Norway Brings DNA Sequencing To National Healthcare

ananyo writes "Norway is set to become the first country to incorporate genome sequencing into its national health-care system. The Scandinavian nation, which has a population of 4.8 million, will use 'next-generation' DNA sequencers to trawl for mutations in tumors that might reveal which cancer treatments would be most effective. In its three-year pilot phase, the Norwegian Cancer Genomics Consortium will sequence the tumor genomes of 1,000 patients in the hope of influencing their treatments. It will also look at another 3,000 previously obtained tumor biopsies to get a better idea of the mutations in different cancers, and how they influence a patient's response to a drug. In a second phase, the project will build the laboratory, clinical and computing infrastructure needed to bring such care to the 25,000 Norwegians who are diagnosed with cancer each year. Similar projects are under way in the United Kingdom and at research hospitals in the United States, France and elsewhere. But Norway's will be among the first to look for tumor mutations using next-generation DNA sequencing rather than conventional genetic testing."

Comments

Dammit Norway

[Gilloh]

Why did you have to be so cold?

Re:Dammit Norway

[Anonymous Coward]

They're not that cold considering their latitude.

Re:Dammit Norway

[Dionysus]

It's -12 C (about 10 F) in Oslo today

Re:Dammit Norway

[hxnwix]

They're not that cold considering their latitude.

Very true. Compare Trondheim's average daily temperatures to those of inland cities at the same latitude, such as Yakutsk. Due to the ocean and the gulf stream, Trondheim is something like 35C warmer in January than you might expect. Even a ways inland here in Skreia, Oppland, my outdoor thermometer is reading -13C, which is still a bit lower than average for this time of year. This is fine for working outside and skiing; grade school recess is outdoors and some kids around here walk 1km to their bus stop in these temperatures.

There's a world of difference between Norwegian and Russian winter temperatures. -10C isn't any sort of problem; -40C is trees exploding, frostbite to your dick if you pee outside.

Re:Dammit Norway

[Deus.1.01]

Its not just a latitude thing.
The more inland you get, and higher...and depending on the altitude and the topography(if the area is sorta walled with hills and mountains which keeps warm air from the coast getting in, and traps the cold air like a bowl of water).

Bjorli usually gets in the -35 -40 range.

But....essentially...we who lives on the coast have no right to complain about the cold... although the combo of snow -> rain -> slush -> and then just about cold enough to freeze the Slurpee to an Olympic skating arena do gets me on my nerves.

Re:Dammit Norway

[Xest]

Yes, but having been down to -42C in Canada, I'd much rather that than the -12C I suffered in the North of Norway near Narvik just inside the arctic circle.

The -12C sea air in Norway was much more painful and more biting than -42C was in Canada. Sure the latter will do more damage to you physically, but at least it was nowhere near as painful!

Re:Dammit Norway

[19thNervousBreakdown]

Due to the ocean and the gulf stream, Trondheim is something like 35C warmer in January than you might expect.

That's one warm stream.

Re:Dammit Norway

[BlackSnake112]

The moisture in the air give the air some teeth. Dryer air even colder doesn't hurt as much. Also, you need more layers or a waterproof layer for the cold in closer to water places. After a while outside your coat will get wet and the cold will go right through it. Wind chill is lower with wetter air then drier air.

Re:Dammit Norway

[del_diablo]

You should visit Bergen some time, the city where it rains the most and the second most rainy location in Norway.
Even during vinter it has a severe humidity, and 2-3 degrees means that even if water doesn't freeze, its too cold.

Too early?

[backslashdot]

I'm not sure with current technology this will be very useful. Better than nothing? As I have said in the past, http://slashdot.org/comments.pl?sid=1408231&cid=29781469 -this is the way forward .. but I hope it's not at the expense of long term. I mean look how long it is taking for us to wean of incandescent lightbulbs and gasoline.

We really need a way to do long reads, coupled with single cell sequencing technology. That's the proper way to attack cancer. Hmm, also we may need a way to find out chromatin structure on a single cell basis too. Get on it.

Re:Too early?

[gringer]

I agree that it's perhaps not the best idea for cancer genome sequencing, but current 2nd-generation sequencing should be beneficial for the standard human genome. Even at a cost of $10,000 per person, you may be able to substitute a single expensive drug for a substantially cheaper generic when knowing that a person has (or doesn't have) a particular mutation. As long as the sequencing is high enough quality (as you should get from a long paired-end Illumina run), it only needs to be done once, and then can be re-used for whatever new genetic discoveries come your way.

I've wondered for a couple of years now why drug companies aren't already doing this (or at least subsidising the cost of sequencing). Some drugs have been brought back from the brink of rejection via genetic tests, and given the high cost of drug research it makes sense to do a relatively cheap genome sequencing if it hasn't been done on a person previously. The cost of whole-genome (and whole-transcriptome) sequencing is now in the range where research institutes are starting to consider it as a routine operation, and it won't be long before it falls into the price range of a cost-conscious consumer.

Re:Too early?

[Daniel Dvorkin]

(Short reads * massive coverage) + better sequence assembly algorithms = whole genomes, cheap. I agree that longer reads would be nice to have, but we're reaching the point where as long as read length is "long enough," we can do the rest computationally.

Also, job security for bioinformaticists. ;)

Re:Too early?

[IrquiM]

Considering there's already a huge line of DNA samples from the police awaiting processing and the government refusing to use private cliniques, I don't see this as happening very soon.

