tv Made in Germany - The Economics of healthcare Deutsche Welle January 17, 2018 1:30pm-2:00pm CET
i hope that this will make us more ethical persons what would life be like as a cyborg and what do you think will happen society there's the human race downgrade i think it's only the beginning of this site works human machines starting february first on t.w. . hitting the street for a run before work a great way to start the day really wakes you up better than a cup of coffee and a darn about the health and fitness industry is looking healthy and healthy out here in berlin clubs are sprouting up all over the place a skinny don't think exercise is the best medicine and being active outdoors is one
of the best ways to keep away the winter blues. all of a sudden everyone so health conscious and it's not just about looking good it's also about living longer a field that's big business feeling young and fit even into old age but can we afford the costs of so many people living so much longer the breakthroughs in science a fascinating in singapore investors a poor in money into new technologies for longevity german entrepreneur preach off debts that took a look at some of the visionary medical innovations in a country that can't afford them. more than fifty years ago it all began here on a small scale which objects now says it's hard to imagine today the german businessman is very impressed by singapore. the city state is now a modern and very wealthy country and its citizens are living longer and longer. so
how do people live longer and remain healthy that's the central question and that's what's mind as he heads out for a round of interviews with scientists in the high tech much office first stop a visit to a lab at the genome institute scientists here cultivating stem cells used to produce miniaturize simplified versions of the human brain you can. order clumps of grey matter just a little larger than a grain of rice but we cute potential. i can see all. around the dimension of the. so-called paving the way to new discoveries in health care we want to see how he never changes at least to the easiest state and we want to see how and when the toxins sort of precipitate the disease state because once we can create all these
things in the lab or treat we can think about stopping the disease progression and if we can do that it give us the leap into how we can dance think about developing therapeutics for talking to these patients for example you know open up a tremendous opportunities in how we can tackle human diseases. parkinson's disease is still incurable and until now research into it focused on controversial animal experiment. it's difficult to carry out research involving humans because. one wants to test things on their brain if they don't know how it will turn out so producing miniature brains allows you to learn much faster and that greatly improves your chances of discovering a drug that will really help fight parkinson's disease your book you can talk of them here. that's there is an internet entrepreneur and he believes technology will
play a key role in making progress. but although the tradition is thousands of years old chinese medicine still plays a major role in health care in the ultra modern city. we should. go in context. i believe that in the context of medicine we talk too much about high tech gene manipulation and all those things that are made possible by technology that is on the other hand there's all this ancient knowledge about healing like the use of herbal medicine or just being there for another person and meant how important is the human relationship for healing a patient how important is it for them to have someone they can talk to someone to contact them to.
look. for eighteen roommates singapore's national university hospital. life and death. new methods to repair human beings. basically print a replacement part for a bone and implant it and then this bone part does. robb's over the years and the bone grows back replacing the temporary prosthesis it's fascinating it's forcing your. osteo paul a starter here is the company that developed this technology. so this is. a three d. printer creates bone implants that customized for each individual which means even
people with very serious cases can be helped for example when large areas of the skull have been damaged fixed. image in. you build the wall tallest building. when the building architecture is finished you have to remove the skull. we remove the scaffold how do you remove it. by creating it into carbon dioxide and water so it's a miracle. to buy but the rate seems the most important over the last ten years we have found that we stumble on a scaffold. where the rate backwardation. small so those cells have time to grow a. brain tissue grown in a petri dish bone implants from a three d. printer detzner wonders how much longer it will be before science can build
a human from the ground up. i can full body parts. are not and never will be. because if you don't draw the line and. you are met scientists. a method this is the one that has no limits. i think scientists must have limits. you cannot do everything. especially when you near to playing god. the scientists who work in fields like these are driven to understand the fundamental puzzle of life so most know it's a puzzle that can't really be solved. for each off that's their things that's exactly what makes research like this so fascinating.
