In the short term the medical expenses of the country will likely continue to rise. The general health of the populace has been decreasing for reasons we have discussed previously. Nevertheless, for economic reasons there will be incentives to improve our general health. In principle, if we begin to eat more sensibly and exercise more, reduce our dependence on tobacco products and harmful drugs, then significant medical expenses associated with chronic disease treatments may begin to decline.
The great costs of treating chronic diseases can decline over time. Routine medical care can then become far less costly and those less at risk from developing chronic diseases will be the primary beneficiaries. Overall, medical costs can be reduced significantly. In addition, medicine itself can become more efficient as computers, robotics and artificial intelligent systems are expected to add efficiency. While this is a topic to expand upon in another post, we can foresee that greater efficiency associated with these advances should eventually reduce costs while improving standards of medical care.
At present, we can foresee continued increases in healthcare costs which may not begin to decline until changes of the kind noted above are instituted. Costs will likely be reduced at the federal level and those individuals and states that are unable or unwilling to assist in altering behavior leading to costly chronic diseases will bear substantial increased costs. The alternative is to find other ways to bring budgets into line. Some of that may be done, but it will mean significant reductions in military spending, tax increases or tax code modifications the Congress is currently unwilling to make. Some of this will need to be done however, as the real benefits of improving the general health of the population cannot be expected right away. Clearly, the general populace is not currently convinced of the need to make these improvements now and may only accept the approach slowly over time as the real costs to both individuals and states and to the nation become apparent over the short term. It could easily take 10-20 years to just get started and begin to see hopeful results. Medical care efficiencies would also improve simultaneously.
For many the process of reducing chronic disease and improving general health has already started — for many it has not. I suspect the process will continue and expand as the Affordable Care Act is implemented and improved upon over time. In principle, reduced costs of continuing care associated with chronic illness means that those who would otherwise suffer costly medical treatments and drugs to try to control chronic conditions would be given more time and would generally remain healthy until later they suffer something something less chronic but treatable to a point. We do not arrest our mortality but, in the end, bring down long-term continuing medical costs.