Re:Too early?

[Anonymous Coward]

I know the VA (United States Venterans Administration) is evaluating the storage costs for DNA sequencing; they've recently looked into pricing as they don't have to pay the patent fee's since the federal government funded much of the research. From what I hear, they want to DNA sequence all military personnel as it would lead to better treatment in the field. Currently, they think they'll do a little better then breaking even, but long term they are anticipating huge savings. If it saves them money and leaves to better treatment, it sounds like a win-win for us as it'll help lower the cost of the technology.

As for the patent-fees, I've heard that's 90% of the cost of DNA sequencing; when I commented how sad that was, they commented just wait a decade for our health system to collapse and then people will be begging for a centralized medical system and we'll all be exempt from patent fees due to the government covering the bill.

Re:Too early?

[biodata]

Clever assembly can only bridge repeats shorter than the fragment lengths. Coverage is not enough, you need fragments longer than the longest repeat unit, however long the reads are. MiSeq are quoting paired end reads in the 250bp per end class now, so as long as you can get them to sequence both ends of a long enough fragment then, yes, coverage can solve it, but I think the bottleneck might be in getting the fragments long enough while still being able to pair the ends.

Re:Too early?

[biodata]

I'm not sure what country you are in but this is not necessarily the case in the UK. Here, the government is closing down the police science service, and outsourcing everything to the private sector. Be careful what you wish for.

Re:Too early?

[Anonymous Coward]

Mate-paired reads are getting long enough (~ 40 kbp). They are still sub-optimally used by current assembly algorithms (specifically scaffolding).

Re:Too early?

[Anonymous Coward]

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Re:Too early?

[Anonymous Coward]

The human genome is stuffed with repetitive DNA, both duplications and parasitic genetic elements, the parasitic elements alone (including their broken leftovers) make up about 1/2 of your DNA. The most populous element Alu is 280 base pairs long plus a pseudo poly-A tail you need at least 320BP probably 500BP to construct though one of these insertions, anything else the sequencing companies tell you is excrement. A lot of the rearrangements and tandem duplications happen between these elements as they are so numerous and smiler, they can for instance cause mistakes when you swap DNA between your parents chromosomes to pass a mixed set to your children. Thankfully read length is going up over time as well as read number so this should not be a problem in 3-4 years time.

Re:Too early?

[Anonymous Coward]

. Currently, they think they'll do a little better then breaking even, but long term they are anticipating huge savings.

ok.. i am posting AC as what i am about to say is potentially quite a karma burner tbh
what the fuck is it with people who cannot differentiate between THEN and THAN
in this post it fucking wastes what is a bloody informative and interesting post.

. Currently, they think they'll do a little better THAN breaking even, but long term they are anticipating huge savings.

there... that's it fixed.. IT'S NOT THAT FUCKING HARD FOR FUCK SAKE.
this is a simple thing yet here and everywhere else you see people make this fundamentally stupid fucking error!

Re:Too early?

[backslashdot]

I think you should focus on what people are saying rather then looking for grammatical quirks.

Re:Too early?

[IrquiM]

I'm in Norway :) This post was about Norway, right? It said so in the summary at least.

In Soviet America

[cosm]

DHS sequence your DNA. Come here comrade, we keep tabs on your DNAs. For your safety comrade. For your safety.

Re:In Soviet America

[Anonymous Coward]

DHS sequence your DNA. Come here comrade, we keep tabs on your DNAs. For your safety comrade. For your safety.

No, no, no.

This is being done for HEALTH CARE.

That makes it perfectly fine, don't you know.

Socialized Medicine

[global_diffusion]

It's sad to think that we can't do these kinds of massive human genome sequencing projects in America. Anybody who got their DNA sequenced would be at immediate risk of losing their healthcare or seeing their premiums triple.

Re:Socialized Medicine

[Fuzzy Viking]

Land of the free - where anyone having health problems are FREE to live in a cardboard box... But then any attempts to socialize medicine gets voted down over there so I guess they have the system they deserve.

Re:Socialized Medicine

[Anonymous Coward]

America has the best health care money can buy. But if you don't have any money...

Re:Socialized Medicine

[JaredOfEuropa]

Socialised healthcare has similar issues as well, make no mistake. If we all pay for our collective well-being, it stands to reason that we all have a duty to avoid health issues that incur costs, right? That means no alcohol, chocolate, fatty foods: these are bad for your health. No more dangerous sports like skiing. And since we're already working towards mandatory helmets while riding a bicycle, why not wear a helmet while walking? Anything might happen and then society would be out of pocket again on account of your carelessness.

Insurers of private healthcare love to quantify risk factors and charge a premium according to risk; DNA sequencing would be a dangerous tool in their hands. Socialised medicine on the other hand equalises risk and cannot discriminate on genetic or behavioral health risks, but it does want to reduce factors that increase that risk, by modifying our behaviour. So you could end up with a government that literally tells you when to pee, for health reasons. With private healthcare at least you'll have the insurers vs. the government (at least if your government doesn't kowtow to those insurers); in socialised medicine you have insurers and government openly on the same side, with the same goals. That scares me, and it already resulted in a number of creepy and far-reaching ideas for health-related laws in my country. Thankfully most got shot down, but with the cost burden increasing in these crappy economic times, that might change.

