The most recent AMA Executive Summary, “Health in the United States: Health Care Trends,” contains both a little hope and a lot of gloom.
population trends
By 2050, the population over 65 will double from today to 83.7 million. This means that the prevalence of chronic diseases will increase dramatically. Since 1990, smoking has fallen from 29.5% to 18.1% of the adult population. Probably as a result, strokes have decreased by 34%, heart disease by 27% and cancer by 17%. That sounds good, but…
Fat and sluggish
Since 1990, the adult obesity rate (defined as BMI over 30) has increased from 12% to 29.6%. During the same time, diabetes increased from 4.4% to 10% of all adults. Not old adults, all adults. The CDC predicts that thirty percent of adults will have diabetes by 2050. As a result, obesity is the leading cause of heart attacks today. Physical inactivity is a major reason. Only 21% of adults get the 150 minutes of weekly exercise recommended by the US Department of Health and Human Services. My observation is that most don’t get any exercise. Many employers now offer wellness programs that financially reward healthy behavior. That could be a big step in the right direction. Of course, there could also be penalties denying health insurance to the morbidly obese or uncontrolled diabetics, especially if the federal government relinquishes the health insurance business to private companies.
Is there a doctor in the zip code?
The AMA reports that GPs are closing their practices and either retiring early or moving into non-clinical fields such as insurance, quality management, pharmaceuticals, or even medical informatics. As the demand for healthcare services will increase dramatically, an increasing percentage of primary care will be provided by PAs and Nurse Practitioners. I assume that they will become increasingly independent. This is not necessarily a bad thing, many of these caregivers are excellent and provide compassionate and comprehensive care. A possible by-product of this trend may be an increasing demand for referrals and subspecialty care, such as B. the referral of diabetics to endocrinologists and COPD patients to lung specialists.
Take responsibility or someone else will
A dystopian future looms, in which the cost of medical care is greater than our resources can handle. In this rather appalling situation, someone must be denied services, likely either the powerless or those who refuse to accept mandatory health guidelines. It hasn’t come that far yet. We still have time to make the recommended diet and activity changes. Think about it, who could have predicted that everyone would quit smoking?
Thanks to Scott W Younkin
