The Future of Health Care

I know very little about health care economics but I know that we need to get this right and we need to do it now.  Health is all we have on this side of glory, and yet I am almost daily astounded at how much inefficiency and inequity remains in the systems that deliver services necessary to our wellness.  How is something so fundamentally important and yet so frequently butchered?

I have no solutions.  But, I can present some reasons why solutions are hard to come by.  Here are three, in no particular order:

First, much of good health has to do with having good habits, and as we all know good habits are hard to learn.  Eating right, exercising regularly, and avoiding smoking and excessive alcohol will get you pretty much all the way to a long life, and none of them require doctors, pills, or surgeries.  Ah, but these are behaviors that are hard to do on a regular basis, and even harder to use top-down approaches to get people to do.

Second, much of good health care has to do with coordination across multiple appointments, caregivers, and institutions, and that kind of coordination is hard to come by.  Patients fall through the cracks and incompatible treatments are prescribed all the time.  No one touch-point in the health care system is in charge of our care, and we lack the knowledge to be in charge of our own care.  So structural inefficiencies and systemic failures remain.

Third, much of the future of health care will have to do with personalized forms of medicine.  I'm convinced that I will live to see the day that our diets, pills, and treatments will be uniquely catered to our individual make-ups, such that we will view our current lack of customized interventions in the same way that we currently look back at doctors who practiced blood-letting or who didn't understand how germs work.  When this day arrives, we will have incredible improvements in quality and quantity of life.  The big question, though, is whether we will have a health care system that allows those improvements to be enjoyed by all, because another scenario is that they are only accessible to those who can afford them.  And that would be the crowning inequity of them all, that not only do the have-not's lack what the have's have, but they will also be doomed to be on the outside of revolutionary advances in the way we fundamentally take care of our bodies.