Don't get me wrong, I think it's good that everyone has access to healthcare over here, but socialised healthcare is not without its problems, and those problems are not all about costs.

Re:Socialized Medicine

[Daniel Dvorkin]

So you could end up with a government that literally tells you when to pee, for health reasons.

You could, but do you? I haven't seen any evidence that countries with socialized medicine, on the whole, put any more restrictions on people's health habits than those without.

Re:Socialized Medicine

[Luckyo]

This is one of the most insane claims I've read on slashdot. Government that tells you when to pee? (Obvious concern troll, but I'll bite).

I think you're talking about things like making a law to ensure people wear helmets when riding bikes. Of course, being from a nordic, free and socialist... excuse me, communist, freedom hating degenerate land of free sex as your types likes to put it, we also trust that people understand that it's for their own good, and there is no punishment associated with it. You can ride a bike without a helmet, and police can legally stop you and tell you to get a helmet. But no fine.

Because people around here aren't batshit insane and imagine that hurting themselves on purpose is somehow sticking it up to the Man.

P.S. Nice concern troll.

Re:Socialized Medicine

[cdrnet]

Isn't drug and alcohol use much less liberal in the USA than in these countries?

Re:Socialized Medicine

[JaredOfEuropa]

There are not many such restrictions as yet, but the pressure is on to somehow punish unhealthful behaviour, and it's not just coming from the crackpot politicians. Our government has traditionally been very active making suggestions for leading healthy and safe lives, and I think that's good, but with the economic squeeze and the looming long-term demographic issues around the corner, they are starting to sound less and less like suggestions. I don't think it will ever be nearly as bad as in my exaggerated example, but looking at the current economic situation and political landscape in my country, I think there's a good chance of at least some of these suggestions making it into the law books.

Re:Socialized Medicine

[JaredOfEuropa]

Yes, I was exaggerating of course. But you're not all that far from the Netherlands; come visit sometime, and put your ear to the ground around parliament. I think you'll find that the notion of these suggestions for healthy living being turned into laws or rules isn't all that far-fetched. The idea of a "socially engineered society", the idea that managing many aspects of people's behaviour and society as a whole through laws and taxes is not only possible but desirable, is deeply rooted in our country.

Re:Socialized Medicine

[Anonymous Coward]

You have not been paying attention to the world very long have you...

Some things you can't be told. But you'll learn eventually.

Re:Socialized Medicine

[anyanka]

Actually, you get too little of this (in Norway, at least).

Prevention (in the form of getting people to eat healthier, exercise more, etc.) is typically paid from a different budget than the health care budget, and it's a lot easier to cut the prevention budget than the health care budget. So in practice the health care budget gets fatter, and little attention is paid to things that could have made people healthier. This also goes for things like welfare; if you'd used health care a bit more sensibly in some cases, you could get more people back to work and earn more taxes and pay less in disability benefits. But that would require a holistic view of spending, across departments and different levels of local and national government.

And, of course, you can't cut the tax on fruit and vegetables without the dairy and meat industry complaining and wanting cuts too. Overall, eating healthy is a lot more expensive than eating junk food (assuming you're educated enough to *know* what food is healthy).

You *do* have campaigns against smoking, though, and restrictions on alcohol (but that's more due to morals/puritanical tradition). But it's almost impossible to get treated for drug addiction, particularly if you life and health isn't already ruined by drugs...

Re:Socialized Medicine

[Anonymous Coward]

I like the way you list a whole load of scary possibilities but the only actual example that has actually ever happened is about the wearing of helmets.

We are naturally lazy and really bad at weighing risk. If a significant number of people killed every year would have survived if they'd worn a helmet, then why not make it a legal requirement? What other way would you achieve this? I already know your response, "Don't enforce it, let them die, survival of the fittest, hyuk, hyuk." A stupid, short-sighted, selfish and deluded response from someone who believes that he could never die falling of a bicycle and that if he did then the only person it would hurt would be himself.

Re:Socialized Medicine

[Anonymous Coward]

America has a higher drinking age, more restrictive alcohol sales laws, and harsher anti-smoking laws than any Western European country. Your country already punishes or restricts unhealthful behaviour very strongly, and you aren't even getting the benefit of universal healthcare.

Re:Socialized Medicine

[Luckyo]

One of the key aspects of our societies (and by our I mean that of relatively small, wealthy European countries) has typically been openness to new. This means that suggestions that you and I find stifling, or even crazy should be allowed to be suggested.

And when it's clearly against our ethics or culture, such suggestions should be shot down. As they do. To suggest stifling debate about those things on political level is to attempt to control the very freedom of speech we so cherish.

Re:Socialized Medicine

[Kjella]

They might be surprised if they expect their costs to be significantly reduced. The top graph here shows the average contribution in taxes/expenses for people of a certain age. What can you say from that graph? Mostly that the very healthy and long-lived are very expensive to the government, in fact if you've worked a few decades and die at 50 you're not actually a net expense. Note that the graph doesn't add to zero since this is per person and obviously there's rather few 100 year olds, but if you multiply by population at that age it ought to be roughly balanced.

Here's the thing, everybody dies the only question is how. A long, protracted decline with failing health is far more expensive than the people that, sorry to be blunt, drop dead. Middle-aged people, even if they've attracted something serious like lung cancer from smoking or heart attacks from obesity tend to either die or recover, either way it's not that expensive. Meanwhile your 90 year old that's been in and out of hospital and made his slow recoveries has been a big expense, never mind the pensions, retirement homes, nursing homes and various other forms of aid. At least on average.

