In a roundtable conversation from The Economist's Look Ahead series, supported by IEDC, the discussion was centered around the topical matter of America’s healthcare evolution. While an incredibly sophisticated sector, the healthcare industry in the United States takes up one-fifth of American GDP but without a corresponding rise in outcomes, made all the more urgent and important by the coronavirus pandemic, according to Daniel Franklin, The Economist’s diplomatic editor.

A renewed focus

While the pandemic has put the healthcare sector under huge strain across the world, particularly in the United States, it has also shone a light on some of the ways in which healthcare can be improved, according to a number of our panelists.

One overlooked area of healthcare highlighted by Jeremy Bonfini of the Allegheny County Medical Society is that 70 per cent of healthcare outcomes are the result of environmental factors and social determinants of health. Susan Bratton of Savor Health echoed those comments and highlighted her work in the area of delivering personalised nutritional interventions for cancer patients. Gurdyal Kalsi of Asklepion Pharmaceuticals highlighted the lack of focus on primary care and prevention in the United States, which spends 90 cents for every $2 of primary care spending in Western Europe.

Another issue taken up by the panelists was the over-emphasis on choice in the United States, resulting in over-utilisation in health, rather than striking a balance between “endless choice and the real world”, according to Andrew Vallance-Owen of Medicover and TestCard. Marc Harrison of Intermountain Healthcare highlighted that the issue is not driven necessarily by consumers, but by providers, and that the alignment of incentives is at the heart of the issue. For Intermountain, which takes on the full risk for their patients, meaning they are fully incentivised to keep people well – moving the focus away from “heads in beds” but rather to ensuring a hybrid model that delivers the right  interventions at the right time.

Yet advances in technology may well come to nothing if the interoperability of data is not solved, and a number of our participants spoke about the great power of data once it is removed from its current siloes. For Greg Horne of SAS, using healthcare data has allowed a project called Healthy Nevada to put patients into cohorts where predictive analytics can put them on the right preventative track to ensure good health outcomes. For Pahini Pandya of Panakeia Technologies, applying data to create behavioural insights is another way of combining healthcare with the overlooked environmental factors discussed at length during the roundtable discussion. Jeremy Bonfini took this further, arguing that cracking the behavioural part of healthcare will be one of the greatest advances in coming years. “One of the great innovations of the 20th century has been decoding the human genome – I believe the greatest innovation of the 21st century will be decoding human lifestyle – because if we’re able to change behaviour, we solve the ultimate problem in healthcare.”