What Will Be the Top Health Issues for 2020?
By Roz Plater
It's 2020 and another year of health-related topics awaits us.
What health issues will take priority? What buzzwords will we all be talking about? How might technology change healthcare?
We asked some experts to peek into their crystal balls and make a few predictions.
They tell us that how you get access to healthcare and how you pay for it will both be hot topics this presidential election year.
In fact, one expert says healthcare could help decide political winners and losers.
"Whoever comes up with a plan that will work, is affordable, and something people can understand, that will push them ahead," said Kurt Mosley, vice president of strategic alliances for Merritt Hawkins, a physician search, consulting, and research firm.
Medicare is front and center as we kick off 2020.
That's in part because "Medicare for All" is the single payer option health plan being touted by two of the top Democratic presidential candidates.
Jeff Becker, the senior analyst for healthcare strategy at Forrester Research says there are also a number of bills in Congress looking to expand access to Medicare as a public option.
"When you look at the polling numbers, our call is that Medicare for All will die in the court of public opinion and become Medicare Advantage for more," Becker told Healthline.
Affordable Care Act
The Affordable Care Act (ACA), often referred to as Obamacare, will be in the courts again this year.
In December, a federal appeals court ruled that the health insurance law's individual mandate provision was unconstitutional.
However, the justices sent back to a federal district court in Texas the issue of whether other parts of the law could continue to exist without the mandate that requires everyone to have health insurance.
Look for some sort of Obamacare case to wind up in the U.S. Supreme Court this year.
"Our call is whether or not it goes to the Supreme Court, the ACA will survive because the individual mandate is severable," Becker told Healthline.
Experts say you'll hear a lot of debate about price transparency, a move designed to increase competition and lower costs.
President Trump signed an executive order in November that requires hospitals and insurers to publish their confidential, negotiated rates for treatments.
"The reason this would be important is you'd be able to figure out what your out-of-pocket expenses would be" said Becker.
But a coalition of hospital groups has filed a lawsuit to block the rule. They argue that the public disclosure of negotiated charges would create confusion about consumers' out-of-pocket costs.
The order is scheduled to go into effect January 1, 2021.
Lower Prescription Drug Prices
"The thing about pharmaceuticals is, if you can't afford them, they don't work," Mosley said.
He predicts the move to lower the costs of prescription drugs will again be on the front burner of the healthcare debate in 2020.
"The problem is Medicare and Medicaid can't negotiate prices with these drug companies," Mosley told Healthline.
The House of Representatives has approved a bill that would do just that. The legislation also caps out-of-pocket expenses for people enrolled in Medicare Part D.
However, the prognosis for this bill becoming law isn't good.
Political observers say the legislation won't go anywhere in the Senate, and the White House has indicated the president would veto it.
Republicans in the Senate have crafted their own prescription drug price plan. The president has indicated he would sign this bill, but it would need to be approved by the Democrat-controlled House.
Access to Health Services
"One of the cross-cutting issues we see as a priority in 2020 is the social determinants in health disparities in our patients," said Amy Mullins, MD, FAAFP, medical director for quality improvement for the American Academy of Family Physicians.
"Patients need more than just access to a physician," she told Healthline. "They need access to good food, safe places to live, to exercise, transportation, community resources, access to medication."
"If you don't address those, it's really difficult to treat your patients effectively," she added.
Mullins says her group has an internal division called the Center for Diversity and Health Equity whose mission is to look at healthcare through that lens.
Mullins also says the issue of vaccine myths is one you'll continue to hear about in 2020.
"We want to do more to counter the misinformation that's out there around vaccines that may be holding some people back from getting what they need," said Mullins.
A recent study concluded that a lot of the false information is being spread on social media by a handful of anti-vaccine ad buyers.
"We're promoting vaccine education to physicians, their healthcare teams, patients, and communities" Mullins said.
A 2020 National Vaccine Plan is currently being developed by the Department of Health and Human Services' Office of Infectious Disease and HIV/AIDS Policy.
"Another of the big priorities for health providers in 2020 is vaping and e-cigarettes," Mullins said.
"We really applaud and support the work the Centers for Disease Control and Prevention and the Food and Drug Administration is doing to try and get a handle on this crisis," she said. "But these products target adolescents and we think the marketing needs more regulation."
A study released last month from the National Institute on Drug Abuse reported that more teens are vaping marijuana.
That's despite a lung illness linked to vaping that's killed more than 50 people nationwide.
Virtual Care Visits
On the digital front, Becker predicts there will be aggressive growth in virtual care visits.
That's where you interact with your doctor via text, video, or phone call.
Becker's group crunched the numbers after looking at outpatient visit data as well as talking to virtual vendors and tracking healthcare investments.
"The result was 36 million net new virtual care visits in 2020," he said.
