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Dr. Contrarian’s Fearless Forecast for Health Care
One of the annoying things about ringing in a new year is having to put up with futurists' top ten
predictions for American health care and their smug, self-congratulatory hype about getting all their
predictions right for the past year.
These people really go out on a limb. Last year one futurist predicted that "hospitals would respond
to terror," employers would demand better health care quality, and the nation would "anticipate
genomics."
What's really alarming is that futurists actually get paid for these astounding insights.
Enough already of wimpy, mealy-mouthed prognostications. We asked Dr. Contrarian, our resident
curmudgeon and purveyor of all things wild and wacky in this skewed up world, to dish up a top ten list
of health care predictions with real cojones, something we could use with pride as guideposts for righting
the wrongs of health care and instilling the proper attitude of cosmic laughter and playful reverence.
Dr. C., who always thinks otherwise and never gives dates, submitted this tongue-in-cheek guide to
health care's future:
- Health plans will apply a powerful WHINE Meter to rate and sort out providers. Social scientists,
working on government money, will scientifically link the propensity for whining to physician age,
income and social status. Older docs with their glory days behind them whine the most; young docs
in high tech specialties whine the least. The WHINE Meter will be used to decertify providers in plans
and hasten early retirement, which is foreordained in any event.
- Despite the best technology and interventions of a health care industry that, if it were a country,
would be the fourth largest economy in the world, all patients will eventually die. This is a bold
prediction, but the evidence seems to point in that direction.
- Employer-based health insurance will disappear. As employees pass on rising health care costs to
employees and the ranks of the uninsured rise, the general public will realize they are paying for
an inequitable and inefficient tax subsidy. Businesses will learn to compete for good employees on
the basis of fulfilling work and a healthy workplace, not on tax subsidized freebies. It will
revolutionize the American economy.
- Women will become the majority in the ranks of physicians, administrators and even politicians.
This will change absolutely nothing, except the restrooms will be cleaner.
- Conservatives will get their way and institute free market reforms in health care like vouchers and
tax credits. One thousand mandates will be repealed, and two thousand new mandates will take their
place as interest groups line up to seek redress for market inequities. Bureaucracy and regulation
will expand exponentially, no matter who's in charge.
- Medical scientists will discover that there really is a mind, and it's separate from the body after
all. This will vindicate hundreds of carve out plans, which have long claimed the mind should be
treated and paid for separately.
- Starbucks will start to buy up hospitals and become the dominant player in ten years. Anyone who
can convince consumers that a small coffee is a tall coffee and worth $3 can easily persuade them to
sign up for high-margin elective surgical procedures they don't need.
- Allopathic providers will continue to be replaced by naturopaths and alternative medicine
providers. People will get sick and die sooner, thus alleviating pressure on Medicare. They'll feel
good about themselves, however, and that's the main thing.
- Legislators will solve the health safety net problem by making charity care illegal on the logic
that no one should get something for free that other people have to pay for.
- Americans will begin to notice that people who don't enter the health care system are healthier
than those who do. Their eminently sane conclusion: The health care system makes you sick, and should
be avoided. This will lower costs big time.
Dr. Contrarian apologizes to anyone he has inadvertently offended. For those who are really upset, he
advises them to get a life.
