What is happening in medicine? How will these changes affect our patients? How will they affect how we deliver health care? These seem to be the questions asked most often amongst physicians across the country. I do not profess to have a crystal ball nor can I state with any certainty what the profession we chose to dedicate our lives to will look like in the near future. However, there is one thing I can say with 100 percent confidence. The world we practice medicine in today will look vastly different in the next few years. Change is here, and it will continue to be forced upon us all at breakneck speed.
Let us look at some facts. According to the Center for Medicare & Medicaid Services (CMS) and the Bureau of Census, as of 2014, health care spending in the United States topped 3.0 trillion dollars or approximately $9,523 per person per year. We spend more than any other country on health care per capita. We spend two times as much as Switzerland, which has the second highest per capita health care cost. In terms of economic output, health care spending now makes up 17.5 percent of the entire nation’s gross domestic product (GDP) in that same year. The United States spends more than any other country per capita on health care; yet according to some estimates, we still have 50 million people without basic health coverage. The National Health Expenditures (NHE) per capita has increased at a faster rate than the consumer price index (CPI) for every year since 1980.
It is also a well-accepted fact, that more health care resources are needed as a person ages. If we take the demographic changes occurring in the United States into account, the funding for health care services takes on a more desperate tone. In 1950, the U.S. population of 65 years of age and older was 8.1 percent. This number is expected to increase to over 20 percent, or 1 in every 5 people, by the year 2050. Let’s look at another way. In 1953, there were 14 workers actively supporting the Part A payroll tax for every Medicare dependent. In 2010 the dependency ratio was 3.6 to 1 and by 2030 it is expected to be 2.3 to 1 workers per Medicare dependent.
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