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Week 2: The future of healthcare

Discussion of the Week, on This Topic
Dan Halvorsen

Dan Halvorsen

Clinical Exercise Physiologist, Exercise Medecine Center & Adjunct Assistant Professor, Integrative Biology and Physiology, University of Minnesota,

What do you think will be the biggest changes in healthcare in the next 50 years? How or why will those changes come about? What impacts will those changes have on our lives?

Check out Dan's video:

Also, to get you thinking, check out Microsoft's "Future Vision: Healthcare" video, taken from the Mix08 presenation by Daniel Makowski:

In your response, consider:

  • Average life expectancy. Will it be more or less than it is now? Why?
  • The aging population. What might change if there are more people over 70 than under 20?
  • Currently, many rural communities have trouble attracting physicians to practice. Will this trend continue? Why or why not?
  • Climate change. Will it impact our health? How?
  • Political will to spend as much as we do, or more, on healthcare.
  • Technological advances.
  • Other influencing factors.
Student Commentator Responses:
Photo of Hannah O.

Hannah O.

I certainly hope that in the next 50 years we can come up with a way to make healthcare more affordable and accessable to everyone. The major issue today is making it affordable. I absolutely hope we can find a way to make sure everyone is able to get the health care they need regardless of the money they have.

Climate change will definitely affect the health of the population as well as the health of the environment. The release of certain chemicals into the air, such as sulphur and excess nitrogen have detrimental impacts to human health. Sulphur can lead to the degradation of the brain as well as cause problems for the nervous system. Other chemicals are contributors to respiration problems and also can lead to a rise in cancer cases.

The other issue I see becoming even worse is the exposure to chemicals we seem to feel are completely harmless yet have incredibly long lasting health effects. Rachel Carson wrote in her book Silent Spring about pesticides and herbicides being mass applied, but those weren't the only chemicals released into the environment. There are plenty more, but we havent seen all of the effects yet. I suspect in the next fifty years the effects of the other chemicals out there will really start to set in.

Politicians are working for the betterment of the people (in theory), and while they are quite aware of the economic aspect, I feel like the importance of well being and health in America (or the world for that matter) should really take precedence.

Technology is really and truly amazing in that with every coming day there are new discoveries and breakthroughs in the medical technology. Whether the technology in detecting issues improves or the technology to start to fix health issues improves either way I can only see the technology being a benefit as we find new and more efficient ways to treat and diagnose diseases.

You would think with all the break throughs in technology and the medical field in general, the life expectancy would be a sure shot to improve, however, until the other problems are fixed, I can't see it going anywhere but down. In fifty years, if the environmental issues aren't addressed, I can't honestly see people living to their 70's.

Photo of Ann D.

Ann D.

Hannah, I certainly agree with some of your statements about the issues that could come up in relation to things like climate change and pollution.

For the first time in a while (or so I've heard) some people are predicting that the life expectancy has started to go down. It going down doesn't necessarily effect our transportation needs, so much as why it is going down. People are getting illnesses due to lifestyle choices and the more health issues they have, the more treatment they need and the more they need to personally go in and consult a physician.

Technological advances definitely do need to be considered too. I think we can expect a lot more at home, and self tests and remedies. I think technology will also change the kinds of illnesses. We may not be exposed to as many bacterial illnesses if we stay more confined to our homes. So then we are looking at a whole knew set of treatments for different problems, that even if we try to prepare for, we may encounter many challenges.

Pressure from citizens will probably encourage more government funding/ money to go into healthcare. I think political changes would actually be one of our smallest concerns. The government will change to please as many citizens as they can, whether it is for personal benefit and/ or the personal benefit of the country.

Photo of Louise E.

Louise E.

I agree with Hannah that affordability and accessibility of health care is one of the most pressing issues for the future. I feel that health care in general has become more about making money as businesses and less about taking care of patients. Companies try to sell you medications through advertisements on TV/websites. and doctors can only meet with patients for 15 min. because they have to get through so many patients in a day. Also, the only solution that conventional doctors seem to have to anything is to administer pills. Although alternative medicine practices such as acupuncture, herbal medications or shiatsu may not work miracles, they can definitely be effective in relieving pain, fighting depression etc. A healthcare approach that would allow for more flexibility in methods and types of medication would be more effective because patients would be able to explore different options and find what worked for them.

