Does the "Future" of Health Care Matter? by Fred Fortin, March 14, 2008

Kevin Kelly, the Senior Maverick at Wired magazine, writes that the future is less fashionable than it was 10 years ago. And it is especially so since the dot.com bust of 2001; the future, it seems, is far less “cool”.

During the industrial and digital revolutions, you needed to discern the future because that was were you were going to spend the rest of your life.

But then something weird happened in the first few years of this decade. The pace of change became so fast that it outpaced contemplation. The future became harder to predict, and exhausting to keep track of. With a long, colorful history of failed predictions, it occurred to almost everyone at once that very little of what we imagined our own futures to be would really happen. So why bother?

We in the US health care industry are very concerned about the future. We always have been. And we’ve spent considerable amounts of money on hiring professional help –scenario planners, futurists and other conjurers — to help us get our short and long term strategies in order. It’s no secret that things like hospitals, information systems, drug development, for example, take considerable amounts of time and money, and we all want to secure the future of those investments one way or another.

But the scale, risks and enormity of resources involved in health care should not blind us to the fact that the only thing we can count on for the future is the unexpected and the unpredictable. (See more here, here and here)

With the kinds of uncertainty we are now facing in US health care — 2008 elections, unsustainable costs and a growing politics of blame and greed — the future is less about, well, the “future” and more about the present, that is our ability to simply hang on for the ride. Both the pace and unpredictability of what now confronts us makes futurists look more like shamans trying to comfort a nervous patient, than professionals who can help us line up, in some understandable order, the drivers of change.

One thing is for sure, however, any official “futures”, at least for now, are DOA. And we don’t need to pay any futurist to tell us how that story will end since the the plot has still yet to be revealed. Stay tuned.

This month we profile the renewed agreement (Memorandum of Understanding) signed on March 4, 2008, between the US and Mexico on cross-border cooperation to address public health issues.

On March 4, 2008 it was announced that HHS Secretary Mike Leavitt and the Secretary of Health of the United Mexican States, Dr. José Ángel Córdova, signed a Memorandum of Understanding (MOU)  strengthening cross-border cooperation to address public-health, medical and scientific issues. They also plan to work together on common health problems. The two countries have a long history of collaboration in public health; the document signed today updates a MOU that began in 1996, and which the two nations last revised in 2001.

“The United States enjoys a solid friendship with México, and our two nations are stronger when we work together to improve the health of our citizens,” Secretary Leavitt said. “A commitment to the health and safety of our nations, and to the spirit of cooperation, provides opportunities for growth in science, cross-cultural training, health care delivery and the protection of our people.”

Through the MOU, the United States and México announce their intention to focus collaborative efforts on public health emergency preparedness and response; the health concerns of vulnerable groups; training; disease prevention and health promotion; and the detection, surveillance and reporting of infectious and chronic diseases.

The two secretaries signed the renewed MOU at the conclusion of the plenary session of the annual meeting of the United States-México Border Health Commission held today. The Secretaries, who chair the Commission, were joined by the Commissioner of the HHS Food and Drug Administration, Dr. Andy von Eschenbach; the HHS Assistant Secretary for Preparedness and Response, RADM W. Craig Vanderwagen, M.D.; Maki Esther Ortíz Domínguez, Deputy Secretary for Quality and Innovation in the Mexican Federal Secretariat of Health; the Commissioner of the Mexican Federal Commission for Protection Against Sanitary Risks, Juan Antonio García Villa; and representatives from the 10 U.S. and Mexican border states.

The group received briefings on the success of the 2007 Border Binational Health Week, during which health promotion events such as screenings and vaccinations reached approximately 150,000 people along the shared border, and on a binational pandemic-influenza table top exercise held in California. They also discussed progress in other areas, including the exchange of expertise on food safety, research into availability of cross-border health insurance and joint state-federal work on early-warning infectious disease surveillance. Later in the day, the Secretaries attended a forum with food growers, producers, shippers, importers and retailers for an open exchange on product safety issues in a cross-border context.

Last November, Secretaries Leavitt and Córdova signed a declaration of intent with Canada that spells out how the three countries can offer each other assistance during a public health emergency.

To read the complete Memorandum of Understanding between the Department of Health and Human Services of the United States of America and the Secretariat of Health of the United Mexican States on Cooperation in the Fields of Public Health and Science, go to: http://www.globalhealth.gov/news/agreements/ia030408.html

For additional information on the United States-México border health commission, visit www.borderhealth.org

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