Healthcare's biggest changes over the next 10 years as spine surgeons see it

Written by Anuja Vaidya | April 12, 2018 | Print  |

Four spine surgeons discuss the key changes that they believe will take place within the next decade.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.

Next week's question: What will remain the same in the healthcare industry in the next 5 to 10 years?

Please send responses to Anuja Vaidya at by Wednesday, April 18, at 5 p.m. CST.

Question: What will change in the healthcare industry in the next 5 to 10 years?

Medhat Mikhael, MD. Pain Management Specialist and Medical Director of the Non-operative Program at the Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): I think we will start seeing more patients paying cash for their care and medications as their insurance keeps limiting care. The only way to avoid that is to create competition across state lines and hold these insurance companies accountable for their decisions. I also expect that research for new therapies may continue to shrink particularly when it becomes very difficult to cover it through payers. Finally, I expect that government involvement in healthcare will diminish.

Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I think we will see a single-payer system. There is no question in my mind that one insurer will probably administer it in a semi-privatized model, like how secondary insurances work with Medicare. Nearly every doctor will be employed or somehow heavily supported by a university, health system or insurer.

Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): The trend toward insurance and hospital consolidation as well as physician employment will continue under the premise that it will lower the costs. The real reason for this consolidation will remain to increase control over healthcare providers and to shift the income further away from the providers and toward those corporations. As a result, healthcare costs will continue to increase and will be followed by further "rationing" of what the insurances are willing to pay for. It will lead to overall decrease in healthcare quality and access for the patients.

As a consequence, the cash-pay models will flourish to offer the patient alternatives to get good quality and reasonably priced medical and surgical care outside of insurance and hospital system control. This will likely result in a two-tiered system of healthcare as has already been seen in other developed countries.

Alden Milam, MD. Spine Surgeon at OrthoCarolina (Charlotte, N.C.): More robotics and automation as well as big data research to provide better optimization of medical care.

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