Which will have the biggest impact on health care in the next 10 years: the aging population, health care costs, health care access or molecular research?

compiled by Monika Guttman

Jeff Tsou
Masters, biochemistry, first year

Costs. HMOs, for the next few years, are still going to be the main providers of health care, and most HMO's are a business and a way people are making money, and They're going to continue to try to cut costs. So whoever has the most money will be the only ones who will be able to afford to see doctors and get concerned medical care or the newest technologies in the near future. The way it's going, I don't think a lot of private practices will continue to survive, thanks to costs.

Linda Azen
Librarian, Norris Medical Library

Health care costs. That's why there is managed care. About six or seven years ago, when I was still practicing nursing, I had given a lot of thought to these issues. I saw the "good old days" and then I saw what happened. But even managed care isn't totally effective, as we see by the enormous increases in health care costs in the past year. What I'd like to see is that there be some sort of return to some of the part of the "good old days" that had value, which included options for care and more of a trusting environment -where if I felt a patient needed something I didn't have to justify everything.

Nancy Koehler
Physician Assistant, fourth year

I'd say it's a toss up between costs and access. The average baby boomer just turned 50, so they won't really be utilizing the health care system in the next ten years the way they will in 15 or 20 years, so the aging question won't be that important for a while. And we're still more than five years away from serious molecular medicine. But costs are rising and will have an effect. I also think it'll be a grass roots movement where employees will go back to their employers and say "I'm not happy. I want another plan or we want other options." Congress has taken some steps, and it'll also be an issue in the court system

Kathleen Keyser
Physician Assistant, fourth year

Access. People are increasingly frustrated by the limitations put on them by HMO's. They're going to rise up, they're going to get angry and try to change it. I think at some point people are just going to be so frustrated with their inability to communicate with their doctors or receive the care they need that they'll start demanding something else. It's already starting to happen.