We've been able to have a retirement age because the cost of carrying people to the end of their lives haven't been all that big. But now more and more people are having sunset decades instead of sunset years and they don't want to work longer just because they live longer. And with longer education, work life is possibly even getting shorter. Study until you're 25, work until you're 65, live until you're 85 - that's more than half your life not working. Top that off with people that are unfit to work - or perhaps more relevant today, out of work - and society is struggling.

At the current predictions, I'd have to work until I'm 70. It's great that maybe we've added five years to the average lifespan so I'll be 90 instead of 85. But to make up for it you will have to take three year from 67 to 70 and turn retirement years into working years. Like so many countries in Europe are finding out now, the government can't make that money for nothing. The cost to keep me alive is coming out of my own hide, one way or the other. If I were to stuff myself full of things to I choke at 70 instead of 90, I should be rewarded not punished.

Re:Socialized Medicine

[rmstar]

The idea of a "socially engineered society", the idea that managing many aspects of people's behaviour and society as a whole through laws and taxes is not only possible but desirable, is deeply rooted in our country.

What you are describing is precisely what a society with a government is. Anyone who thinks that a "socially engineered society" is not desirable at all is a libertarian. And, IMO, also deluded. You will get a socially engineered society anyway, the question is, who will engineer it to the benefit of whom.

Personal freedom, and the right to be a fool, are things that a well engineered society allows. Within bounds.

The idea of attacking cancer by a massive data mining exercise is probably a very good one, as almost all other approaches have essentially failed. Only a very healthy society can afford the risk this approach represents, though. I sincerely wish Norway good luck with that.

Re:Socialized Medicine

[Tsingi]

I guess they have the system they deserve.

They deserve to have health care just as much as you or I do. The government in the US no longer represents the people. That's a problem for all of us.

Re:Socialized Medicine

[spectrokid]

a government that literally tells you when to pee

You know there is this thing called Democracy. That's like when you don't get elected based on how much money you raised, but based on how batshit crazy your ideas are. Really should try it, there back in the states. Works wonders...

Re:Socialized Medicine

[SomethingOrOther]

So you could end up with a government that literally tells you when to pee, for health reasons.

Nice troll.
Norway significantly outranks the US on the Democracy Index.
As do all the Nordic countries for that matter..... all with the strong Nordic healthcare & welfare systems in place.

Re:Socialized Medicine

[stephanruby]

Health Insurance Companies are not allowed to discriminate based on dna information. I believe that bill was signed by W Bush.

Thought, this law doesn't protect against this type of discrimination for Life Insurance. Life Insurance is a little bit more tricky than Health Insurance, because if insurance companies are told not to discriminate on dna for Life Insurance, then people who have deadly genes will play the odds and load up on as much Life Insurance as they can just before their number comes up.

Re:Socialized Medicine

[Anonymous Coward]

I guess they have the system they deserve.

They deserve to have health care just as much as you or I do. The government in the US no longer represents the people. That's a problem for all of us.

They represent the people who vote. The reason democracy is not working for the american people is because the american people don't bother to work the democracy. Consistently abyssimal voter turn out equals letting others run the show. It is easy to complain on the Internet about "the system", "they", it requires more effort to be politically active, work for alternatives, improving policies and candidates from within, working to gather external support, ensure massive voter turn out every time. Yes, your efforts will be a drop in the bucket, your combined efforts won't. The 90% do actually decide who sits in the chairs politicans covet so much, not lobbyists or rich donators, they have no real voting power, the people have - actually the poor people have, as they are the majority.

If there are aspects of the system you don't like, including election/campaign funding rules, work for a change, vote out the ones who don't, not one or two times but multiple times. You are not allowed to give up just because "we tried with Obama, didn't change anything". That is not enough, and even though some extra voters turned up to vote Obama in (still way to few compared to more people-active democracies), you need to keep doing it, more of it. I assure you they will get the message of who controls their access to their positions. This isn't a naive dream, it is how it work other places! (you know, there are rich corporations in other countries than US, but in active democracies the people make the system work for them).

Re:Socialized Medicine

[stephanruby]

You could, but do you? I haven't seen any evidence that countries with socialized medicine, on the whole, put any more restrictions on people's health habits than those without.

If anything, it would seem the US is trying to overcompensate for its lack of socialized medicine, by over doing it on its war on cigarettes, on its war on drugs, and on its war on good food (by enriching it with all kinds of vitamins and other junk).

Re:Socialized Medicine

[backslashdot]

Obama's healthcare plan, as passed .. simply states that you must get private insurance. The few who cannot afford it will get taxpayer assistance. The overall taxpayer input will not justify the govt. telling people they can't eat chocolate. In fact, the INSURANCE companies can do that .. they already have stuff like that .. for example if you have health insurance and you smoke .. if you get sick .. they can tell you you voided the contract by smoking so you're out of luck. Why would a private insurance company want to insure people they know are going to fall ill? The fears of being regulated can happen without government. It'll be quite easy for healthcare companies to write in loopholes like that to get out of their obligations.

And btw the FDA already "decides" what you can and cannot buy in a store .. for example can you buy diseased rotten meat? And guess what the helmet laws exist regardless of "socialized" healthcare.

