The Future of Healthcare: Innovations and Challenges Ahead
By Wilde Carmen
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The Future of Healthcare - Wilde Carmen
1
Introduction
This paper discusses the future of healthcare. In contrast to the many studies which have examined the technological potential for innovation in medicine, we will present a case for expecting less technical innovation and change in healthcare in the future. We point out that although the technology is in place for dramatic change, the healthcare industry is structured in such a way that the incentives for realizing these gains are very limited.
Prior to proceeding with the analysis, it is important to make several methodological statements. It is first important to emphasize that our analysis is based upon US healthcare. At present, the structure and operation of other countries' healthcare systems are different from those of the US, such that it is not clear that we would expect similar results in healthcare markets outside of the United States. Second, we stress that our focus is on healthcare as an industry and not the merits and demerits of healthcare as a public or social good. While we recognize the importance of healthcare as a public good, we do not address or analyze public issues in healthcare. Such an analysis is treated separately. Third, in discussing the prospects for technical change and innovation, we have focused on the delivery system and not on product or process innovation.
1.1. Purpose and Scope of the Study
The second system will not be full-service,
but it will be concerned with health. It will promote health. Its aim is to provide care for people who do not need comprehensive services, or who for reasons of convenience, economy, or both, and desire reduced service. It appears that a large part of contemporary discussion about improved healthcare delivery is occupied with urgent attempts to contain costs. The challenge is to contain costs without further eroding the health rights of a great many Americans. Whether we can meet this challenge with our present healthcare arrangements is a matter of grave doubt; it depends on whether that future of health care and that second class system can be made attractive enough to encourage many more people to join than we now find so attracted. The scope of this serious enterprise is vast. I propose a rather prosaic design for the nature of that second-class system, dare to suggest that many new services others have considered exotic could be slipped into the mainstream health care system of the future without causing a hiccup. I should add that what you are about to hear is heavily populated with the personal opinions of a distinguished physician; to the text of whom I have shown a courtesy write as has been extended to