I outlined the future of healthcare delivery as characterized by one of a crisis of expectations. The prognosis was dire, but there is a more positive scenario, one that will require new levels of political will, accountability, tough decisions and collaborative hard work on everyone’s part. Healthcare providers will need to more effectively expand their current focus on episodic, acute care to encompass the enhanced management of chronic diseases and the life-long prediction and prevention of illness and they will need to set aside their own biases. Providers must play a key role to help consumers remain healthy and extract greater value from the healthcare system. They must also assist care delivery organizations and clinicians in delivering higher value healthcare. Consumers will need to assume greater personal responsibility for their health and for maximizing the value they receive from a transformed healthcare system. Suppliers will need to work collaboratively with care delivery organizations, clinicians and patients to produce products that improve outcomes or provide equivalent outcomes at lower costs.
We need to make realistic, rational decisions regarding lifestyle expectations, acceptable behaviors, and how much healthcare will be a societal right and what will be delivered as a market service. This discussion needs to extend beyond the limited and often staged arguments that currently characterize discussions of healthcare responsibilities. A radical rethinking of the healthcare accountability structure including appropriate authorities and responsibilities is long overdue. Finally, governments must address the unsustainability of the current system by providing the leadership and political will power needed to remove obstacles, encourage innovation and guide society to sustainable solutions.