbugs are diluted out, because the only think that keeps them around is the evolutionary pressure of our antibiotic misuse). Is this fantasy? Nope. Example is France and South Corea where antibiotics are over the counter. Because of that ... people would buy them and use them like candy and hence in the mid 80s to 90s they had resistance problems ... Ministry of Health intervened ... restriction of customer choice enforced ... and they do much better the US now
- hypertension: this is the "silent killer". When PO hits, lack of all this processed salty food (have u seen Supersize Me?) will go away and problem will go away by itself. Most effective treatments? drugs available since the 50s synthesizable by low intensity chemical reactions of simple chemicals (obtainable i.e. by biofuels)
- heart attacks, strokes etc: Aspirin was found before OIL! The obligatory weight loss of postPO will make them much less of a nuisance. S o will vegetarian diet (no more Angus beef). Simple artery opening drugs can be synthesized from bacterial products (in fact the first such drug was synthesized by the bacterium that causes sore throat) or can be genetically engineered into bacterial (and cloning genes etc is an extremely low intensity and high tech endeavour). However this means that more people with scientific skills knowledge need to be around and this translates to all of us asking more questions about the quality of higher educations (i.e. why are there so many business and not molecular biology schools etc)
- organ replacement therapies (i.e. chronic kidney/liver/heart/lung disease): Bad news is that people who need high intensity treatments will probably not fare well because the energy / manufacturing to support such therapies will be scarce. People with chronic kidney failure who need dialysis will be especially in trouble. The situation will be akin to Africa or India where people cannot afford those treatments and die. However ... low intensity treatments i.e. organ transplantation are actually extremely easy to perform (at least for kidneys) and living donation is an option (safe for the donor). This is why buying a kidney from a living donor is semi-legal in india/Africa ... there is no other choice. A mandatory opt-out system for organ donation (similar to the one that exists in a couple of Western European countries) where ALL organs of brain-dead or deceased patients are used without asking for consent from the relatives will also be an option. The opt-out system is actually seriously discussed today and I believe Oregon came pretty close to passing a state low a few years ago . Again the surgeries for transplantation will be feasible unless we go back to stone age (but I seriously doubt it). Even with a 18th century infrastructure they will be technically feasible but some high tech gizmos will be required.
- overall health care outlook: look at Cuba. They went through their PO in the 90s ... the average life expectancy did not drop ... in fact is is higher than the US but they practise effective and sound medicine focusing on disease prevention and deploying effective low tech interventions. Biotechnology boomed in Cuba after the oil crash of the 90s enabling them to produce vaccines to prevent infections and antibiotics. In addition they had extremely proficient medical and affilitated health personnel with sound theoretical and practical knowledge. Their problem is availability of consumables (i.e. gloves, syringes, needles etc) and for this we might have to go back to the days of sterilization of glass syringes and needles ... but at least know we have hepatitis vaccines.
Cheer up ... the game is not lost yet. Get up, consume less, educate others and fight for a better tomorrow

[RG73]

Phage therapy, the use of bacterial viruses to kill infectious bacteria, will also be available in a low energy world. It's easy to do, cheap, and low tech--which is exactly why we don't use it in the West, but why it has been used more widely in Russia/Georgia and other parts of the former Soviet Bloc. Also, since the viruses self-replicate, it's not really a big seller here since you can't make money from a medicine that self-replicates. And it is more time consuming--doctors will actually have to type the strain of bacteria infecting you since bacterial viruses are often species specific. But, they should have been culturing infections for a long time before handing out antibiotics like candy. But we'll at least have that tool available to treat some bacterial infections.

[0mar]

What's actually scary is that a lot of new bugs are antibiotic resistant and also are as vigourous as non-resistant strains. So those strains can survive even without anti-biotic selection; normally, removing anti-biotics leave those strains at a disadvantage, usually metabolic, so that non-resistant strains will reproduce faster. Some, not all, resistant strains can grow just as well in the presence of anti-biotics and in the absense as well. That's scary shit.