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Medical isotope shortages.

When there is a raging debate about healthcare overhaul and the likely possibility of a governmentrun healthcare system, the story with technetium-99 is instructive. Since the mid-1990s, the medical supply of technetium-99 has been tenuous. Most of the U.S. supply comes from Canadian reactors that have been progressively aging and needing repair. One company responsible for the technetium purification that has been quite profitable contracted with the Canadian government to build a replacement facility. However, the safety of the Canadian replacement facility has been questioned and it has never opened. Currently, the Canadian plant has closed for repair and the alternative European supplier is also closed as a result of unscheduled repair problems. This leaves the supply of technetium-99 in very short supply, essentially being rationed across the nation. Technetium is an isotope with many therapeutic uses, including being helpful in cardiac diagnosis of ischemic heart disease, detecting metastatic cancer disease, its extent in cancer, and its location for targeted palliative therapy and for the location of lymph nodes optimum for biopsy. These and many other uses make the availability of the isotope for medical purposes indispensable. So where has the federal government been during the last decade and a half? The nuclear industry is the most regulated in the world; this is not an area off the federal government’s radar. The Congress and multiple regulatory bodies have been engaged in inaction, disputes over methods of technetium production without any provision for the production if and when the current aging supply facilities were needed to close. First, the United States should have had its own protected supply for national medical emergencies. Second, an alternative manufacturing facility should have been mandated when all were aware of the failings of the Canadian misadventure. The ineptitude of Congress, especially the House Energy Committee, raises serious questions about the competency of government. If we cannot supply a critical medical isotope, how are we to trust Congress to overhaul health care? It is imperative that problem areas be targeted for effective solutions. Grand schemes to overhaul a system need to be put on hold until the government can prove it can advance reasonable solutions that are cost-effective.