Institute For The Future

PROVOKING THE FUTURE OF HEALTH: 48 micro-forecasts from the Blended Reality 2008 crowd-sourcing experiment

At our Fall 2008 Technology Horizons Conference, we crowd-sourced five questions (via Twitter, blogs, email, and SMS) about Blended Realities in 2019. Here are the massively collaborative health results!

Question #1: It’s 2019. What is your

experience of healthcare?<o:p></o:p>

<o:p></o:p>It’s 2019. What is your experience of healthcare?

That cough isn't going anywhere. I place a claim online with my Wellness Agent, an electronic hodgepodge of different personality traits and interface options meant to make it easy and comfortable for me to report illness. At times, my Wellness Agent is an automated email that diagnoses my problem with varying degrees of success. At times it's a real person, rarely in my city or even country. The Wellness Agent will sometimes recommend I see a doctor, never of my choosing unless I have opted for a MUCH more expensive plan, and will give me directions on how to reach this doctor. I'm often frustrated with my Wellness Agent as it doesn't seem to care about my cough. Thankfully, my employer pays for nearly all of my health costs and I'm always totally positive of the costs that will fall to me before I receive service. Those without insurance, I hear, wait days for service. Thankfully, there aren't very many of those people around in 2019. At least, not that I can tell.

mrjudkins: @avantgame Healthcare: Like so many I've become incredibly suspicious of profit-driven drug companies & try alternatives first. #2019

theineffabelle: #2019 Mobile Doc helps provide health care for all via doctor's appointments through video chat on cell phones. Efficient but impersonal.

emilicon: @avantgame I share my feelings via MRI-scan displays, there are businesses that now provide coaching on how to fake MRI patterns #2019

infrarad2019: #2019 Health care: random time sampling games on a massive scale thru mobiles gave us a practical chronobiology

jonaslamis: #2019 Heathcare: Havenots - Social healthcare. Even more reactive not proactive. Health tourism to India is popular among havenots.

jonaslamis: #2019 Heathcare: Haves - personal sensors monitoring health/early warning detection. Drugs designed for my DNA, non-invasive robo surgery.

senatorgrant: #2019 HEALTH I'll probably get a variety of opinions from providers i choose to share my data with, and then i'll get bids from a subset

It's 2019. I'm going for my first annual dentist's appointment. Most people without employer-based health insurance get theirs from the federal government, but for some reason dental is handled through the state. Whatever. Another card I need to keep track of. I had my annual physical last week, and it seems like the drugs are working and my cholesterol's down, so I'm feeling cheery on doctors today. The lines aren't any longer than they've always been, but there are primary care clinics on more corners than Starbucks and Fishy Joe's combined. I'll have to get a root canal though, which will actually cost me some money out of pocket. Ugh. Universal health care can be such a hassle.

I am no longer uninsured.  I have enough money to buy government subsidized health care through a government administrated corporation, which offers reasonable programs on a sliding scale.  I still never really go to the doctor though.  Anti-depressants and other mood-altering drugs become more and more mainstream, but avoid getting them myself.

pervasive data collection has made health care into a set of probability statements. No one knows why men of my age, history, genetics can expect 1.1 additional years from eating almonds but get only a -1% adjustment to Alzheimer's risk from fish oil, but that's what the Bayesian analysis says. We can't help but think wholistically now... When you answer the TwitteRx question (How are you feeling right now?) upon getting the random time sampling prompt, you don't answer on behalf of, say, your liver.

In 2014, my family decided to go for the embedded health monitoring chips, privacy be damned. My youngest had hers implanted at birth. There were some initial calibration problems, but now we're pretty confident about when a cold is just a cold... and our doctor's office calls us in if something threatening pops up. No more avoiding the dentist when the alternative is a blinking light 24/7. Still trying to find a way to hack that "feature."

The life expectancy of the ultra-wealthy has reached 100, and they enjoy the same level of care that the wealthy today get. For the rest of the people, insurance is too expensive. Free clinics and ER visits are the norm. To get any care, most people start lining up the night before in order to get one of the coveted spots in line. People frequently die in line.

mikekirkwood: @avantgame In 2019, sensors assist us in daily and basic tasks, like breathing, drinking, and eating. Doctors tie in to grid. #HIMSS #2019

In 2019, it would be nice if health issues were a thing of the past. Alas, we're more resource shy now than ever before. Water and food shortages have consumed much attention and funds, meaning fewer health practitioners, fewer advances in medicine (most notably antibiotics), and a deteriorating health infrastructure. Additionally, the cheapest, most readily available food is of the high calorie-low nutrient variety, exacerbating society-wide health problems. Emergency rooms? Hah, more or less a thing of the past. Overrun, they've been replaced by "community emergency centers," which, while typically offering increased access/treatment volume, are not prepared to handle severe situations. Only the wealthy can afford direct access to care in life-threatening situations.

