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Dr. Contrarian's Fabulous Future of American Health Care

We are thrilled beyond words to share with our readers Dr. Contrarian's fabulous future of American health care.

Dr. C, whose mantra is "think otherwise," scorns the mealy-mouth prognostications of linear forecasters and apologists for the status quo who can't see beyond their next paycheck and organizational flow chart. Mired in the cement of fixed belief, they deny themselves the joy of sifting through the hallucinations of the unfettered imagination.

Dire predictions of physician shortages, stratospheric health care costs, the demise of Medicare, not enough hospital beds? BOR-RING! Dr. C conjures up a forecast with real cajones. Share these pearls with your friends who work in the healthcare industry and watch them come unglued.

1. We will need fewer, not more, physicians in the future.Today's nurses are tomorrow's physicians, today's physicians are tomorrow's technocratic managers. Medical schools will be subsumed under schools of business and engineering; routine care will be provided online in ever more elaborate scripted conversations informed by home-based monitoring. Electric companies, banks and supermarts will become providers of choice. Say goodbye to primary care as you know it.
   
   
2. All health care will be standardized in replicable algorithms of practice. This will proceed under the fiction of 'personalized' medicine, which is a marketing ploy to sell you ever more health products and services. These algorithms will be delivered via software (big pharma, big genetics) and robotics. Eventually, we'll all just sit at home hooked up to our virtual personalized worlds of optimum health. Our main activity will be checking to see if we still have a temperature.
   
   
3. Children born into this fabulous future will undergo a battery of tests at birth that will provide irrefutable evidence of a multitude of deficits. They will need a lifetime of professional services and products to get well. Economic development, indeed.
   
   
4. Medical researchers, no doubt working on government money, will finally locate the conscience, which is a small organ sandwiched between the memory and moral recall. A smart surgeon from China will perfect a technique to remove it, thereby earning him the Nobel Prize for Peace. His fame will be short-lived, however, because the conscience is destined to wither away from lack of use.
   
   
5. We will finally discover a cure for cancer. Millions will be saved. Millions of medical researchers will be out of work, however, and the government will institute a cancer research worker subsidy program that will make agricultural subsidies look like a budget rounding error.
   
   
6. Pharmacists will be obsolete in 20 years. All meds will be distributed through ATM- and soft drink-like dispensers, accessible with your own medical smart card. Think Dr. C. is making this up? These machines are in use today.
   
   
7. Free market advocates will see their dream of complete information transparency between buyer and seller in the health care market come true. Consumers will be so shocked by the waste, price fixing, exorbitant salaries, inexplicable variation in quality and Kafka-esque armies of middlemen that they will rise up against the excesses of capitalism in health care and usher in a single-payer, highly regulated system that will turn out to be relatively efficient, effective and benign compared to market alternatives. In time, single-payer insurance will become bloated, over-regulated and inefficient, and the free market will rise phoenix-like from the ashes of public policy. And so on, in an endless cycle.
   
   
8. After years of exhaustive research, we will discover that personal health care costs can be reduced by staying out of the health care system. This novel insight will usher in the golden age of wellness. Smart hospital managers, seeing the writing on the wall, will try to get out of the acute bed business and into wellness - but Wal-Mart and other businesses will beat them to it.
   
   
9. Through the miracles of science, we will learn to reverse engineer a human being, and eventually life itself. This will result in a process whereby humans will be born old and grow young. The social ramifications will be profound: Medicare for the 0-20 crowd and Head Start for the geriatric set. We will go to school from 100 to 80, be in the workforce from 80 to 20, and retire from 20 to O. Come to think of it, we're already there.
   
   
10. Contrary to medical progress elsewhere, researchers will not succeed in finding a remedy for enlarged prostates in aging males and multiple trips to the bathroom during the night. Ditto for lower back pain. Suck it up, boys.
    

Dr. Contrarian is capable of holding several conflicting ideas at once. Readers might see why we keep him on a short leash.

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*The Drift reflects the views of the author, and does not represent the official view of SLHI's Board of Trustees and staff.