At least governments can be voted out within 2 to 4 years of sh*t hitting the fan. Again, Obama's health care plan only says everyone should get insurance and those who can't afford it will be given assistance to purchase it. If you smoke or eat excess chocolate, you will simply have to pay more .. the govt. assistance won't cover it. This is how it would be under a private system too.

Re:Socialized Medicine

[Slashdot Assistant]

And, of course, you can't cut the tax on fruit and vegetables without the dairy and meat industry complaining and wanting cuts too. Overall, eating healthy is a lot more expensive than eating junk food (assuming you're educated enough to *know* what food is healthy).

I find that eating healthily more expensive in terms of time spent preparing food, while the food itself is cheaper to buy - excepting of course shit like the giant bags of "chicken" nuggets and chips that the stereotypical mum in sorely strained stretch-pants will be shoveling down the necks of Chantelle and Darren. Vegetables are generally cheaper than processed stuff, and a far better option if mum doesn't want Chantelle's future boyfriends to struggle to differentiate a hole from a fold in her flesh. Chubby can be cute. Waddling down the road, with an arse that would send Sir Mixalot running, is as attractive as being punched in the neck.

Re:Socialized Medicine

[Anonymous Coward]

They're talking about doing sequencing on TUMORS. These people already have cancer. Their insurance is going to care far more about that fact than what their specific tumor genome type is. Whole genome sequencing (on a person's inherited, germline DNA, not the effed-up DNA of a tumor cell) is fraught with ethical, legal, and social complications (just had a seminar at work about it- we in the genetic counselling world are pretty hesitant from an informed consent and patient care/education perspective).

Re:Socialized Medicine

[bws111]

Insightful, really? How about 'complete bullshit'. Maybe you (and the idiot mods) should read about GINA.

Re:Socialized Medicine

[tomhath]

Norway can afford all kinds of nice things thanks to North Sea oil. Few other countries have that luxury.

Re:Socialized Medicine

[Anonymous Coward]

That's ridiculous. You don't have to ban risky behaviors or otherwise infringe on one's freedom. There's nothing that prevents socialized medicine from having the best of both worlds. Equalize risks and don't discriminate on genetic backgrounds, but do discriminate on some behaviors, such as taxing alcohol and tobacco, which is definitely a good thing since they are far more damaging than casual skiing. When it comes to qualifying risks such as amateur skiing, I would prefer not to. Having your private insurer do so means they can always decline you the treatment you need since you failed to disclose some minor risk taking behavior. And it also means they have to infringe on your privacy in order to do so. There's nothing about private healthcare that can't be done better in a socialized way.

Re:Socialized Medicine

[Anonymous Coward]

Nah, not really - there's strict limits on how much of that income we use in the national budget (about 4% max, I believe), while the rest is invested in a massive fund. The idea is that the percentage we allow ourselves to use now is comparable to the interest we can expect from that fund in the future. I believe it works out to a low single-digit percentage of the yearly national budget.

Re:Socialized Medicine

[operagost]

First of all, you have a funny idea of "freedom". You might think that it's government's job to redistribute wealth to ensure that everyone has health care-- fine. But you have to face the fact that that is not freedom, it's social justice. As if that wasn't enough, you claim that any attempts to socialize medicine get voted down even though the Affordable Health Care act was recently put into law and GWB added prescription drug benefits to Medicare less than 10 years ago. I'm not making any political statements-- you're simply WRONG and those who modded you up are idiots. In fact, I'm going to metamod as soon as I finish this in the hope that I see your post there.

Re:Socialized Medicine

[TheGratefulNet]

blaming the voters and lack of turn-out? really?

if 100% of the population showed up and voted, the politicians would STILL vote based on which corp gave them the most.

stop thinking that we still have a stay in things.

we do not have a 'say' in things. corporations have 100% total rule right now. this is what the occupy guys were primarily angry about and what most of the younger generation does know, but no one in power is willing to break from the financial gains you get by sucking corporate cock.

Re:Socialized Medicine

[Anonymous Coward]

Mod parent up. I live under the socialist healthcare regime of Great Britain and I can speak from experience.

As we all know, beer, cigarettes, chocolate and fried food are completely outlawed in the UK since 1948 when the NHS was founded, and every citizen must complete a mandatory 60-minute exercise regime to the tune of the national anthem every morning under penalty of death. It was only when I was lucky enough to visit the Land of the Free, America that I got to experience what freedom is all about. I had to work extra hard to impress my local apparatchik and earn myself the right to apply for a passport, but I was determined to go to America to see some old people - we aren't allowed any of those over here. I hear they look all crinkly and smell funny.

When I needed healthcare during my visit to the US (got drunk on a bottle of Budweiser, then cracked my skull on the toilet bowl while violently throwing up 3 chill-cheese covered chocolate-coated deep-fried Big Macs in bacon batter) I was reassured because I had proudly purchased some very expensive private health insurance and was eager to see how healthcare in the best free country in the free world would compare to our drab grey communistic hell-hole back in England.

Sadly, although I got treated (the hospital seemed about the same as back home) I had to pay the full cost of treatment (which seemed very expensive - $200 for a band-aid!). It seems that I'm not very good at this freedom thing, because my insurance company exercised their democratic freedom to deny me coverage based on some small-print in my contract. However I don't consider it money wasted, because although my insurance money didn't go towards paying the the doctors and nurses who cared for me, it did help to sustain the huge army of freedom-defending lawyers, administrators and claims adjusters required to make sure that I wasn't getting anything I'm not entitled to.

