This post is part of the ‘Think Further’ series, sponsored by Fred Alger Management, Inc. Follow the link for more #ThinkFurther content.
It is human nature to think about the future, and to predict great advances. Fifty years from now – we say to each other – the world will be entirely different. But in what ways? Some futurists, including some great science fiction writers, get parts of the future right — but the big picture is often elusive.
In health care, there have been tremendous advances in the past fifty years, and we quite reasonably expect the pace of change to pick up and bring us into a profoundly improved future.
The science will surely advance, but far more complicated is the social milieu within which the science must develop.
Alzheimer’s Disease and other chronic conditions now occupy most of our attention, as modern medicine has effectively eliminated most serious infectious disease. Social factors rather than scientific factors have kept us from calling a final end to polio and a handful of other infectious diseases – religious opposition to inoculation, economic hardships limiting the availability of reliable refrigeration for vaccines, cross-cultural fear of quarantines – but we are nearly there.
How will we be able to get to the next level in terms of control, or even prevention, of debilitating chronic diseases including Alzheimer’s? Well, the model of personalized medicine is compelling, and is of a piece with the rapid advances in genomics that we have seen over the past decade and which are likely to continue into the future. The key challenge is making sure that we can achieve and exploit advances in personalized medicine in a cost-effective manner – bringing us back full circle to the social factors that determine health status of individuals and populations.
Some medical futurists predict that costs will fall as technological advances are made, but this is not an ineluctable conclusion.
As runaway health care costs in the U.S. are poised to shatter the 20% of GDP barrier, we have no choice but to work to ensure that health care is as efficient and cost-effective as possible, to create a paradigm shift that moves us away from overuse of health care resources, away from the “technological imperative,” and away from a mindset that defaults to concluding that more expensive health care is by definition better quality health care.
It is my fearless prediction that in the future we will be more sensible, that the social contract around health care will be improved, so that the medical advances of tomorrow may be equitably shared with those who may reasonably expect to benefit from them – without breaking the bank and without continuing to mortgage the next generation’s future.
Improved patient engagement, improved outcomes tied to patient self-determination, and improved partnerships between clinicians and patients that make the other improvements possible are the stepping stones to achieving the population-level goals of improved quality, improved cost-effectiveness and improved population health status.
David Harlow
The Harlow Group LLC
Health Care Law and Consulting
