Wednesday, September 22, 2010

Notes on the Future of Health Care in America: 2020-2050

The health care industry will continue to grow in importance, both in the U.S. and around the world. New technologies, in particular, will play a key role in dramatically changing the practice of medicine and improving people's health. In addition to the National Health Information Network (NHIN) in the U.S., global health information exchange networks will be put in place by 2040 to support the continued growth of the global health care industry and to fight global pandemics. 

Do we have a long range national plan and strategy to position the U.S. to be a major player in this arena? What should it be?  (I was surprised at the scarcity in the number of documents I could find substantively discussing long range health care plans and strategies for America)

The following are excerpts from strategic health care plans and various reports on the future of health care in America produced by a number of public and private organization:

·         Almost 100 percent of Americans will have health coverage of some sort by 2020. About half of the the population will be covered by Medicare, Medicaid, Children’s Health Insurance Program (CHIP), Veterans Health and/or the Military Health systems. Most of the remaining population will purchase subsidized coverage through the new state health insurance exchanges.
·         The emphasis in health care will shift to disease prevention and health promotion, and reinvigorating the public health system over the next several decades.
·         The emphasis on ambulatory care and long term geriatric care in the U.S. will continue to grow over the next several decades.
·         There will be a continuing shift to personalized health care. By 2020, patients will have become empowered, involved participants and will start to better manage their own health care. As a result, patient adherence to prescribed treatments will improve.
·         By 2020, the process of health care will be substantially digitized and electronically enabled. Managed care will switch from a restrictive gatekeeper approach to one of highly automated care management.
·         Technology will enable managed care to better coordinate treatments in a more most cost-effective way.
·         The most pervasive change in the new millennium will be how technology empowers patients to take control of their healthcare. Internet-informed patients will become partners in the promotion of their health in partnership with their health care providers.
·         The growing acquisition and use of electronic health records (EHR), personal health records (PHR), health information exchange (HIE) networks and other health information technologies will have a tremendous effect on the business of health care and people's health.
·         EHR systems connected to HIE networks will result in quicker notice from hospital emergency departments to patients’ primary care physicians.
·         Information technology will help patients to access the health care system on a "7x24" basis, at their convenience.
·         There will be major advances in biotechnology, nanotechnology, diagnostics, information technology, stem cell treatments, vaccines, and organ transplants by 2020.
·         By 2020, telemedicine will play a much bigger role in health care. New physician-to-physician and physician-to-patient communications and health care processes will have developed and been accepted.
·         By 2020, medical decisions will be based on better data. Technology will improve clinical decision-making and quality of care.
·         New wearable body sensors that capture continuous physiological data streams during daily routines--as opposed to discrete data captured at isolated moments in time--will provide clinicians with greater context and enable them to diagnose based on robust evidence.
·         Medical advances will include: teeth regeneration; cures for hearing loss; stem cell R&D; major advances in genomics and preventive care; use of implantable medical devices and nanobots; and much more.
·         Complete organ replacements grown from stem cells will become possible in the 2020-2030 timeframe leading to growth of a major new bio-industry.
·         Recent breakthroughs in remote surgery, gene manipulation, cloning, and molecularization of microchips have opened a world of untold possibilities.
·         By 2020 about one in five health care dollars in the U.S. spent on people ages 50-69 could be consumed by obesity-related medical problems -- up about 50 percent from 2000, according to a RAND Corporation study.
·         Home health care and self care will grow. Diabetics are already measuring their blood sugar continuously; other continuous sensors, such as Corventis "smart bandages," which measure seven vital signals, including heart rhythms, are en route.
·         By 2020 scientists may even be able to customize drugs for their patients based on their genetic make-up.
·         Technology will help coordinate care results and yield consistently better outcomes.
·         By 2020, technology will result in better measurement of outcomes which in turn will result in improved clinical guidelines and documentation of 'best practices'.
·         Large quantities of hard data collected by EHR systems transferred to public health data repositories via HIE networks will result in improved medical research.
·         More robust public health data repositories will result in improvements in monitoring public health, responding to potential threats (e.g. pandemics), etc.

* For more information on a Vision for America through 2050, visit

Let us know about any other studies freely available on the web about the future of health care in America. Do you have notes to add to this blog based on reliable sources or information?  

National Priorities for the U.S. over the Coming Decades

National priorities for the U.S. ought to include – ensuring national security, providing clean and affordable energy, protecting the environment now and for future generations, educating an engaged citizenry and a capable workforce for the 21st century, improving our health care system, maintaining a leadership position in global economic competitiveness, and working internationally to build a safer world. In addition, a common element across all these urgent priorities is the key role that research and development (R&D) and technological innovation will play in solving problems and advancing our national interests across the board. 

The following are a selection of special reports or studies one ought to read that provide information that may have a bearing on America's future:

If you know of any other good studies or reports that are available on the web, please let us know.  What are the other high priorities that you see for our country?

Monday, September 20, 2010

America's Future: 2020-2050 - Blog Start Up

According to the author of the book "Betrayal of American Prosperity", China's number one export to the U.S. is $46 billion of computer equipment (we used to be number one); the number one export from the U.S. to China is waste - $7.6 billion of waste paper and scrap metal. The U.S. is rapidly losing its basis for leadership, wealth, and power in the world.  All Americans need to be more concerned about our future and hold our business and government leaders at all levels accountable for taking positive action to reverse the course of the past decade and putting us back on a path to a brighter future .

We need to be retain our leadership in innovation, build up our industrial base, become energy independent, care for our people, place justice and righteous behavior above greed and immorality, protect our country and our constitution, and …??!!  Let's not be fearful about the future. Let's be serious, thoughtful, and hopeful about our future. Let's discuss the future and see if we can reach a general consensus on the positive direction we want our country to take and what our highest priorities ought to be. Let's revive and reshape the American Dream to help guide us to a better tomorrow.

So may of our business and government leaders seem to have lost their way and don't really have a vision for the future of our country that we can get behind.  They're too focused on the next fiscal quarter or the next election. They focus on the negative and constantly harp on the topic of fear. America is supposed to be the home of the brave, not the home of the fearful. There are still a lot of hard working, creative, and hope filled folks out there trying to make a difference and move us forward. They are helping to create a new vision of the future for America. 

This blogging site and the America's Future: 2020-2050 web site tries to raise issues, provide information, and give you links to credible web sites where other discussions about the future are taking place and answers are being generated. I have tried hard not to provide links to web sites that offer no solutions or are simply fronts for political campaigns and posturing. Where political parties have put together a serious plan for our future, they have been included - whether Republican or Democrat.

Peter Groen
Charles Town, WV