Why can’t we have healthcare like “The Jetsons” did?

You remember The Jetsons, don’t you?

I loved watching The Jetsons growing up; I watched The Flintstones too. The Jetsons was an animated sitcom originally aired in 1962. While the Flintstones lived in a world which was a humorous version of the “stone age”, with machines powered by birds and dinosaurs, the Jetsons lived in a comical version of the future, with elaborate robotic contraptions, aliens, holograms and whimsical inventions[1].

The Jetsons depicted life 100 years in the future, the year 2062. Flying cars, skypad homes raised high above the ground on adjustable columns, home robot assistants (future Alexas and Roombas perhaps), all kinds of futuristic tools to make life easier, better, and happier.

Now that we are a little over 50 years closer to “The Jetsons future”, I thought it would be interesting to do a “wellness check”, and compare our healthcare system today against theirs in 2062.

The Jetsons had access to healthcare – and I think it was universal access too

The picture above shows that The Jetsons had access to telehealth: real-time virtual visits with their care provider. I imagine that if a prescription, a specialist consult, or a lab test were required, services would be provided and sent to the patient’s skypad home. If needed, any of The Jetson family members (George, Jane, Judy, and Elroy) could probably enter a virtual reality office, meet a hologram doctor equipped with haptic feedback, and then get a full physical exam. So how does our healthcare reality in 2018 compare to the life of The Jetsons in 2062?

Although they are not commercial yet, we have flying cars (Zee.Aero, EHang, Terrafugia, eVolo, Airbus, Boeing) and I’m confident they will be ubiquitous well before 2062. We have reusable rockets (SpaceX, Blue Origin), we have virtual reality headsets, we have live videos (Skype, Zoom, FaceTime, Facebook) - we have several technologies depicted in the show, and we’re 50 years ahead! Today’s consumer-facing industries have adopted human-centered design combined with technology to deliver great experiences for consumers - think Starbucks, Amazon, Dollar Shave Club, Harry’s, Warby Parker – these companies and many others have disrupted traditional industries by putting consumers first in all aspects. Even an old-school industry like banking has adopted tech - first we called it “Online Banking”, now we just call it banking because it’s part of daily life (credit to Lisa Suennen for coming up with that line a few years back).

Do we have to wait another 50 years for customer-centric healthcare experiences?

First, which health technologies and services are available today? We have telehealth - doctors available on your phone 24/7 at a push of a button. We have incredible diagnostics - we can mail in our saliva and get our genome sequenced, our ancestry genealogy mapped, and have alerts sent to us regarding potential risk factors - all from the comfort of our own home. We have therapeutics - we’ve made incredible progress in drug development, medical device technology, understanding the impact of nutrition on health, and surgeons can perform complicated procedures from thousands of miles away using robots and remote video access. So, with these advancements, why does our healthcare experience still stink for the most part?

That’s because our US healthcare system was never designed around its most important stakeholder - the consumer. It was built to capture billing opportunities, be convenient for provider administrators, maximize revenues, be price opaque so customers could not shop for the best quality and value. Customer experience is an afterthought and/or regulated necessity – it’s not build into the “system”. Yes, there are notable exceptions but they are few and far between today.

As a result, we have an exploding healthcare cost curve and less than stellar health outcomes. In the US, we spend over 17% of our GDP on healthcare - that’s $3.3 trillion dollars per year, yes, trillion with a “T”, which works out to $10,348 per person[2]. Yet the US does not break the top 10 in health quality metrics such as life longevity, quality of life, and 1-year birth mortality[3]. No matter where you stand on the political spectrum, this is not acceptable. Some organizations are taking matters into their own hands - JP Morgan Chase, Berkshire Hathaway, and Amazon are so frustrated with healthcare costs and delivery that they are overhauling the current healthcare system and designing a new approach for their roughly 1.2 million employees[4].

Healthcare has been a slow adopter of technology – and there are good reasons for this, sometimes. Patients lives are ultimately at risk so safety must be foremost – after all physicians take the Hippocratic oath – “First do no harm”. However, other reasons don’t pass the sniff test - many healthcare systems hoard our “personal health data” for their own use, making it difficult for patients to take it with them and get care at “another” health system. It’s our data, we should get to choose who has access to it. We need financial and incentive reform – in many cases today, if a healthcare professional provides preventive care, outside their brick & mortar walls, and gets better patient results - they often get paid less or none at all. Today most providers get paid for doing something to you, not preventing something from happening to you.

Changes are progressing, ever so slowly – there is more focus on prevention and value for care. For example, I recently had an experience where as a customer I was almost impressed with my insurance company. 

My family, on my paternal and maternal sides, has a history of colon cancer and I’ve had 5 colonoscopies in the last 20+ years. During my last annual physical, my primary care physician didn’t mention needing to set up my next colonoscopy. Shortly after my physical, my insurance company, through an interactive voice recording, called my cell and told me they noticed I had not scheduled my next colonoscopy. My first thought, was “WOW”, this is impressive and this is my insurance company, the one who’s going to pay for this, actually reaching out to me proactively. Good, so far. Next, it asked me if I wanted to set up an appointment, I pushed 1 for Yes - and here is where things went south quickly. I was transferred to another recording that said - “sorry, our office is closed, please call back during our working hours, M-F, 8-5pm PST”. Really, then why did you call me at 7pm PST? As frustrating as this was because it came short of delivering a full-service customer experience, I give them kudos for trying something new. I have provided them feedback and hopefully, they’ll get better.

Healthcare Industry Leaders – Get onboard or step out of the way

Healthcare system incumbents really never had to worry about the “patients” they serve; we show up, they provide episodic care, they send us on our way, bill insurers who deduct our co-pay or deductible, bill us for the rest, and if we show up again for the same health issue, that’s great for their business and the cycle restarts. Perhaps they haven’t realized that their “patients” really don’t want to spend time in their brick and mortar facilities, we’d prefer to use as little health care services as possible – we want to get healthy and stay that way. Well, most of us do, and yes, we all need to be engaged and take responsibility for our health.

If you think healthcare incumbents are going to solve the problems in healthcare because they’ve “seen the light”, then we’re good to go. Otherwise, let’s encourage the smart use of tech-enabled services, engage with innovative entrepreneurs, and let’s expect and do better. We won’t get everything right the first time so let’s not dismiss early failures with “I told you so” - let’s learn and move forward while keeping patient safety front and center. It’s about time healthcare was flipped on its head and focused on consumers.

We have incredible tools that are ready to use today. Let’s not wait until 2062 to figure how the right incentive payments can deliver healthcare value for everyone. Perhaps, we just need to figure out how to use Bitcoins to pay for healthcare; maybe that’s how the Jetsons are paying for their fabulous healthcare. Engage now, we can do better.

[1] https://en.wikipedia.org/wiki/The_Jetsons

[2] https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

[3] https://www.kff.org/slideshow/how-does-the-quality-of-the-u-s-healthcare-system-compare-to-other-countries/

[4] https://www.nytimes.com/2018/06/20/health/amazon-berkshire-hathaway-jpmorgan-atul-gawande.html