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What Is The Greatest Challenge Facing Health Care In America?

What Is The Greatest Challenge Facing Health Care In America?
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What do you think will be the greatest healthcare challenge over the next 30 years? originally appeared on Quora - the knowledge sharing network where compelling questions are answered by people with unique insights.

Answer by Prabhjot Singh, M.D., Ph.D., author of Dying and Living in the Neighborhood and director of the Arnhold Institute, on Quora.

Healthcare in the U.S. is at its most dynamic and formative moment in more than fifty years, since Medicaid and Medicare were passed. That's the glass half-full answer, because we have a choice ahead of us: do we pay attention to how and where people live and how that shapes their health? Or do we neglect that in favor of healthcare as usual? I am confident that a growing network of Americans are paying attention because I've spent time with them across our country, and so I do see promise amidst crisis.

At the same time, let's put some stakes in the ground:

  1. If our next president does not bring down the financial and regulatory walls that sequester 3 trillion people in our underperforming healthcare sector, and enable resources to be redirected to smart partnerships with our education systems, food systems, financial services, and housing networks, then we will be in crisis by the end of the second term, if there is one. By then, healthcare will be nearly a quarter of our economy, creating a triangle of painful choices that we are poorly equipped to manage. Make no mistake, a healthier nation isn't just about the next cure. It's about healthier, happier, and more hopeful lives.

  • If our nation's extraordinary tech industry can build self-driving cars, build a new generation of spaceships, and embed the internet into everything around us, it can and must contribute to a new generation of civic-minded solutions. Government can remove the barriers, but it can't invent, imagine, or implement the people-centric technologies that allow us to exchange solutions within and across neighborhoods. We will be in crisis if our tech titans focus on big data from within our bodies without a similar obsession for the contexts that shape them. We need to do both. I've been keenly watching groups like Sidewalk Labs, which aim to "build products addressing big urban problems." Let's cheer them on.

  • Equity must be the price of entrance to a healthier country: social, financial, geographic, and racial. Health is political because it's about having the power to shape our contexts, and those contexts are different for each of us. This results in an inevitable clash between groups when we want different things from the same contexts, or we build equity into how we develop solutions. We know how devastating it has been to poor, minority communities. We're also learning how poor white non-hispanic Americans have been seriously impacted through the work of Anne Case and Angus Deaton. Look at the health of different people as a reflection of their power and representation in our nation's political life: if the health of any group in America is in crisis, so is the promise of a more perfect union. I've been enthusiastic about the 100 Million Healthier Lives movement because their national network puts equity first.
    • This question originally appeared on Quora. - the knowledge sharing network where compelling questions are answered by people with unique insights. You can follow Quora on Twitter, Facebook, and Google+.
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