Healthcare will be run primarily by the government, and will be much

cheaper, but it will still be driven by a desire to save money (due to

the need to pay down our deficit rather than profit on the part of

corporations).  I need to make a routine appointment, and I have to

wait a month.  I'm pregnant, and they expect me to be an outpatient

regardless of my condition.  Pharmaceutical companies, no longer

making as enormous profits as they do today, will simply re-cycle old

medications in new packages, or ask doctors to combine regimens in new

ways. Basically, I think healthcare will be pretty much the same as having

an HMO today, except it will be cheaper and the government will

administer it.  I don't know that we'll ever get to the European model

of single-payer healthcare, at least not by 2019.

Busy communities with an aging population. More older adult day care.

The price of more technology will mean less personal time with health

care folks. Everyone is trying to reinvent health care procedures that

have the same result. More gadgets that are not necessarily needed. More

government control, less consumer choices.

Pessimistic:

The decline of the US and its inability to escape privatized healthcare

means my choices are a) a rare job with insurance b) patronize one of

the thriving cheap black clinics that offer substandard service to the

poor c) become a medical tourist.

Ideal:

Socialized medicine in the US is finally taking hold, and new

biotechnologies means that diagnosis and treatment are both faster and

cheaper.

Busy communities with an aging population. More older adult day care.

The price of more technology will mean less personal time with health

care folks. Everyone is trying to reinvent health care procedures that

have the same result. More gadgets that are not necessarily needed. More

government control, less consumer choices.

Healthcare wouldn't affect me appreciably, since I already have health insurance, but I would hope a national health care system would have negotiated with doctors, hospitals and insurance companies to create a predictable and consistent rate scale for services and procedures. The benefit, hopefully, would be that those without health insurance now would be covered in the future as the cost of insurance would be brought down by a more sensible and standardized medical infrastructure.

everyone will receive an annual mandatory mega injection booster shot

for the flu/vitamin essentials/calcium/HPV/herpes and zero gravity

workout routines are going to be hitting their stride, even as the

majority of the population continues a downward slide into

diabetes-morbid obesity

Cryptic, Byzantine systems which disable both providers and recipients within the healthcare system.  

Though there might be some mild improvements on the administrative side of things, finding relevant doctors could be next to impossible since half of those in practice want to quit anyway. see: Many doctors plan to quit or cut back: survey Tues Nov 18 bit.ly/u9pI

Healthcare is outsourced -- all the best doctor's are in India and you better go there to get preventative care.

High cost of coverage, $150 copays, drug companies prescribing directly to consumers.

Nano robots in your blood stream that diagnose inside of you. And provide the right medication when you need it, even repairs tissue damage.

When I moved my family to Abu Dhabi for a 2 year consulting gig I was surprised at how effortless the transfer of all their medical records was -- we brought full history on a personal optical drive and had backups transferred via Google Health's free global relocation service.

My teenage son doesn't like to go to the doctor because he can't understand what the doctors say—English is their second language (usually they are Indian or Chinese) and every time he goes, it is a different doctor (they are all on short-term contract with US HealthCo, a private Healthcare provider formed and subsidized by the US government). To make matters worse, he often has to go office for several days just to get one visit with the doctor because his time slot keeps getting bumped due to all the elderly (the population of people over 70 is growing) who have complicated needs and longer visits.

3 hours of waiting, 30 seconds of face time.

Tort reform and widespread online education mean that most primary care can be done via phone to nursing call centers staffed in India and the Phillipines. In-person medical visits will be consolidated at fewer hospitals and will be for emergency or in-patient medical treatment only.

I've followed the growing trend of folks joining a private group; my doctor does house calls for the smallest cold and meets me at the hospital if the worst happens. He has all of my history saved down and he can pull it all up to share and consult with any surgeons, etc., that may need more info for a proper course of action. He and his small team help me navigate the broken healthcare system and ensure I'm fully educated.

