The U.S. spends nearly twice asc muh on medical care compared to other high-income countries, yet does not yield better health outcomes. By 2020, fully one-fifth of U.S. gross domestic product will be spent on health, but there’s little confidence that the increase in cost will be matched with patient outcomes. Can we break this cycle of high spending and flat results?
No surprise that a growing number of major U.S. tech companies think this is the ideal moment for disruption. The increased involvement in the health sector by Amazon, Apple, Google and others, some in partnership with other major U.S. non-health companies, foreshadows what could be a remarkable era of innovation in the health sector. As detailed in A.T. Kearney’s new report, America is at the center of a confluence of technologies that are converging to transform our approach to human medicine.
Breakthroughs in the life sciences are accelerating, especially in genomics. The cost of gene sequencing has fallen exponentially, driven by improvements in processing, data storage, and sensors. In gene editing, the development of CRISPR-Cas9 continues to redefine medicine and biotechnology. This “cut and paste” tool for DNA can easily and inexpensively delete, repair or replace genes with precision, creating unprecedented opportunities to alter the human genetic code and cure diseases.
Personalized medicine, allowing for custom treatment based on a patient’s DNA, is also rapidly advancing. In 2015, personalized medicinesaccounted for 42 percent of all drugs in development and 73 percent of cancer drugs. Precision treatment leverages diagnostic tests, as well as a patient’s personal and family health histories, to discern optimal treatment for the individual. Alongside the development of faster diagnostic tests such as liquid biopsy, medical providers will be able to make rapid treatment adjustments and provide better outcomes, with potential significant reductions in treatment.
A new wave of digital medical technology is also emerging. Remote connectivity, “internet of things” devices, virtual and augmented reality, artificial intelligence, robotics and 3D printing are just a few of the new technologies that are transforming provider capabilities, as well as patient experience and outcomes. The proliferation of electronic health records and new health data sources such as wearables is creating new troves of health data.
This will fuel machine learning, pairing with advances in artificial intelligence and delivering new diagnostic insights and predictive approaches to managing health. IBM CEO Ginny Rometty has claimed that Watson, the company’s proprietary AI, will soon “be able to address, diagnose, and treat 80 percent of what causes 80 percent of the cancers in the world.” As machine learning accelerates, and with the unprecedented power of quantum computing on the horizon, it is likely that these numbers will improve further.
All of these developments in health technology will ultimately benefit patients and have the potential to reduce cost of care. However, questions surround equality of access. There is an existing, clear correlation between economic inequality and disparity in U.S. health care outcomes. The richest 1 percent of American men live 15 years longer than the poorest 1 percent. As costs have risen, health-care spending for the wealthiest quintile of Americans increased nearly 20 percent between 2004 and 2012. Conversely, spending decreased by 3.7 percent over the same period for the poorest quintile.
Put simply, the gap in spending and outcomes is widening. New technologies and life science breakthroughs could reverse this trend in the long run. But at present, costs remain high and it is an open question as to whether these staggering technology benefits will be available to all patients — or just those who can afford the price of admission.
So too, the scope of progress in genetic manipulation at scale — and with permanency in the human gene pool — raises a series of questions about what happens when humanity can control its own evolution. Jennifer Doudna, one of the discoverers of the CRISPR-Cas9 gene editing technique is blunt about the risks. She has written, “The power to control our species’ genetic future is awesome and terrifying. Deciding how to handle it may be the biggest challenge we have ever faced. I hope — I believe — we are up to the task.”
Make no mistake — we are on the cusp of a health revolution that will transform our lives. But realizing the full potential of this revolution for the largest number of Americans will require real leadership that takes on difficult questions and addresses complex challenges. The importance of the issue is clear to average Americans, who in poll after poll rank health care as their first or second policy priority. But judging by the partisanship and acrimony surrounding recent health-care reform efforts in Washington, there is real cause for concern that the full opportunity will not be realized. It is critical for both public and private sector leaders around the country to educate themselves on the stakes. The future of health care and the country’s health depends on it.
Sam Brannen is director and Terry Toland is an associate at A.T. Kearney’sGlobal Business Policy Council. A.T. Kearney recently launchedHealth@250, an initiative to help guide the health policy debate.