This idea also ties into having a more personalized healthcare system where treatments could be prescribed more based on lifestyle rather than weight/gender/age (although this is still important). Also, personalized healthcare would create a stronger relationship between the doctors and patients. Increased communication between patients and doctors would result in fewer errors in prescriptions, and less misunderstandings. I can see how having communication with doctors via the internet and technology could be helpful especially for elderly people who are house bound. Also, it could allow patients access to opinions of multiple doctors easily, avoiding having to schedule multiple appointments. However, I don’t think appointments via technology could ever completely replace in person visits. Using technology regularly to communicate medical information would pose issues concerning privacy of medical records as well.

I liked Halvorsen’s ideas on increasing walking and biking as modes of transportation in order to reduce obesity. With school budget cuts, many physical education classes have been cut back/eliminated, adding to the increase of obesity in children. Also, another issue that connects healthcare and transportation is the transportation of elderly and the disabled. I recently read an article in the Star Tribune that briefly touched on this subject: http://www.startribune.com/politics/statelocal/120428474.html (article found here)

Photo of Joey L.

Joey L.

Life expectancy is probably going to see a decline in the next 50 years, due to the ongoing rise in obesity. A lot of this rise has to do with the rise in technological development, from the Playstation to the television, and with diet. Kids these days have little time for exercising or caring about what they eat. As shown in Supersize Me, most kindergardners know who Ronald McDonald is before they know who George Washington is. While that experiment may be extreme, there are people, even kids who eat nothing but fast food. Also, as kids (and adults too, but I'm just referring to our own and to future generations) spend more time in sedentary activities. One thing that restrains people actually getting to healthy foods is the so-called "food deserts". What this means is that in a developed area (Chicago is one example) it has become hard to get healthy, affordable food. So what this does is open a doorway for cheaper, non-nutrious food to get new buyers, people who are reliant on what they can get from this source, regardless of the healthiness of said sources (FAST FOOD).

Climate change impacting our health is another issue. If you've been hit by the recent string of tornadoes in the South, you know this for a fact! But seriously, shrinking ozone and air pollution in large cities is leading to damage to your skin, lungs and other parts of your body. Smog, for instance, is a makeup of air pollutants and fog that hangs around cities. Los Angeles has a lot of smog. What it does, beside weaken building supports and rust metal, is damage the lungs of younger and elderly people. There have been studies that link smog exposure to asthma development in younger people. It would not surprise me that as more pollutants are released into the air, more and more damaging conditions to humans will soon be observed, if they haven't been already.

Photo of Nafiso Mahad

Nafiso Mahad

Health care is one of the biggest conflicts people deal with?Health care effects our everyday lives. , I believe that in the near future the governement will more or less provide coverage to millions of uninsured citizens. But the way to get it will probably be hard. There would probably be large amounts of taxes because if this. The technology will increase and so will the medicine. There would be less interactiveness betwwen the doctors and the patients. It seems as though, technology always decreases our social skills. MONEY-will be the underlying reason for treating patients. Therefore, causing doubt within patients, I also believe that medicine will be less trusted. Doctors will become too advanced to a point where natural remedies are considered by the patients.

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Jack, I loved that video link. Thanks for sharing! Interesting that this vision for the future doesn't revolve aorund inventing something new, it's connecting what's already there and patient-focused.

If this vision were applied to transportation, what do you think it would look like?

    Minnesota design consultancy firm Worrell created this short film which features a novel approach to healthcare stakeholder engagement and a conceptual patient centric technology, holding the possibility of transforming the delivery of healthcare.

    Check it out, it does a great job of articulating both concerns and solutions.

    http://www.youtube.com/watch?v=twhomDhjWAY

      To add on to Louise, efforts for government regulations have been rejected regardless because these companies prioritize their business over the general welfare. For an example, why don't we rid of Taco Bells? Eating a taco or burrito gives you a hearty amount of uneccesary calories, high blood pressure, and a lot of grease. Indeed, if these regulations were set in stone I think not as many people would be obese and with horrible eating habits! But I think not only does our food intake have something to do with obesity, but our habits of staying inside and not partaking in an active sport or organization. 

      And wow, to Lindsey's post! I think the only problem left is if patients are comfortable with it. But couldn't there be more room for flaws and miscalcuations if virtually and not in person?

      If there's technology like this now, then this could possibly lead to getting doctors not only from home but anywhere. What about iPads or computers? I think the Internet would become a vital factor in this, and since the internet is being used so much, another thing made easier for patients would be seeing the doctor's schedule. On sites like Facebook, a patient could check on a doctor's schedule or send them a private message and make their own appointments online. 