Sadly, I got deported shortly after leaving hospital at a TSA freedom checkpoint on the highway because, due to some kind of misunderstanding with my accent (I think it has something to do with the words "toothpaste" and "terrorist" sounding similar), my name had been added to some kind of secret government freedom list.

However I can't wait to go back to America. I've been trying to earn another foreign travel permit, doing TWO hours of exercises a day and volunteering for extra shifts on the Community Life Expectancy Enforcement Panel at my local hospital. And I'm not worried about healthcare either, because I hear you free Americans get free X-rays in the airports now!

Re:Socialized Medicine

[Anonymous Coward]

You seem to forget that government unlike private enterprise are under democratic control. If a government tries to implement policies that people don not think can be justified they will be voted out.

Frankly I think your comparisons are a bit ridiculous. You compare the motives of a country to those of a private enterprise. They are so different on so many levels that your comparison makes no sense. A private insurance company can increase your premium for smoking. A country has quite a lot more methods to achieve something similar. They can have anti-smoking campaigns. They can put extra taxes on smoking etc. There are lots of ways they can reduce smoking or collect money from smokers for their habits.

Smoking incurs a large cost to health care for a country because so many people do it. However there are a lot of conditions which are so rare that they represent very small expenses even if they cost a lot to an individual. In socialized medicine it is much less likely that an individual suffering from some rare and expensive disease is going to get shafted the way they are going to be when dealing with private insurance.

Re:Socialized Medicine

[tomhath]

True that a small percentage of the profit is being spent today. But take away all the oil related jobs and income taxes collected from those jobs and the numbers are a lot different.

Re:Socialized Medicine

[Deus.1.01]

You shouldn't extrapolate to much out of the 60 year perspective reports, they are not there to make any serious predictions.
They are to to point out potential problems and worrying factors and use it as a yardstick for reports in later quarters.

That said, "But now more and more people are having sunset decades instead of sunset years and they don't want to work longer just because they live longer."

Here i must disagree, i have the last four years heard how more and more people are working long into their seventh decade.

http://www.tu.no/jobb/article285712.ece

This is not a given for everyone of course, more physical and labor demanding professions can exaust you in the long rung in more ways then one, but I also think that the one who spent 5 or 7 years on their education, are the one who are most likely to work postpone their retirement.

I can understand the industrial workers when they say they got the shaft regarding the pension reforms, but...they were also the ones who were earning paychecks earlier.

But whatever the case, i think the careers of people do stretch to fill the gap that the new longevity in the population.

Re:Socialized Medicine

[operagost]

A high level of democracy does not equate with a high level of freedom.

Re:Socialized Medicine

[Anonymous Coward]

I've voted for people who said they'd do X, then they didn't do X. How can I influence that, huh? With a gun? I'm willing, will you back me? Seriously, will you get on a plane and fly the fuck over here and BACK ME ON THAT?

Re:Socialized Medicine

[Anonymous Coward]

This is what Fox News viewers actually believe.

Re:Socialized Medicine

[del_diablo]

But Norway is also one of the worlds richest countries. So, in this case it equates one of the most free nations.
Providing you are not attempting to build a tall house of course.

Re:Socialized Medicine

[Anonymous Coward]

The government in the US no longer represents the people. That's a problem for all of us.

Well, did they?

I mean, revolutions are typically seen as people of the lower suppressed classes raising up against the upper class that controls them and the land. In USA it was done by the upper class that controlled the land, against a king far far away.

Re:Socialized Medicine

[shiftless]

Of course, being from a nordic, free and socialist... excuse me, communist, freedom hating degenerate land of free sex as your types likes to put it, we also trust that people understand that it's for their own good, and there is no punishment associated with it. You can ride a bike without a helmet, and police can legally stop you and tell you to get a helmet. But no fine.

That would never work in the United States. Tax.....er, fining, arresting, and imprisoning people for "bad behavior" is how a large and growing portion of our population makes its living. What would those poor prison guards and armed thugs do with themselves if they didn't have potheads and speeders to bust and dollars to collect from seat belt violations? Which come in handy BTW as a convenient excuse to further intrude upon the crimin...er, citizen's rights during the "routine" traffic stop, by nosing around into other aspects of his/her business. "Papers please, operating license, proof of taxes paid to vehicle licensing bureau, proof of bribes paid to insurance cartel. Where are you going? Where are you coming from? You got anything you're not supposed to have? Any drugs or weapons? Mind if I have a look around? Why not? What are you hiding? I smell marijuana. Step out of the vehicle please."

Clearly our country is much more of a communist, freedom hating, degenerate land of free sex than yours is. So put a sock in it, cause America's still NUMBER ONE, gawddurnit!

Re:Socialized Medicine

[Anonymous Coward]

blaming the voters and lack of turn-out? really?

if 100% of the population showed up and voted, the politicians would STILL vote based on which corp gave them the most.

stop thinking that we still have a stay in things.

we do not have a 'say' in things. corporations have 100% total rule right now. this is what the occupy guys were primarily angry about and what most of the younger generation does know, but no one in power is willing to break from the financial gains you get by sucking corporate cock.

1. You have never tried, but given up before trying. 2. This is working much better for people in countries that actually do vote and engage. Not perfect, but much better. We have corporations too.

