Medical Device Daily

ATLANTA — The final day of the first National Health Promotion Conference sponsored by the Centers for Disease Control and Prevention (CDC; Atlanta) had futurist Andrew Zolli painting a view of the healthcare needs that the U.S. will be facing by 2050 as very different, with healthcare delivered differently than today.

Zolli — futurist-in-residence at Popular Science and American Demographics magazines, corporate consultant, and a fellow at the National Geographic Society (Washington) — said that tools and approaches are changing so rapidly that it is essentially unsettling to some individuals.

Especially unsettling, he said, will be the rising costs of innovation, most directly seen in healthcare.

“We spend one-sixth of our economy on healthcare,” Zolli said, noting that in 2005 the cost of healthcare rose 7.4%, compared to income growth of 3.8%. “It increases the price gulf between what we can do vs. what we can afford to do,” he said, and nobody knows that more than providers of high-tech healthcare.

Population changes spread out over the globe will also affect global politics and business dynamics. For example, in time, there will be 20% fewer people living in Europe, and 24% fewer people living in Russia. On the other hand, a country such as Morocco is already seeing the results of progressive healthcare policies put in place in the 70s, and now 70% of its population is under age 30.

In the U.S., “we are headed toward an hourglass” in age distribution for the first time ever in our country, whereby there are both more seniors and younger people than there are middle-range wage earners to pay for all the services they will need.

The growing number of older individuals tends to be more conservative and vote conservatively, Zolli said, while consumer companies want to market to the expanding numbers of those who grew up under the influence of pop songstress Britney Spears.

“Very small changes have enormous impact,” he said, and the hourglass paradigm is likely to lead to more “intergenerational conflict.”

Also, more people are going to be outliving there retirement savings or income, even when at the same time they want a high quality of healthcare services and there are more and more drugs targeted to this age group, Zolli said. MetLife, a large insurer, for example, is now selling policies for individuals who outlive their means and end up with no money for necessities, he noted.

As another example, Zolli asked any female born after 1971 to stand up in the audience. He then informed this sizable group that they would end up taking care of their mothers in the future longer than their mothers took care of them. Add perhaps even a mother-in-law living under this roof, and he said, the “family dynamics” – and perhaps more importantly, the family expenses – are definitely in for significant pressure.

“The fastest growing segments of our society for the next 10 years will be 'Married with Parents' and 'Married with No Children,' the latter the result of the difficulty of affording children while caring for older parents.

That, in turn, will “change the economics of health,” Zolli said, adding later, “You can't run an hourglass society for too long without outsourcing” because there won't be enough people to produce all the products and services we as a society want to consume.

Turning to new electronic technologies, he said that people will be using the Internet to 'leverage social networks” to achieve better health as a consumer.

Zolli gave the example of one message board on the Internet concerning an antidepressant. One initial posting by one person about that particular antidepressant, and the negative side effects he was experiencing from the drug, led to five responses all agreeing with him. There were then 161 secondary responses. All of that involved 41 patients, 54 family members and 21 doctors, resulting in the availability of 64 online resources, 11 prescription changes and four changes in physicians.

“That's what modern, consumer-led healthcare looks like,” he said, adding that this represents “the connectivity between people” that exists today, driven by new technology.

And while families may not be living together happily ever after in the homes of the future, there will be more “self-care” – an idea Zolli says “we haven't even begun to tap” and more dependency on family members in the home setting. (Parenthetically, he predicted an increasing Asian influence on the concept of healthcare, with more of an integrated family approach and Asian ideas of therapy.)

There are now an enormous number of monitoring systems being developed for care in the home, he said, showing the audience on two large screens a photo of a special toilet that can monitor a person's glucose level or any number of drug dosage effects through urine.

Another example he cited is the use of microchips for self-care, the chips sending an e-mail to a patient in the home if he or she forgets to take medication, in addition to RFID technology that will be used to track drugs through the manufacturing and delivery pipelines.

The “core mission” for institutions like the CDC will be to “find key inflection points” in such trends, he said, and a huge part of healthcare delivery in the future will the requirement to “learn how to leverage communication networks.”

Networks, he said, will become the “source for finding innovation.”