Reviewing the arc of healthcare history over the first four decades of Modern Healthcare's existence as a part of Crain Communications, two major themes stand out.
First, as a nation we have moved inexorably toward joining the rest of the advanced industrial world in providing health insurance coverage for all of our citizens.
Second, advancing technologies have been a dominant force in shaping how healthcare providers deliver care.
Both are unfinished evolutions. Despite improvements to Medicare for the old and disabled, expansions in Medicaid for the poor, and, most recently, the subsidized individual market created by the Affordable Care Act for those in the working-age population without employer-provided coverage, we still have about 30 million in the U.S. without insurance.
We're the richest nation on earth. Yet compared to other advanced nations, a 10% uninsured rate is still an outrageously high number.
Let's hope that by the time that Modern Healthcare celebrates its 50th anniversary, we will have finally closed this gaping hole in our social safety net. We still have a lot of work to do.
The advance of healthcare technology will always be a part of our evolution as a species. Over the past 40 years, scientists and engineers made spectacular gains in the fight against disease. From CT scans to electronic health records and telehealth, from artificial body parts to targeted drugs, from more sophisticated diagnostic tests to machine-aided precision surgery, the healthcare system can deliver care today that the earliest readers of Modern Healthcare would have considered nothing short of miraculous.
Will we see the same advances over the next 40 years? Undoubtedly technology will continue to advance. But the unsolved problems of today—many cancers, dementia, the inevitable deterioration of the body as it ages—remain unsolved because they are difficult if not impossible medical challenges.
Moreover, if we take the long view, the greatest advances in longevity came from public health measures. Clean water, better housing and heating, less arduous work—these achieved far greater gains in life expectancy than any single medical advance.
Mid-20th century advances like antibiotics and vaccines sharply reduced early mortality from infectious diseases. But while we occasionally still get a major advance against a disease, the extension of life afforded by most of the latest new drugs or other medical technologies is measured in months, not years.
There is a growing understanding among healthcare leaders that the next wave of medical innovation must return to its roots in public health. We can do far more to extend life expectancy today if we tackle issues such as obesity, poor nutrition, chronic stress, unemployment and underemployment, and economic insecurity—the so-called social determinants of health.
The next 40 years are going to be an exciting time to be covering a healthcare system that gets serious about managing the health of our population—before it gets sick as well as when it gets sick. Modern Healthcare plans to be there—with news, information, data and insight—every step of the way.