Our cover story this month, deals with the inevitable. Baby boomers are getting older, and there's no reason to suppose that they won't shake up health care with the same ferocity that they've shaken up every other institution they've encountered between Station Cradle and Station Grave. Just how they'll do it is the high-octane stuff that fuels experts' salaries.
Poetic intuition has already led us down this path. Long ago, Robert Browning wrote:
"Grow old along with me!
The best is yet to be
The last of life, for which the first was made."
The line probably resonates more today than it ever did in Browning's time. Boomers are expecting a healthy sunset — or else! Those born between 1946 and 1964 won't, to quote another poet, "go gentle into that good night" but will rather "rage, rage against the dying of the light."
They'll want the best medicine someone else's money can buy. Will managed care be able to provide it? And how?
Just what that medicine will be, and the considerable payment concerns surrounding it, is the subject of a column that makes its debut this month. Check out "Tomorrow's Medicine". Thomas Morrow, MD, vice president and medical director of Matria Healthcare and a member of our editorial advisory board, will discuss the latest biologic medicines, and there's going to be a lot to cover. By 2004, it is expected that there will be 197 such products creating a $40 billion market. The issues could become sticky.
Many issues in contemporary health care have a little or a lot to do with cost, and the cost implications are enormous here. Will they commensurate with the improvement in care? And even if they are a bargain, can we afford them? Or should I say, are we willing to afford them? Perhaps we'll ration them to those who can pay privately?
The nitty-gritty of coverage issues can almost make one jaded about just what's afoot here, technologically. Almost. As Time puts it, medicine will be "utterly transformed." As Browning put it:
"Ah, but a man's reach should exceed his grasp,
Or what's a heaven for?"