Health Care

by Roger Bourke White Jr., copyright September 2017


Health care is undergoing lots of changes in the 2010's. The changing is going to continue and likely get even more dramatic. By the 2050's things are going to be very different.

What will stay the same is that lots of ritual will be mixed in with the science and technology solutions. The rituals are there because they make people comfortable and sleep better at night.

This essay is about how technology and ritual will be mixing in the 2050's.

Adding technology to ritual

Health care dates back to prehistoric times. Helping fix a broken bone, helping a person eat and sleep while suffering from a recoverable disease, helping a young mother give birth, all these benefited the tribe living in Stone Age times. The tribe survived better. These Stone Age conditions lasted for thousands of generations, and these caring successes changed human instinctive thinking to embrace these activities. This is the source of the emotion supporting health care rituals.

Fast forward to the Industrial Age and the emergence of science, technology and scientific thinking. These started mixing with health care -- plaster casts, aspirin, and forceps helping a child down the birth canal are early examples.

As health care science and technology improved two big questions emerged:

o What really works and what is pseudoscience quackery?

o How to mix these new science-based methods with traditional rituals?

These are on-going questions that we still face in big ways in the 2010's.

Envisioning the 2050's

Some of the high-profile differences between medical technology in the 2010's and 2050's are going to be: artificial intelligence, pervasive surveillance and wearables that can modify body chemistry as well as monitor it.

But while there is going to be lots more science and technology in the health care mix, the rituals aren't going to go away -- they are still going to have a big effect on how health care is delivered.

There will still be instinctive demand for a lot of ritual -- "demand" in the "consumer demand for a product" sense. So, even if the combination of wearables and pervasive surveillance can bring "fast fixy" to people, they will still want rituals of many kinds entwined in the health process, such as visiting doctors for health advice. The rituals will be nutty when looked at from a cool-headed analytical perspective, but many health care participants will want them and think they are both very important and comforting. The rituals will help them sleep better at night... even though wearables will be doing that for them even better.

Ambitious and necessity health care

The ambitious and necessity communities are going to have different health care environments. Both are going to get the basics, and the basics are going to be real good compared to what is available at all levels in the 2010's. In this basic care arena much will be the same for both groups.

The biggest difference in overall health care is that ambitious people will have luxury money to devote to adding to what they get in the way of health care. Most of this difference will be devoted to cosmetic and performance effects -- luxury folks are going to look better and move through life better than necessity folks.

Another difference is risk-taking: How much risk can a patient accept when undergoing a treatment? Ambitious folk will be able to accept more risk.

Still lots of ritual

There is still going to be lots and lots of ritual mixed in to health care. These days this tendency to ritualize shows up both in how patients and health care people treat each other and in how health care is paid for. The government regulations and health insurance practices are both just nuts -- both are held deeply hostage to The Curse of Being Important.


Editorial: Embracing "Patient Pays"

How we pay for health care these days is just nutty. It is nutty in so many ways, and the alternatives that are emotionally embraced by lots of people in the community are even nuttier.

One alternative that I embrace is much simpler and more rational. I call it the "patient pays" system. Basically, people are given health care vouchers and they submit those to pay for treatments that they (the patient) choose to have. The patients choose, not the insurance companies or the government. This system would be lots less expensive (because of improved competition) and either more rational or better customized to what makes the patient feel good. This will be the patient's choice: If a patient feels better with a witch doctor performing rituals, why not? There is plenty of cheap technology also available to take care of the science-oriented issues that are causing the ailment.

In this system the important issue, in terms of choices made, is what makes the patient feel good.


Ritual shows up in many other areas of providing health care -- think of the routines when visiting your doctor's office. The hard question to answer is: How much should these rituals be tolerated? Especially those that are expensive, exclude using effective technology, and are prescribed by on-lookers, not the patients themselves?


Health care in the 2050's is going to have a lot more technology mixed in. These will include better health care devices, artificial intelligence and pervasive surveillance monitoring. The result is going to be a health care environment that is much more effective than that offered in even the best 2010's environments.

There will be differences in what people are provided. Those who have luxury money to devote to health care will be able to get things beyond the basics.

There is still going to be lots of ritual mixed in. These rituals are going to look silly to some people, but they are going to make others feel more comfortable and able to sleep better at night. This is why they will persist.

All-in-all, it is going to be quite a different health care world.



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