This is 2019 we are talking about ppl, expand your visions ! :D

Nano robots reporting about your condition to your doctors / health providers. :)

I'm an optimist--we will have a streamlined and efficient universal healthcare system with the focus on education, prevention, and research.Call me crazy.

Karl, you're forgetting that people are scared of that Terminator shit. And it's 2019, not 2119. What was health care like 11 years ago? Not much different.

The nanobot revolt wars will have to come first anyway. They'll want rights as sentient beings eventually. Haven't you read *Prey* by the late, great Michael Crichton? May he rest in peace. We *might* have more ubiquitous remote operating/diagnostic rooms where machines actually do the cutting while the surgeons are in control rooms with virtual reality gloves and interfaces.

Healthcare is like a prostate exam.

Complicated, painful and expensive.

Freedom of choice has all but disintegrated and bureaucratized healthcare options are the norm. Under government management costs rise while quality comes down and doctors continue to bail out of the profession. Shortages of doctors under new less free working conditions result in the lowering of standards for healthcare professionals as there becomes some shortage in people willing to enter the profession.

At this point I move to the last vestige of a free society that has formed itself on old drilling stations off the cost of texas. Here we live a paradigm much like kevin costner's post apocalyptic water world. ;)

no human contact in healthcare, you email a question/problem or search on webmd then call a toll free number to talk to someone

I hope you and your flipper-babies will be happy and prosperous in your new aquatic home.

Hopefully it will be a good mix of nationalized healthcare and privately owned institutions. Each has its fallings. It sends chills down my spine thinking that there is a big chunk of the country which lacks healthcare because they cant afford insurance. On the other hand, I am assuming that in places with nationalized heathcare like Britain, Cuba and Canada, the queues are long and appointments difficult to come by. As long as the Indian accent is concerned...ahem.. get used to it people..its here to stay!

EMT certification has become a requirement of all undergraduate college degree programs.

I'm sure glad Barack Obama fixed this system just as I started needing it.

Deep under ground, under the Swiss alps, The Large Hadron Collider (LHC) the world's largest and highest-energy particle accelerator at CERN was turned on this fall. No one was sure what would happen when opposing beams of protons or lead ions were collided almost at the speed of light. December 12th, 2008 a crack in the collider was noticed around section 228 of the West bridge. A strange leak of green smoke was pouring out of the crack. As various scientist from around the globe came into investigate, people working at CERN became very ill. December 14th, 2008, the workers who had previously become sick had now turned into zombies. December 15th, 2008, the humans on earth have exactly 7 days left. The LHC had opened a gateway to another dimension of space, and through this gateway a strange sickness had wiped out the human race. December 22nd, through the gateway, a large race of alien monsters forced their way onto our planet, nothing could save the poor humans, not even health care.

It's 2019, and despite the environmental vicissitudes people are starting to live better. Preventative health care has finally taken off. Nationalized health plans subsidize gym memberships, but only if we actually go. We get tax credits for walking to work, or for biking as long as we follow reasonable safety precautions. Cars and many unhealthy foods are more expensive due to regulation and free markets that force companies to take on their formerly externalized environmental and societal costs. On the other hand, society is finally accepting death as a good and natural process. The baby boomer generation nearly crashed the health care system, but it forced us to realize that we can't afford to cover extensive end of life care and still provide good services to keep younger people healthy longer.

I keep track of my medical appointments, food lists, and social networks on a tiny screen implanted under my cornea -- a technique derived from the flip-back-the-eyeball-flap LASIK procedure. I see the screen projected as a large translucent overlay to my normal vision, a la Robocop and Terminator. Since thought-controlled computer technology is still restricted to DARPA labs and, according to investigative reports, to top-secret military missions, I still compose updates to those appointments etc. via various keyboards and touchpads embedded in my personal tech devices, clothes, and solid surfaces at home.

Now that we have downloaded all of our memories and minds into the great server and our bodies are now meaningless health care now revolves around keeping the server running and my profile free from viruses

Since health care was taken over by the government, everything is rationed for everyone except government employees.  You have to wait in line for hours to see a mediocre doctor.  You no longer get to choose your doctors. The only advantage is that all medical records are digitized. Unfortunately, not all doctors/hospitals use the same file structures so your information is not easily viewed by the different institutions.

I forsee the growth of death by choice.  Half of

America's medical costs are spent on the last six months of life, but

imagine if people diagnosed with terminal cancer at the age of 85

decided to check out a little early -- not right away, but around the

time their bodies really started going downhill.  Dignified and

frugal.