The assumptions of today blind us from seeing the radical changes needed for healthcare, argue David Gleicher and Darko Lovric. Read the Sustainable Health Systems: Visions, Strategies and Scenarios report.

Before Davos became what it is today, it was known as a sanatorium. With its clean air and calm character Davos was a place where the sick went to overcome illness in a pre-antibiotic world. The setting in Davos is very different today, and of the thousands who make the journey to the World Economic Forum’s Annual Meetings, few will be aware of its past. A little pill has seen to that.

Innovations in health, from antibiotics to genetics, have and will continue to change our world in surprising ways. Just as patients in Davos 100 years ago would have difficulty imagining our health systems today, our own assumptions about what’s possible may be blinding us from imagining the health systems of our future. By drawing out our assumptions and broadening what we think possible, we can improve decision-making in the present. This is the essence of the Forum’s work in strategic foresight.

In 2012 the World Economic Forum engaged more than 200 high-level decision-makers from the public sector and a broad range of private sector organizations in workshops and interviews. In each case participants discussed the uncertainties that might reshape the context in which health systems form and operate. Six uncertainties were identified as critical:

  • Attitudes towards solidarity:Will solidarity – the willingness of individuals to share the population’s health risks – increase, decrease or be conditional upon certain factors?
  • Origins of governance: Will power and authority be predominantly located at the national, supranational or local level?
  • Organization of the health innovation system: Will innovation come from within or outside the existing system? What will be the level of funding? What will be the types of innovation produced?
  • Access to health information: Who will take responsibility for collecting and analysing health data? Will people give their consent for their personal data to be used?
  • Influence over lifestyles: To what degree will active influence over individual lifestyles be accepted and implemented?
  • Health culture: Will healthy living be a minority choice, a civic duty or an aspiration?

These critical uncertainties show us that health systems of the future can, and will, be very different from what we think of as healthcare today. The World Economic Forum’s new report, Sustainable Health Systems: Visions, Strategies and Scenarios, explores three ways in which these uncertainties could shape health systems in the future.

In Health Incorporated, the boundaries of the health industry are redefined. Corporations provide new products and services as markets liberalize, governments cut back on public services and a new sense of conditional solidarity emerges.

In New Social Contract, governments are responsible for driving health-system efficiency and for regulating organizations and individuals to pursue healthy living.

In Super-empowered Individuals, citizens use an array of products and services to manage their own health. Meanwhile, corporations compete for this lucrative market and governments try to address the consequences.

The ways we promote and deliver health services and outcomes in society today are unsustainable and will have to change. Health can no longer be thought of in terms of healthcare alone. The scenarios show us that the future of health lies less in a new magic pill and more in a shift in how we understand and strive for health in society. Health is created beyond the confines of hospital walls and doctors’ offices. It is being created in the places we work, the products we buy and (increasingly) the cities we live in. The report shows that new visions for sustainable health systems can be achieved when actors from across government ministries, industries and civil society come together prepared to test their most central assumptions.

Despite their best efforts and resources, world leaders can’t predict or forecast exactly what the future will hold, but by being open to all the possibilities and challenging business-as-usual mindsets they can make better decisions today – decisions that will guide us towards a healthier future.

Authors: Darko Lovric is Senior Manager and Global Leadership Fellow, Strategic Foresight, at the World Economic Forum. David Gleicher is Project Manager, Strategic Foresight, at the World Economic Forum

Image:  The foot of a newborn baby in New York Downtown Hospital. REUTERS/Andrew Kelly