The 2030 Crisis in Health Care and What We Can Do to Avoid It

Recent talk about Obamacare and its possible repeal has focused on cost, rather than care. The law’s supporters believe underinsured Americans should be subsidized by younger and healthier Americans. Opponents favor lowering costs through competition across state lines, including competition and transparency in pricing and reducing malpractice insurance costs.

What we can all agree on is that no American should suffer in pain, and no life should be cut short because of a lack of access to health care.

But the debate in this country is missing the bigger picture: We’re living longer and need more health care services than ever; at the same time, we face a growing shortage of health care providers. Consider the facts.

By 2030, we will have a shortage of 121,000 physicians, according to the Association of American Medical Colleges. And due to the Balanced Budget Act of 1997, the number of medical students is capped — so future supply is fixed. This is despite the fact that the U.S. population by 2030 is estimated to be 354.8 million, nearly a 33 percent increase since the law’s passage in 1997. And it’s not just doctors — by 2025, we will face a shortage of 446,000 home health aides, 95,000 nursing assistants, 29,000 nurse practitioners and nearly 100,000 lab technicians and technologists.

The entire baby boomer generation will be 65-plus by 2030. And by 2040, one in five Americans will be 65 or older. Today, it is just one in seven.

As we age, we accumulate more health problems and increased medical costs. Just look at where we are today: 61 percent of Medicare beneficiaries age 65 and older have hypertension; 31 percent have arthritis; 34 percent have heart disease; and 28 percent have diabetes. And the 2018 Medicare Trustees Report estimates Medicare will run out of money by 2026.

Don’t expect the American taxpayer to foot the bill for these surging health care costs. Our $21 trillion debt will be $29 trillion by 2028, according to Congressional Budget Office estimates. This means we’ll have to pay $761 billion in net interest annually by 2028 simply to service our debt. Money for discretionary domestic programs — including education, the environment and health care — will be scarce.

And perhaps the most pressing issue of all is the lack of quality care for sick Americans.

Here are five steps Congress could take now that would bring down health care costs and improve overall care.

Allow competition in drug pricing. Americans pay the highest prescription drug prices in the world. If we allowed Americans to buy drugs even from Canada alone, Americans could save up to 55 percent off the list price of these drugs. We also need to ensure that drug companies, our legal systems and our health care systems are not incentivizing doctors to run tests and prescribe treatments that are unnecessary or more expensive than equally good treatment options.

Shift to consumer technology for monitoring, treatment and training. Personal health devices such as Omron’s wireless blood pressure monitor, Livongo’s diabetes meter and the Apple Watch’s new Food and Drug Administration-approved electrocardiogram sensor will increasingly provide less-expensive, more-accurate monitoring than medical professionals. They can also be used to assist doctors in making medical diagnoses.

Platforms such as Doctor On Demand, a national health care network that provides high-quality video telemedicine interactions between doctors and patients, allow appointments to take place in the comfort of a patient’s own home. Americans waste countless hours on trips to doctors’ offices and hospitals for basic testing when technology can remotely provide the same information to health care professionals. This would mean appropriately incentivizing doctors to consult remotely.

And companies such as OSSO VR are using virtual reality technology in surgical training, which lets less-experienced surgeons learn on the computer rather than on patients. The more-experienced surgeon has the most successful results.

Encourage standards and transparency. Recently, major technology companies, as well as the Consumer Technology Association, came together at the Blue Button 2.0 Developer Conference, held at the White House, and pledged to remove all barriers to the interoperability of health data. This means enabling connected care, giving patients access to their data and the flexibility to use products and services across different systems. These changes will help doctors and insurance companies provide top-quality service at lower costs.

Reward healthy behavior. One provision stripped out of Obamacare would have allowed for lower insurance rates for healthy behaviors such as exercise and eating a balanced diet. Americans need to own their own health care, starting with healthy lifestyles. United Healthcare’s Motion program, which rewards subscribers who achieve health goals, is a great example of this.

Increase the supply of health care professionals. We need to change the laws limiting the supply of doctors in this country and incentivize students to pursue the health care field. This might mean changing laws regarding licenses for immigrant physicians or giving lower-interest education loans to those pursuing in-demand fields such as nursing.

We are facing a health care crisis, and it is not about the repeal, or lack of repeal, of Obamacare. Our present health care system is unsustainable, but it’s not unsalvageable. Let’s put real issues at the forefront of our political platforms and our news cycles and provide innovative, affordable solutions to ensure Americans live healthier lives.


Gary Shapiro is president and CEO of the Consumer Technology Association, the U.S. trade association representing more than 2,200 consumer technology companies, and author of the New York Times best-selling books, “Ninja Innovation: The Ten Killer Strategies of the World’s Most Successful Businesses” and “The Comeback: How Innovation Will Restore the American Dream.” His views are his own.

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