Chopped by Benard Ogembo

The Global Healthcare Future.

With increasing global connectivity, the impact of an event travels across today's world with the speed of a broadband internet connection.

The relevance of national borders is dwindling, and people and determinants of health flow freely in every direction. It is no longer possible to address healthcare in one country without taking a global view.

As we look into future, 10years from now, the following changes will be noticed in the Global healthcare:

There will be more technology. As genetic diagnosis and treatment translate from cell to bedside, the information and armamentarium available to the clinician will increase perhaps inconceivably over the next 10 years. DNA chip technology or genetic fingerprinting will vastly improve risk assessment. Knowledge of the risks will increase the ability of other technology to extend life.

As the technology improves, the information deriving from patient care will also improve. With the Internet and its successors, which among other features will provide the important safeguards for confidentiality, the electronic medical record will not only be able to store patient information but also to provide information on best practice instantaneously, whether it is derived statistically from the practice of the physicians, or based on health plan data or nationally generated practice guidelines.

As patients surf the web and as employers perhaps no longer choose the health plan for their employees rather giving them a defined contribution to buy their own healthcare, they will become the ultimate consumers. Measures of patient satisfaction and other patient-oriented report cards will assume increasing importance.

With improved availability of data to the public, process and outcomes will improve. Those not capable of achieving the best outcomes will likely either improve or stop doing the procedure. In the next 10 years, process and outcomes will be optimized for a significant proportion of patients with relatively common diseases.

As care for many patients becomes more regularized and process and outcomes data become more similar, competition among practitioners will be based less on who has the best outcomes for common diseases and more on ability to innovate: developing the best care delivery models for patients with common diseases or developing new strategies for patients with uncommon diseases or presentations.

While it is clear that in addition to more efficient billing, less wasteful tests and procedures will be done as better information on appropriate care becomes available, and more efficient care models will emerge with technology for care of patients at home, these improvements will be dwarfed by increasing costs.

As costs rise, the major payers in the private system, the employers, will attempt to reduce their costs by reducing coverage and increasing the burden to the employee. As premiums continue to increase, workers will be less able to afford even basic health insurance, and the ranks of the uninsured are likely to increase.

All providers are being paid approximately the same amount by the majority of payers, whether the government or private insurers. As costs increase, health plans will pay the increases to those they must and reduce payments to the others.

The costs for employers will continue to rise, causing many to desire exiting the healthcare business; the number of uninsured people will also continue to increase with a widening gap between what can be afforded and what is available.