Imagining the Future Us

By Kim Bellard, October 17, 2018

One of the most thought-provoking articles I've read lately is Tom Vanderbilt's Why Futurism Has a Cultural Blindspot in Nautilus.   In it, he discusses how our technological visions of the future seem to do much better on predicting the technology of that future than they do the culture in which they will be used. 

As he says, “But when it comes to culture we tend to believe not that the future will be very different than the present day, but that it will be roughly the same. Try to imagine yourself at some future date.... Chances are, that person resembles you now.” We need to keep this in mind when thinking about the future of healthcare: not just the nifty new technologies we'll have, but who and how we expect to use them. 

All too often, especially in healthcare, we develop technology to solve incremental issues, not foundational ones.  All too often, especially in healthcare, we develop technology and then try to fit it into our existing culture, rather than imagining the culture we want and developing technologies to help achieve it.

It's not so hard to imagine how technology will change what health care is likely to look like in the not-so-distant future. But, like imagining that "office of the future" in the 1960's, what will the healthcare system in which they are used look like? 

Here are some open questions about the culture in which all these cool technologies will be used. Will we live in a culture:

• that accepts health problems becoming financial disasters for some people?
• in which poor people can expect to get less care, to be less healthy, and to live less long?
• in which where you live dictates how well and how long you live, and the quality and quantity of care you receive?
• that treats social determinants of health and public health as secondary considerations?
• that treats health as primarily a medical concern, with too many people delegating responsibility for their health to their healthcare professionals and expecting some kind of medical interventions to deal with any health problems?
• that expects "treatment at any cost for any chance," especially for terminal issues? 
• that treats services like dental, vision, or "custodial" care as step-children?
• with an ever-growing array of medical experts? 
• that treats medical expertise as primarily a local/state-level issue, rather than a   national/international  one?  

If the healthcare system of the future looks pretty much like the healthcare system of today, just with more and better tech, we will have failed.  And probably be broke. 

We need a different culture for health, and that culture needs new designs.  Marcus Engman, the former head of design for Ikea, told FastCompany:  “I want to show there’s an alternative to marketing, which is actually design.  And if you work with design and communications in the right way, that would be the best kind of marketing, without buying media.”

I read that and I think "healthcare."  Substitute "health care" for "marketing" in Mr. Engman's quote and we start to get to what Steve Downs calls Building Health into the OS -- that is, designing to make health an integral part of our daily lives.  That's design.  That's a culture change.

We have a culture of health care -- or, more accurately, of medical care -- rather than a culture of health.  Technology can exacerbate this, or help change it.  It's up to us to imagine the future in which we're most likely to be healthy.

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting