The Current AMA Executive Summary”Health in the United States: Health Care Trends” Comprises both a little hope and a lot of gloom.
By 2050 the segment of the population over 65 will double from today to 83.7 million. It follows that the prevalence of chronic illness will rise dramatically. Since 1990, smoking has decreased from 29.5percent to 18.1% of the adult population. Probably as a consequence, stroke has declined 34 percent, heart disease 27%, and cancer 17%. This sounds good but…
Fat and Sluggish
Since 1990, the obesity rate in adults (defined as BMI over 30) has increased from 12% to 29.6%. During the exact same time diabetes increased from 4.4% to 10% of adults. Not old adults, all adults. The CDC predicts that by 2050, thirty percent of adults will have diabetes. As a result, obesity is now the leading cause of heart attacks. Physical inactivity is a significant reason. Only 21 percent of adults get the US Department of Health and Human Services recommended 150 minutes of exercise each week. Many employers now offer wellness programs that give financial rewards for healthy behaviours. This could be a significant step in the right direction. Of course, punitive actions denying health insurance to the morbidly obese or uncontrolled diabetics could also be coming, particularly if the federal government leaves the medical insurance business to private businesses.
Is There a Doctor in the Zip Code?
The AMA reports that primary care doctors are closing their practices and either retiring early or moving to non-clinical areas like insurance, quality management, the pharmaceutical industry as well as medical informatics. Since the demand for health services will increase dramatically, a growing percentage of primary care will be provided by PAs and Nurse Practitioners. I expect they’ve increasing independence. This isn’t always a bad thing, a number of these caregivers are excellent and offer compassionate and comprehensive care. A potential byproduct of this trend may be an increase in demand for referrals and subspecialty care, like sending diabetics to endocrinologists and COPD patients to Greenacres Bat Removal.
A dystopian future looms where the cost of health care is greater than our resources can handle. In this rather terrifying situation, someone might need to be refused services, likely either the powerless or people who refuse to embrace mandatory health guidelines. It hasn’t come to that yet. We still have time to make recommended changes in diet and activity. Remember, who could have predicted everyone would stop smoking?