also fascinating the price tag the pharma industry generally puts on life saving medication for most patients especially in the developing world their way out of reach no question about that the interesting part is how companies justify raking in all those juicy profits. for years this man suffered from hepatitis c. a viral disease that was destroying his liver. he was forced to spend most of his time in bed. he doesn't want to be identified by name. i get up with my wife at six am have a cup of coffee down again later i go out with the dog for a short walk and was so exhausted that i had to go back to bed. he doesn't know how he contract to this contagious disease. but his doctor provided him with a cure. in twenty fourteen
a drug came onto the market which for the first time was able to eliminate hepatitis c. from the body. it blocks the ability of the virus to reproduce and usually after a few weeks there is no trace of it in the patient's blood. dr stephanie says a two month course of treatment costs forty thousand euros a price tag he finds unconscionable production costs he says are way cheaper in germany health insurance carries the costs but around the world many people can't afford the treatment. there are a number of things that infuriate me about the price first no health system can really afford this treatment for all patients with hepatitis c. . in many parts of the southern hemisphere it's much more difficult than it is here . the company does offer different prices for various countries but in many
european countries for example it's so expensive that the health system just can't treat everyone. in twenty eleven the u.s. pharmaceutical company gilliard sciences took over the biotech company that had developed the drug it paid nine billion euros for hepatitis c. drug at ten billion euros in twenty fourteen its first year on the market profits have since fallen but each year the billions continue to pour in. for years the company has defended its pricing policy. our philosophy about pricing is we price interiors so dose countries that are high on the economic development index like europe united states we price it higher in those countries that are in the lower price at much lower for instance each. total at one course of treatment we price to that nine hundred dollars but even with ten pricing some can't afford
to pay at least in germany everyone with health insurance gets treated this man is certainly grateful to have his life back. and i'm sure he'd say it's worth every cent let's talk about innovation rights and greed in health care with a philosopher and medical ethicist that's what he is a medical ethicist first of all i got that right the nih yeah well that's of ethics is a branch of philosophy and ethics deals with questions of values and the norm said we have to articulate our values and this is a prospective that is genuine in that it doesn't reduce to what empirical science can tell us and it's very valuable to have this perspective today with all the technology and the pickle science around us can we reduce it to a number those someones life how much is my life worth for example well that's what
insurance companies have to do but you wouldn't put a number on your life's worth what you. paid of interesting. and actually our life is. most valuable asset if you want to call it such and that's why that's why i would do almost anything and want other people to do almost anything in order to save our lives or prolong on us but when it comes to some of this medication i wouldn't be able to afford it i mean people in developing countries wouldn't be able to afford it at all. how how do these big companies justify that well the big companies are part of a worldwide market a pharmaceutical market a health care market and after all we're in capitalism so it's demand and supply but it's also monopoly i mean when you develop a new truck nobody can really sort of tell you how much you can charge for it it's
just elastic prize other ways though to. try to enforce these companies to set a standard that all or scale or system that works for people in developing countries as well well there are big international injustices this is an ethical point in health care but name you name it in all other kinds of activities also in health care because as you say i mean poor countries cannot afford certain types of medicine that would be very valuable for their population given the health conditions. but there are also. initiatives and bought political projects that put that aim at bridging this gap and making it less injust that's not also not only just about saving lives it's also about staying alive for longer
longevity. how does that differ in this debate well don't have a t is for some people an ideal utopia of medicine. on the other hand one must be very clear that the core of medicine as we know it today is curative that is it is disease it's about treating patients whereas long i mean ageing isn't a disease so long every t. is not a project of curative medicine it's a project of what i have called the medicine of desire and this is something that probably a solid eric community of insurers shouldn't pay for and if everyone's getting into this everyone's on the fitness bandwagon and wanting to live longer can we afford that. can we afford it is different from asking can i afford it and if that's my goal and if i want to afford it or want to spend money on this don't think it's worthwhile just have to will again our society can now call it a maze support that many people living not much longer. big questions
and i'd say that is way beyond the medical questions of demographic question ok we'll come back to you in a moment stay with us first of all we'd like to look at another topic a surgeon's job which is never being easy of course working alongside robots in extremely intricate and delicate situations makes it a little more easier as well as lifesaving in many circumstances but doctors have to muster the software involved and standardize aleutians would help in this case which is exactly what physicians and programmers in like sick working on right now . the patient has arrived today's procedure will be an especially tricky one brain surgery that should take around four hours. the patient complained of some visual impairment and fatigue with imaging technology we were able to locate
a tumor in the area of the pituitary gland directly beneath the surface of the brain. the surgeon performs this operation largely by hand but technology plays a key role every step of the way. computers supply a constant stream of data on the affected organ and the patient's condition it can be hard to maintain an overview. a final tool during the procedure these blue forceps. sound of later it destroys tissue with alter sound. the operation went well the members of the team are satisfied and the surgeon is relieved he didn't have to get up during the procedure to check the computer that controls the forceps. it's too far away from the operating table. just not to
