You are unlikely to have heard of an Implantable Cardioverter Defibrillator (ICD). If, at some stage in the future, you develop the heart condition that causes most sudden cardiac deaths, you will, writes Mark Brennock.
The condition is called ventricular arrhythmia, in which the heart has a tendency to stop beating and merely "quiver" rapidly, usually resulting in death. In the last few years, however, many with this condition have had a new device, an ICD, implanted. This, should you develop the condition, may keep you alive, while in the past you might have died.
Cost? €18,000 to €33,000 per person, with the demand for them growing all the time.
Then there is Infliximab, a new drug for those with rheumatoid arthritis and Crohn's disease. It is more effective than previous drugs, modifying the disease and improving quality of life. Cost? €710 per vial. €30,000 per patient per annum.
Mabthera is a new, more effective drug to treat leukaemia. It cost Tallaght Hospital alone an extra €152,000 in 2002 compared to 2001.
There are dozens more devices and drugs that have been developed in the past few years. Many cost a fortune. They will improve or even save our lives when we become ill.
The Minister for Finance, Mr McCreevy, regularly wonders aloud about how so much money can be poured into the health services, suggesting that it makes no real difference to the health of the population.
The Taoiseach said last week that he was perplexed as to where health spending went. "It does puzzle me how we can give so much resources, so much staff, so much equipment and there are still difficulties," he said.
Ministers are doing a grave disservice to their own achievement in increasing health spending by €5.3 billion or 158 per cent since 1997 by the regular implication that this is a waste of money. Health spending - money allocated by Mr McCreevy - is, in fact, transforming and prolonging the lives of tens of thousands of citizens. People are getting treatments that a few years ago they would not have got. People who would have died are surviving.
The cost of medical advances is going to mushroom further in the immediate future. Biotechnological research continues to produce wonderful new treatments. The biggest political challenge in the next decade will be to build a public consensus around the idea that health is going to cost each individual a lot more. Suggesting that it's not worth paying extra for it at all is severely damaging to this task.
There are undoubtedly enormous cost-control problems in the health services, with major wasteful inefficiencies to be tackled. Mr McCreevy and the Minister for Health, Mr Martin, are right to take a hard line on this. The visible inefficiencies - waiting lists, patients on trolleys clogging up hospital corridors - create a lack of public confidence in the ability of the health services to deliver better care.
But the extraordinary medical advances show there is a capacity to provide much better care. It can only be done in a streamlined, efficient, confidence-inspiring system. But if we, citizens and Government, are willing to pay, we can buy improvements to our lives that will be more valuable than any material goods.
There is a series of new drugs for breast, bowel and lung cancer available which will have a major financial impact. Cancer patients now have second or third rounds of treatment after relapses. Medical professionals debate the effectiveness of many of these expensive treatments. But if the voters don't agree to pay substantially more for health, who will they blame if they are denied an enormously expensive round of drug treatment because its cost outweighs the chance of success?
There is great hope for substantial advances in the treatment of Alzheimer's. If these come they will be in the form of drugs which health professionals believe will add tens of millions to the national drugs budget.
Even routine diagnostic tests have spiralling costs. If you damage a joint or need a neurological examination or an investigation of almost any internal organ they can give you much more than an X-ray. The relatively new MRI scan will produce a much more detailed result, at a cost of €495 per scan.
A PET scan will find internal cell changes long before cancer symptoms that were detectable by older investigation methods show up. It costs €2,200 a shot. The list goes on.
In this context a constant Government drive for greater efficiency and cost control in the health services is very necessary. But this should not be accompanied by a message that increasing health spending is wasteful per se.
People of every political persuasion in Ireland would be repelled by the idea of a society where access to such treatments was available only on an ability-to-pay basis.
The decision has to be made, the political class and the public have to wake up to the fact that the good news is that we can live longer and better, but the bad news is that we must pay - a lot.