Re:Socialized Medicine

[Anonymous Coward]

I've voted for people who said they'd do X, then they didn't do X. How can I influence that, huh? With a gun? I'm willing, will you back me? Seriously, will you get on a plane and fly the fuck over here and BACK ME ON THAT?

Democracy doesn't equal getting instant gratification for minimum effort, or even getting your will at all. I am amazed about the degree to which Americans are willing to ignore that there are democracies out there that work much better, and look at what that would take. What you do? You vote according to your conviction next time as well (eg. not on the ones letting you down). You actively put in effort and work to convince others to do the same. You sign up to work for the causes you believe in. You become politically active to work for parties fronting candidates you like. etc. etc. And you and everybody else does this consistently for decades, generations.

The reason politicans listen to protest movements in Europe is because they know it will actually have consequences come next election, and they don't want to be voted out. The reasons protest movements in US usually are not listened to is because it very rarely has such consequences when it comes election time.

Re:Socialized Medicine

[Anonymous Coward]

What you are describing is precisely what a society with a government is. Anyone who thinks that a "socially engineered society" is not desirable at all is a libertarian. And, IMO, also deluded. You will get a socially engineered society anyway, the question is, who will engineer it to the benefit of whom.

I doubt you'd know libertarianism in practice if it fell on your cock. Like any political persuasion there's a spectrum; I myself am center-left with a libertarian slant here in the US. I believe that the federal government should provide what is delineated in the constitution explicitly, and nothing more. The rest should be handled at the state level.

Personal freedom, and the right to be a fool, are things that a well engineered society allows. Within bounds.

Maybe you think I should wear a helmet when I ride my motorcycle. Maybe I think that you shouldn't have sex until you're at least 25 years old AND married. Both are better for society, right? Or are they...
There's a concept that only two nations have ever understood, and unfortunately it's becoming a thing of the past. It's the concept of "mind your own fucking business, and as long as I'm not hurting anybody else butt out." The U.S. and the Australians used to get this; unfortunately this is no longer the case.

Good for Norway but not current patients.

[Anonymous Coward]

Cancer genomes have so many secondary mutations and chromosomal aberrations, that unfortunately thousands will die before any usefull data will be discovered from such research.

Re:Good for Norway but not current patients.

[semi-extrinsic]

In the words of Napoleon: "If it will take that long, we must start at once!"

Re:Good for Norway but not current patients.

[damn_registrars]

thousands will die before any usefull data will be discovered from such research.

That simply isn't true. Sure, some will die before advancements are made from sequencing their tumors, but they would still receive standard oncology care during the process same as they would have without the sequencing initiative - in other words, they didn't die from the sequencing.

Even more so, new treatment modalities have already come online in the past decade or so that have come from genomic identification of tumors. Genomics has changed what we know about cancer progression and has allowed for much better tailoring of treatment already. You don't need to necessarily sequence the entire genome of a tumor to know quite a bit about it; most tumors fall into a few genetic classifications rather quickly and that information is tremendously valuable in treatment decisions.

real school

[Anonymous Coward]

I've wondered for a couple of years now why drug companies aren't already doing this (or at least subsidising the cost of sequencing). Some drugs have been brought back from the brink of rejection via genetic tests, and given the high cost of drug research it makes sense to do a relatively cheap genome sequencing if it hasn't been done on a person previously. The cost of whole-genome (and whole-transcriptome) sequencing is now in the range where research institutes are starting to consider it as a routine operation, and it won't be long before it falls into the price range of a cost-conscious consumer.

Re:real school

[Samantha Wright]

The drug design process takes too long for this approach to yield profitable results: first you have to do a genetics workup on all of the mutations to find out which ones are important and which ones are spurious; some may even have novel mutations that aren't fluff either. Drug companies don't generally fly into action until medicine is sure of what they need to target; it's far easier to justify that sort of spending to their shareholders, as there is less risk involved (and drug design is an extremely risky business, as it is.)

For the time being, I imagine they have their hands full with enough other projects and approaches—although you can be sure they'll be interested in the data and results this endeavour generates. At any rate, the patients will be long dead before anything based on their genomes hits the market.

Slashbias

[Anonymous Coward]

How come when the US thinks about doing something like this, the story gets tagged "Gattaca" and people scream and decry invasions of privacy and healthcare that costs you extra because of something you had no control over (like your genes) but when Norway does it no one even blinks? I guess Americans trust Norway's government way more than their own, but I'll just bet they know even less about Norway's system of governance than they do about their own, if that's possible. Very strange.

Re:Slashbias

[Anonymous Coward]

Because Norway's governments (both right and left wings) have, repeatedly, demonstrated an ability to not fuck over the citizenry. Both sides are jockeying for positions, obviously, but where your politicians are downright evil, the worst people we have are merely incompetent.

Re:Slashbias

[Anonymous Coward]

Sad, but true.

And if the TSA did this?

[Anonymous Coward]

The /. crowd would be apopleptic.

The privacy invasions that cause the /. crowd to go berserk suddenly become A-OK when done in the name of government-provided health care.

Re:And if the TSA did this?

[Samantha Wright]

And? What's your point? This is a medical procedure. It belongs in a medical process. Relatedly—and you may want to hold onto your knickers for this onepeople would also get upset about the TSA asking them to strip naked, but not a doctor asking them to do the same. Is your mind boggled yet?

Re:And if the TSA did this?

[19thNervousBreakdown]

I know this is a troll, but...

