Does it surprise you that the first Baby Boomers have been eligible for Medicare since 2011? Or that per capita healthcare costs for patients over 65 are three times higher than those patients under 65?
Or that, according to the CDC’s latest “State of Aging and Health in America” report, “two of three older Americans have multiple chronic conditions, and treatment for this population accounts for 66% of the country’s health care budget”?
It certainly surprises me, and it immediately brings to mind “Logan's Run,” the classic dystopian science fiction film and TV series about a future society in which everyone who reaches the age of thirty is euthanized in order to prevent overpopulation and conserve resources.
If we lived in that society, the looming healthcare crisis would be solved, right?
Instead, according to the Centers for Medicare & Medicaid Services, we live in a society where “U.S. health care spending grew 5.3 percent in 2014, reaching $3.0 trillion or $9,523 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.5 percent.”
Unchecked, it’s estimated that this could grow to 34 percent of GDP by 2040.
Those numbers don’t merely represent a dramatic shift from how things are going to how they’re going to be. They represent a dramatic shift in the very trajectory of U.S. healthcare spending.
Fortunately, with precision medicine, there’s now an equally dramatic shift underway in how we capture and utilize healthcare data, and with it comes a promise as encouraging as the Centers for Medicare & Medicaid Services’ note is daunting.
But today, your Facebook account alone might hold two terabytes of photographs and videos. Warehousing it, or even an entire genome, is all but child’s play now.
With software that can make sense of all of that data, we can now associate more types of data with a given healthcare record than ever before, like environmental (e.g., where a patient lives, the availability of healthy food in that area, the weather, etc.), wearables (e.g., physical and sleep activity metrics from Fitbits, etc.), social media, education, socio-economic, and more. We can cross-analyze this data and identify, for example, specific demographics that are at risk for a certain disease. Seventy years from now, children who were subject to the the Flint water crisis—a drinking water contamination issue in Flint, Michigan that began in 2014—will be senior citizens whose clinicians will take that then-decades-gone exposure into account when issuing treatments. Those senior citizens won’t even have to remember the crisis, let alone mention it.
If we lived in the society of “Logan’s Run,” we wouldn’t be incentivized to think about this—about how today’s children will be tomorrow’s senior citizens—and we wouldn’t feel any need to create the systems that will empower today’s and tomorrow’s patients to keep their low-cost, manageable conditions from flaring up into expensive, unmanageable ones.
Instead, we live in a society where enhanced, multimodal engagement of a patient is possible, and the notion of giving a patient a care plan specifically suited to all the known variables within their holistic patient record is ideal.
And with software that can actually ensure patients are following their care plan, we’re becoming a society that’s embracing proactive and preventative care as a best practice, not a nice-to-have. We can nudge patients through their mobile devices (e.g., “Jennifer, did you take your meds this morning?”) and even take the burden off of them to remember to pick up their prescriptions (e.g., a geo-tracking feature that alerts a patient that the drugstore they’re about to pass can refill a prescription that they’ll need to refill anyway in the next week).
If we lived in the society of “Logan’s Run,” we wouldn’t be incentivized to equip our people with the behavior-modification tools that virtually hack human nature and incentivize healthy activities through rewards.
Instead, we live in a society where a payer can recruit members within the payer’s system to participate in wellness programs that track positive behaviors through wearables (e.g., 10,000 steps taken in a day, three hours spent at a gym in a week, etc.) and reward those behaviors with anything from discounted rates to cash prizes paid out of the savings their employers realize through having healthier, more productive employees who enjoy lower healthcare premiums.
Because we don’t live in the world of “Logan’s Run”—because we’ve refused to turn our back on all but the youngest third of society—we have been prompted to seek out an approach that might solve the healthcare crisis anyway. And I believe that if we get the buy-in from all the key players—from payers to clinicians to patients—we’ll almost certainly find it.
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