Chapter 1 Healthcare, History, and Heartbreak

Over the past decade, we have unlocked many of the mysteries about DNA and RNA. This knowledge isn’t just sitting in books on the shelf nor is it confined to the workbenches of laboratories. We have used these research findings to pinpoint the causes of many diseases. Moreover, scientists have translated this genetic knowledge into several treatments and therapies prompting a bridge between the laboratory bench and the patient’s bedside.

—Barack Obama on the Genomics and Personalized Medicine Act (S. 976), March 23, 2007

While we are surely poised to continue to make tremendous medical advances—notably in personalized medicine, pharmacogenomics, and precision medicine—we are also facing substantial challenges. The challenges facing healthcare today are many, and if we do not adequately address them we risk missing opportunities, pushing the cost of care up, and slowing the pace of biomedical innovation. In briefly surveying the state of healthcare, it is not my intention to offer a political diagnosis or solution. Rather, it is my intention to use our current technical knowledge to point the way to practical solutions. For example, a long-theorized solution to health records management would be a single cloud-based system where healthcare information sharing exists universally. But if I were to present this as the best technical solution, it would not be my intention to also advocate for a shift to a single-payer healthcare system. ...

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