You may have noticed that Friday is often a day when the commentary deals with a report I am not overly impressed with. Something about the end of the week or whatever. I have great respect for the actuarial firm Oliver Wyman and the work they do, but they had the misfortune to issue a report on the future of health care which caught my eye. (Oliver Wyman Report) The premise of the report is that we are in the midst of development of a revolutionized health industry, which it refers to as “Health Market 2.0”. This new paradigm will allegedly be created by tech savvy entrepreneurs bringing consumerization to health care. Heard that before? Once again, we hear about the thousands of health-related apps which will empower patients and all the new information and analytics capabilities that will create efficiencies and improve quality. All this opportunity is encouraging venture investment to keep the cycle going. And of course, there are the usual characteristics attributed to this new system: 24/7, convenient, personalized, holistic, more focused on prevention and prediction, as opposed to needing cures, less reliant on hospitals and using e-visits more, etc. etc. Three primary innovations are said to power this revolutionary change. One is the “quantified self”, in which consumers have a deep understanding of their health states. The second is transparent consumer markets in which everyone has real-time access to all kinds of cost and quality data on health care services and products and the third is smart care teams, which offer coordinated, personalized services that are oriented toward wellness. You are getting sleepy, very sleepy, your eyelids can hardly stay open.
I think I could go back five years and find several papers making the same kind of prediction. It is not that some of what is described isn’t occurring, it is the complete failure to understand that what happens in the subsegment of upper-middle income consumers who are relatively healthy is pretty irrelevant to the totality of health access, spending and quality issues. There is a limited intersection of consumers who have very high health costs and consumers who use, or are even capable of using, mobile health apps. There will certainly be companies that make some money offering products for this segment. But this is unlikely to be where mainstream health care is headed.