        Re: the virtual doctor... I came across this in this month's Fast Company... check it out! It's a new telemedicine initiative where doctor's can diagnose without being in the same room.

        http://www.fastcompany.com/magazine/155/the-virtual-doctor-will-see-you-now.html

        This gets right to what many of you have been saying AND it gets to cost and access issues too! What do you all think of this?

          I think having home visits by doctors is a great system especially for the elderly, disabled and young children.  People who have trouble getting out of the house could have more frequent access to health care and wouldn’t wait until symptoms got worse to go to a doctor’s appointment. 

          As Liz mentioned, many countries have lower obesity rates than the US.  I think this is also due to healthier diets and eating patterns.  I also have visited China and the food is so much healthier and more balanced than are everyday meals in the US.  (I can no longer stand eating Americanized Chinese food.)  I think companies who manufacture cheap, unhealthy food have a lot to do with America’s obesity crisis.  Perhaps if there was government regulation on how much fat, sugar, preservatives etc. could be added to foods, then the America’s obesity epidemic would be eliminated.

           

            Hannah - It hasn't become that everyone has an opinion. Its that almost everyone has a willingly uninformed opinion about topics.

            Back off politics and on topic, something that is interesting is that Wal-Mart is working to make organic produce available at an affordable price. Because Wal-Mart is the world's largest retailer this could help organic farms by providing them with a major outlet, and help poorer people have access to organic produce. I used to think Wal-Mart was a really awful place but they have made several changes that are impacting the world in a positive place by reducing their carbon foot print and helping to make healthy food more affordable to different people.

              Liz -- You have a knack for making me think! On the online doctor thing, how would he feel if my glands are swollen? Or take my weight? Or take samples to send to the lab?

                Kim - Hmm, the image of a doctor is seeming to change. What about online visits from the doctor? There are probably also video-calling conferences that makes a doctor's schedule less hectic and save a trip to their house. 

                Over the next 10 years or so, a third of current physicians will retire, and the physician deficit will increase from 7,000 to over 100,000 with shortages in all specialties. Could this shift possibly force nurses to "revamp" the way they're educated so that they have a bigger role in the future of healthcare? (What about adding artificial intelligence? Have bots transporting things on an outlined map of the hospital so nurses won't have as much of a load?) 

                They're also incorporating a "targeted approach to treatment" where tests show what type of 'personalized medicine' a person will need. Also, if there were a bigger investment on medical research (such as Alzehmer's), there'd be more savings to government programs like Medicare and Medicaid.

                  Joey-- I definitely found the irony in the Chipotle McDonalds connection, but I guess, the steps Chipotle has taken still seemed like something interesting to think about. I think one of the major issues in relation to Organic farming and the cost has a lot to do with the locality.. if the organic farms are far away.. the cost to transport is much higher.

                  And, to be honest, I think no matter what approach was being taking to the "Let's Move" campaign.. she'd be getting criticized. That's just society today.. and politics. Everyone has an opinion and no matter what the leaders in poitics do, there's going to be opposition.

                  And thanks for the recommendation! I'm excited to look into the book =]

                   

                  Liz-- I loved your idea about mandating a carpooling system.. if not for everyday, at least pushing towards a bit more efficiency.. Certainly cutting down the number of cars on the road will cut down the number of respiratory issues related to carbon emissions from cars.

                    I can't help but see overlaps with what we're discussing over in the "achievement" project this week, particularly on the subject of obesity.

                    Liz you pointed out China lining students up for exercise -- that is an example of a high regulation approach. Ending adolescence (the subject of the achievement dialogue this week) might be another extreme -- a low regulation approach. One has to wonder what might happen with the low regulation approach -- maybe teens would have more time to exercise, maybe teens would have more incentive to exercise, maybe obesity rates would drop as well as other teen health issues because "teen turmoil" (depression, drug use, etc.) would diminish. [If you haven't been over to the other discussion, Dr. Epstein cites evidence that the turmoil simply doesn't exist in non-Western cultures where "adolescence" isn't a recognized life phase.]  As teens become adults, more impacts might ensue...

                    ***

                    When I first heard the question I also had the immediate thought of doctors going to people. Already there are homes in my area that have small businesses to care for aging patients. Between those and people working and learning from home, house calls just might become profitable (and maybe even help prevent disease spread)?

                    Thoughts?

                     

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