He points to how employers and insurers are already embracing the concept. Amazon recently launched a pilot program called "Amazon Care," a virtual clinic for its employees in Seattle.
Walmart recently expanded its telehealth services to workers in Colorado, Minnesota, and Wisconsin with $4 online or video care visits.
Humana has teamed up with "Doctor on Demand" to offer a virtual primary care plan at significantly lower monthly premiums.
"Everybody is moving toward a model where we're not using high-cost care centers like emergency rooms," Becker said.
"And consumers are demanding more cost effective services, too," he added. "In 2018, consumers took out $88 billion in personal loans just to pay for out-of-pocket medical costs."
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By 2030, almost a third of all the energy consumed in the European Union must come from renewable sources, according to binding targets agreed in 2018. Sweden is helping lead the way.
Sweden is a world leader in renewable energy consumption. Swedish Institute/World Bank
Naturally Warm<p>54% of Sweden's power comes from renewables, and is helped by its geography. With plenty of moving water and 63% forest cover, it's no surprise the <a href="https://sweden.se/nature/energy-use-in-sweden/#" target="_blank">two largest renewable power sources</a> are hydropower and biomass. And that biomass is helping support a local energy boom.</p><p>Heating is a key use of energy in a cold country like Sweden. In recent decades, as fuel oil taxes have increased, the country's power companies have turned to renewables, like biomass, to fuel local 'district heating' plants.</p><p>In Sweden these trace their <a href="https://www.sciencedirect.com/science/article/pii/S0360544217304140#fig3" target="_blank">origins back to 1948</a>, when a power station's excess heat was first used to heat nearby buildings: steam is <a href="https://www.sciencedirect.com/topics/engineering/district-heating-system" target="_blank">forced along a network of pipes</a> to wherever it's needed. Today, there are around 500 district heating systems across the country, from major cities to small villages, providing heat to homes and businesses.</p><p>District heating used to be fueled mainly from the <a href="https://www.sciencedirect.com/science/article/pii/S0360544217304140" target="_blank">by-products of power plants</a>, waste-to-energy plants and industrial processes. These days, however, Sweden is bringing more renewable sources into the mix. And as a result of competition, this localized form of power is now the country's<a href="https://www.sciencedirect.com/science/article/pii/S0360544217304140#fig3" target="_blank" rel="noopener noreferrer"> home-heating market leader.</a></p>
Sweden is using smart grids to turn buildings into energy producers. Huang et al/Elsevier
Energy ‘Prosumers’<p>But Sweden doesn't stop at village-level heating solutions. Its new breed of energy-generation takes hyper-local to the next level.</p><p>One example is in the city of Ludivika where 1970s flats <a href="https://www.buildup.eu/sites/default/files/content/transforming-a-residential-building-cluster-into-electricity-prosumers-in-sweden.pdf" target="_blank">have recently been retrofitted with the latest smart energy technology</a>.</p><p>48 family apartments spread across 3 buildings have been given photovoltaic solar panels, thermal energy storage and heat pump systems. A micro energy grid connects it all, and helps charge electric cars overnight.</p><p>The result is a cluster of 'prosumer' buildings, producing rather than consuming enough power for 77% of residents' needs. With <a href="http://www.diva-portal.org/smash/get/diva2:1232060/FULLTEXT01.pdf" target="_blank" rel="noopener noreferrer">high levels of smart meter usage</a>, it's a model that looks set to spread across Sweden.</p>
<div id="d7bf9" class="rm-shortcode" data-rm-shortcode-id="8757b138d5570bec9d6aad18074a429a"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1273556364263071744" data-partner="rebelmouse"><div style="margin:1em 0">Read more about Western Harbour and book a visit: https://t.co/ujSmVs9rNK 🏡🌳🌊 https://t.co/C5PuPziqIM</div> — Smart City Sweden (@Smart City Sweden)<a href="https://twitter.com/SmartCitySweden/statuses/1273556364263071744">1592474473.0</a></blockquote></div>
Scaling Up<p>A recent development by E.ON in Hyllie, a district on the outskirts of Malmö, southern Sweden, <a href="https://www.eonenergy.com/blog/2019/February/sweden-smart-city" target="_blank">has scaled up the smart grid principle</a>. Energy generation comes from local wind, solar, biomass and waste sources.</p><p>Smart grids then balance the power, react to the weather, deploying extra power when it's colder or putting excess into battery storage when it's warm. The system is not only more efficient, but bills have fallen.</p><p>Smart energy developments like those in Hyllie, Ludivika, and renewable-driven district heating, offer a radical alternative to the centralized energy systems many countries rely on today.</p><p>The EU's leaders have a challenge: how to generate 32% of energy from renewables by 2030. Sweden offers a vision of how technology and local solutions can turn a goal into a reality.</p>
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