The recent AMA Executive Summary “Health from the United States: Health Care Trends” contains both somewhat hope and many gloom.

Population Trends

By 2050 the segment in the population over 65 will double from now to 83.7 million. This means that the prevalence of chronic illness will rise dramatically. Since 1990, smoking has decreased from 29.5% to 18.1% on the adult population. Probably because of this, stroke has declined 34%, heart problems 27%, and cancer 17%. This sounds good but…

Fat and Sluggish

Since 1990, the obesity rate in grown-ups (thought as BMI over 30) has risen from 12% to 29.6%. During the same time diabetes increased from 4.4% to 10% of the adults. Not old adults, all adults. The CDC predicts that by 2050, thirty percent of adults should have diabetes. As a result, obesity is currently the leading reason behind heart attacks. Physical inactivity is often a major reason. Only 21% of adults obtain the US Department of Health and Human Services recommended 150 minutes of exercise weekly. My observation is the fact most get no exercise. Many employers now offer wellness programs that provide financial rewards for healthy behaviors. This could be a large step in the best direction. Of course, punitive actions denying health care insurance to the obese or uncontrolled diabetics is also coming, specifically federal government leaves the health care insurance business to non-public companies.

Is There a Doctor inside Zip Code?

The AMA reports that primary care doctors are closing their practices and either retiring early or moving to non-clinical areas like insurance, quality management, the pharmaceutical industry and even medical informatics. Since the interest on health services raises dramatically, a large percentage of primary care will likely be provided by PAs and Nurse Practitioners. I expect they may have increasing independence. This is not necessarily a bad thing, a great number of caregivers are wonderful and offer compassionate and comprehensive care. A possible byproduct of the trend could be an increase in interest in referrals and subspecialty care, including sending diabetics to endocrinologists and COPD patients to lung specialists.

Take Responsibility or Someone Else Will

A dystopian future looms the spot that the cost of health care bills is higher than our resources can manage. In this rather terrifying situation, someone should have to be denied services, probably either the powerless or people that refuse to adopt mandatory health guidelines. It hasn’t go to that yet. We still need time to make recommended adjustments to diet and activity. Remember, who can have predicted everyone would to give up smoking?