Editor’s Note: What if You Ignore the Signs?

Hatred of the hypothetical is a very American notion. We are a nation of dreamers and planners, but we are also people of action, too busy building to really worry about what might happen. Healthcare leaders can perhaps be forgiven for a special distrust of the hypothetical. Playing too many games of "what if" in an industry of impossible complexity can seem indulgent with so many urgent challenges.

Years ago I was forced into a touchy-feely visualization exercise where I was supposed to draw on paper what life would be like in 10 years. I drew a question mark. Eventually I realized that the stupid exercise was less about predicting the future than preparing for it. Events will always force you to react, and preparing is less about having a specific disaster manual to pull off the shelf than it is about being flexible, seeing opportunities and preparing resources to move.

In this month's cover story we look at a few "what if" events that might happen to alter the course of healthcare. Some, like, "What would happen if Americans actually started taking care of themselves?", are sweeping and pretty unlikely. The sad truth is that there can only be one answer to that question. Others, like, "What if safety-net hospitals started to fail?", are frighteningly close to coming true. And unfortunately it appears that the virtual extinction of primary care providers has already begun.

We avoided a few "what if" scenarios that are perhaps too obvious-one being the very real possibility that increasing pressure to cut duplicated services will force some hospitals—not just the safety-net ones—to get smaller or close. The idea of a drastically reduced Medicare world is one we explored in a cover story in our June issue, "Weaning Your Hospital Off Medicare."

Our intention in playing "what if" is only to draw attention to some trends that represent either an opportunity for reinvention or a call to alarm for disaster. Most of these will fall by the wayside, but a few will hook in. You be the judge of which ones can draw the biggest question mark on your future.

Jim Molpus
Editor
jmolpus@healthleadersmedia.com