2019
Last year was a marvel of health advancements – precision medicine, 3D printing to tailor medical devices to the patient, scanning visor for stroke diagnosis, moving past open-heart surgery for valve replacement, tons of AI advances – the list goes on. It’s a big profitable market and as long as it stays that way, we will continue to see progress that blows our minds. Even as 2020 begins, AI is doing quite well diagnosing breast cancer.
But these are not the things I remember best. The things I remember best are the things that scared me. If I had to choose the top three, they would be these:
The measles outbreak. Measles was eradicated from the United States in 2000. But a wave of anti-vaccine sentiment, growing since a false 1998 study linking the vaccine to autism finally caught up with us. As a result, some states started curtailing parents’ options for not vaccinating their children. Getting the measles can be deadly with a strong immune system. For the rest of us, the 3% of vaccinated people and still aren’t immune seemed suddenly relevant.
ACA Lawsuit. Essentially, two federal courts, one in Texas and one in Louisiana, declared the Affordable Care Act (Obamacare) unconstitutional. The judges are not asking for any changes yet as the case heads toward the Supreme Court, but patients stand to lose a lot if this case is successful. Recently, SCOTUS has indicated that it may hear the case this year instead of next year, putting us out of our uncertainty misery.
On a slightly more positive note, I have no data on this, but it felt like we talked a lot more about mental health. Americans’ shrinking life expectancy finally made it into mainstream news, and it was time to start examining why. As it happens, a lot of us aren’t taking care of our mental health to the same degree we try to when it comes to our physical health.. People – famous and not – came forward with their stories. The more we talk, the less the stigma can flourish, and that can only be good.
2020
With the upcoming presidential election, healthcare policy is going to be front and center. But the industry may make some long overdue strides in the right direction, as well. There are so many things I want to happen, but if I had to choose the three I would most like to see:
As social determinants of health continue to gain traction at conferences and other industry gatherings, perhaps looking at us, their patients, as whole people as opposed to conditions with legs will help make greater gains in how our providers treat us.
The Supreme Court hears and rules on the ACA case. Hopefully they will protect the rights that came with it. And in the meantime, states continue to pass legislation that protects the rights outlined in the ACA.
Congress addresses surprise medical billing. The series by NPR and Kaiser Health News on the most egregious of surprise medical bills began raising awareness last year, and it finally filtered through to Congress. I suspect that the various plans to cut drug prices are hopelessly mired in partisanship and industry lobbyists and will have to wait until the next session to move forward. Legislation on surprise medical billing is my best hope for actual progress.
Looking back, we know what has happened for better worse. It’s hard to not focus on the worse. Looking forward, we don’t know what is going to happen, so it’s much easier to hope. To borrow a phrase from my father, we shall see what we shall see.