give you this machine is one that they're operating surgeon needs to control not an assistant if there even is an assistant in the o.r. start moment. to speak to. the neurosurgeon helps found a research project at leipsic university hospital. a dummy operating theatre has been set up at the site to promote digital advances in medicine. since backup provides the researchers here with concrete information on how to improve the o.r. like the fact that the vital computer is too far away during neurosurgery. another problem is that machines made by different manufacturers don't always communicate well with each other and he'd like to control them all with one central program. if you can get it insurgents need to be able to directly control all of the different instruments that are used during a procedure and if it's
a spending cut or head for example we need to be able to change the rotating speed ourselves. around thirty programmers and software engineers are involved in the i.c.c. s research project the millions of euros its cost so far have come from state coffers manufacturers of medical devices will also profit from the project in the long run . we develop these standards in tandem with the industry and it's never a good idea to try to do that without them at the end of the day the standards can be used by anyone only when we have standards like this are we able to develop value added functionality in a meaningful way. the engineers and programmers channeled the data from all the medical equipment into an interactive control panel. during this test the machines are communicating with one another. i think the future of
our technology is digital what you see today is that many devices really don't have a lot of associated support software that a lot of medical machines are does for down the road as machines are in other areas of industry but i think they'll start using it more and more in the coming years. before long smart software will start playing a much more central role in the o.r. backed up by robots like this one. it can't replace a surgeon yet but it might soon be at least handing over the forceps. so when we go to reach the day that. there are no doctors is that it's all or demise. we see in some futuristic philips well that will probably not happen
since you can only autumn a time as a put all. who teen activities and a lot of medicine and medical treatment is so intricate and individual that it won't be able to just put it up to machine so it's always going to be about eighteen rather than replacing do you think that's an interesting ethically interesting difference i think that one should distinguish between a person aiding or supporting technology like an operate of operating as i mean you want to have technology that helps you with your expertise or the human eye for these and on the other hand present replacing all present limits of technology and the trouble is that there's a certain fascination with technology that once you have it you want to have it everywhere so the ubiquity of technology is almost automatic in itself and this is ethically highly. alarming because it's all it all.
it's not it's not at all clear that wherever we can replace people but technological systems it's a good thing to do it. and the costs are also fascinating as i mentioned before with medication this technology we're talking about surely it costs a lot. surely it costs a lot but it's probably gated with the promise to save costs i mean that's one of the main rationalizations of pervasive technology they always tell you it's going to save costs at least in the long run it's almost never true especially not in health care costs simply are exploding whatever you do so. what road are we going down where where are we going to end up are we going to end up living longer living healthier lives. or is something missing here well from an ethical point of view with taking into view the good life life as such a form of life i think it's oh it's already
a mistake to look only at the health system and not at the way we live because most of our. diseases and illnesses have to do with the way we live and repairing disease is completely different from preventing it by how their lifestyles or how or more responsible lifestyles it is can i thank you very much for coming in and i'm sure you've heard from your doctor before sports great for your health that leads me to a glaring question why are there so few women in the upper echelons of professional football. is the sport of bread contre diversity she spoke about gender inequality with zondervan she'd love chair of the supervisory board of a bonus league club. hey guys how about listening to our goals for a tank was. to see in us almost like
a piece anything on its own rolls at the one thought and. but how do we get their. former feet up was it not that once called for women to work more feminine clothing on the pitch what if you have a mind. tattered teacher at some point the answer to attract more people to the stadium. that there's days are over thank goodness current person just means something else is gender equality should be a priority but in the top flight that's not the case your money is women have won the world cup twice but not a single one is exactly a female president and so it is they only one woman has written reads i'm in this league homage. but there's one general thought that has women in management positions how to work some quality recently chose christiano hall and as one of its vice presidents and for years the supervisory board has had
a chairwoman of sam. do you think the vice really opened up to women or are borders needed help you out along like a doctor but for many years i thought you didn't need closure as that it would somehow equalize on its own but in the past couple of years i've come to realize that yes it might one day happen but it could take a century mention there's an imbalance not just in terms of pay but even when it comes to the young kids it starts with training we've centers to develop talented young players we have professionalism in soccer but it's all concentrated on boys and men we have to break this gender split by supporting young girls just as much that means we need the will and we need a lot of investment in terms of both time and money have you ever faced texas yeah yes i've heard remarks like oh a woman on the board we can sell pink toasters again maybe next year we'll have
pink jerseys. i'm qualified for this job why doesn't anyone ask me about past it's always focused on my being a woman and found no one asks me about my skills and why i was elected. you argue it's all about wheel and money and don't even think about insulting us with a price of processing instead of prize money i'm not kidding this is what the german team got after the woman european cup not feeling tonight. we went on the pitch and in minutes when the old hockey. if you'd like to watch any of those reports again just head for our web site and is there something you've been dying to tell me get in touch on twitter thanks for joining us to see you again sir.
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