Yes, when somebody is trying to save my life, I'm happy to provide them with as much information as they need, and when somebody is trying to ruin my life to justify their worthless job, I'll do everything I can to be unhelpful.

Hint: It's not a privacy invasion if I volunteer the information. And, "if you don't want to share you're obviously hiding something" is the very definition of coercion.

Norway is full of atheists

[Anonymous Coward]

They do not like to pray cancer away like the civilized world.

Biomarkers

[garthsundem]

I write science part-time for the University of Colorado Cancer Center -- biomarkers are totally the way of the future. In lung cancer, we discovered that a ALK-EML4 gene rearrangement predicts great response to the drug crizotinib; we know about PSA in prostate cancer; we test for hormone dependence in breast cancer. Hopefully the Norway sequencing will add to this list of biomarkers that allow us to find cancer early and give doctors clues to its treatment. (Now, the next-gen is *protein* sequencing.)

Re:Biomarkers

[biodata]

The other angle I have heard on biomarkers for cancers is not to look for individual ones, but to look at hundreds or thousands at once, and relate 'biomarker configurations' with disease. Genome sequencing will help this approach a lot too.

Re:Biomarkers

[garthsundem]

Yes! In many cancers a whole "panel" of biomarkers are affected -- researchers are dialing in the algorithms that recognize these biomarker signatures of disease. For example, maybe one biomarker isn't predictive, but in combination with 5, 15, or 100 others, the panel as a whole becomes predictive. An example is Dan Thoedorescu's COXEN panel, which looks for a host of biomarkers to predict bladder cancer: http://www.ucdenver.edu/academics/colleges/medicalschool/departments/Pathology/academicprograms/cancerbiology/Pages/theodorescu_canbio.aspx Researchers are even using gold nanoparticles to detect biomarkers in exhaled breath, to predict lung cancer. The tech's not quite there yet, but soon you might be able to breathe into a bag at the grocery store and it would screen your breath for the signatures of lung cancer.

Just at the right time

[Rooked_One]

We need to keep mister blonde!!!

I don't know if blonde hair blue eyes girls are evil, but they sure are beautiful and when we get to the point where all the genes have been mixed together and we all look like goobacks from southpark, bringing back some "neanderthals" from the 21st century couldn't possibly be a bad thing.

Re:Just at the right time

[Samantha Wright]

Actually, blonde hair went extinct over a hundred years ago. Didn't you hear? It was in all the newspapers.

MODERATORS!!!

[Anonymous Coward]

Mod parent down! This smug piece of TEA party TRASH has been planted by corporate interests to disagree with liberty and justice. And suck on my salty chocolate nuts while you're at it, mods.

Homogenous Norwegian population

[Anonymous Coward]

Don't forget to mention that with a largely homogenous population the results will be even more useful and applicable.

Good Management

[andersh]

Here we go again, it's always just because we have oil, what a convenient excuse. Never mind the fact that we had socialized medicine long before we found oil & gas. The expense of this project is not extremely high or impossible for other systems to acheive.

Oil and gas accounts for 25% of Norway's GDP. The revenue is only invested abroad by our SWF, we allow ourselves a meager maximum 4% of the surplus on the fund. We consider ourselves simply the custodians of this wealth, it belongs to future generations of Norwegians.

As for "few other countries having that luxury", I give you all of "oil-free" Scandinavia; Sweden, Denmark, Finland and even Iceland.

Germany and France also have strong public health systems.

Criminal and Medical cases

[andersh]

The key difference between the two is that what you're talking about is criminal investigations where we don't want to use private cliniques, this is a medical research project.

Re:Criminal and Medical cases

[IrquiM]

But the labs that are available are already busy

Different Labs

[andersh]

I think you have the labs and roles confused, that's why I pointed out that there are different labs for medical and criminal cases.

What was formerly known as the Division of Forensic Medicine ("Rettsmedisinsk institutt"), is now, as of 2012, part of The Norwegian Institute of Public Health ("Nasjonalt folkehelseinstitutt"). This division was indeed plagued by the [public] capacity problems you refer to.

The Norwegian Institute of Public Health is a "... national centre of excellence in the areas of epidemiology, mental health, control of infectious diseases, environmental medicine, forensic toxicology and drug abuse.".

The Division of Forensic Medicine and Drug Abuse Research analyses biological samples with respect to alcohol, drugs (medicinal and illegal) and toxic agents in cases where the results may have judicial consequences. The analytical results are usually interpreted and commented and, in many cases, expert statements are submitted to the courts.

The issue was not a lack of general capacity in the health care system, it was handing over work generated by criminal cases to privately owned labs. These are completely different and separate areas.

The Norwegian Police and Prosecuting Authority ("påtalemyndigheten") are frequently looking for positive DNA identification of suspects in murder and rape cases. This differs greatly from the lofty goal of mapping the complete exome, the human genome, in all future Norwegian cancer patients.

This national project will utilize and expand the existing capacity of the regional cancer centers, i.e. Norwegian hospitals, through:
"... establish[ing] sampling procedures and sample logistics, bioinformatics infrastructure, analysis and pipelines, ...". It will in no way impact, reduce or take away focus from the criminal cases handled by the Forensic Division. Of course, that is merely my opinion, that I gathered from what I read.

Source(s):
http://www.cancergenomics.no/
http://www.fhi.no/
http://www.forskning.no/