Throughout history, healthcare has often been a privilege of the affluent, a trend that continues into 2024 despite technological advancements
This essay is part of the "What to expect in 2024"
As 2024 approaches, the healthcare landscape is increasingly marked by a dichotomy: advanced technologies and innovations suggest a future of unprecedented medical capabilities, yet these advancements often remain within the reach of only the affluent. Healthcare's revolutionary strides in areas like Artificial Intelligence (AI), gene editing, and digital transformation contrast sharply with persistent issues of access and equity. This piece offers a forecast into the healthcare sector in 2024 and aims to explore how, despite progress, healthcare access and quality continue to be influenced significantly by economic disparity, shaping a future where healthcare innovations will remain a luxury for many.
In 2024, the healthcare sector is set to further advance its use of generative AI and digital transformation. This movement is driven by the need to enhance patient care and operational efficiency. Generative AI, especially through Large Language Models (LLMs) and Large Medical Models (LMMs), will revolutionise healthcare by transforming how patient data is processed and care is delivered. These AI tools will likely play a crucial role in predicting in-hospital mortality, managing the length of hospital stays, and processing medical claims, thus boosting the efficiency of healthcare organisations across the world.
Healthcare's revolutionary strides in areas like Artificial Intelligence (AI), gene editing, and digital transformation contrast sharply with persistent issues of access and equity.
Despite these advancements, the digital transformation in healthcare brings its own set of challenges. The uneven integration of these technologies could potentially widen the healthcare accessibility gap between affluent societies and others, raising concerns about regulatory and safety aspects in the rapidly evolving field of generative AI. Moreover, the impact of these technologies in the Global South raises questions about global healthcare equity. While generative AI has the potential to democratise healthcare, disparities in resource distribution might limit its benefits to wealthier nations, exacerbating global health inequities. Addressing these challenges requires concerted efforts from healthcare leaders and policymakers to make generative AI and digital healthcare tools universally accessible and beneficial. This could be done through investment in technology, infrastructure, and regulatory frameworks to ensure equitable healthcare outcomes globally.
In 2024, the healthcare sector's landscape is expected to be shaped by ongoing mergers and acquisitions, driven by the necessity for operational efficiency under financial constraints. This trend is leading towards the formation of larger, more integrated healthcare systems, which promise improved service delivery and operational efficiency. However, there are concerns about the commercialisation of healthcare and reduced accessibility for lower-income groups. The focus is shifting towards value-based care, with healthcare organisations prioritising strategies that enhance patient care quality. Additionally, trends like remote patient monitoring and a growing emphasis on mental healthcare, facilitated by digital health technologies are becoming more prominent. The involvement of non-traditional players in the healthcare sector, such as tech companies and private equity firms, is expected to further fuel these mergers and acquisitions.
The uneven integration of these technologies could potentially widen the healthcare accessibility gap between affluent societies and others, raising concerns about regulatory and safety aspects in the rapidly evolving field of generative AI.
Unfortunately, one outcome of industry consolidation under financial pressure could lead to the shutting down of many novel initiatives, similar to Babyl Rwanda, which has done remarkable work to enhance equity in a low-income country by working on a cross-subsidisation model. This underscores a significant challenge for the healthcare sector: balancing the drive for efficiency and expansion with the need to support and sustain innovative models that prioritise healthcare equity. The dynamic and evolving healthcare landscape of 2024 will require careful navigation to ensure that advancements do not come at the cost of diminishing access and equity, particularly in regions most in need of innovative healthcare solutions.
In 2024, the healthcare sector is expected to face intensifying workforce challenges, primarily driven by talent shortages and clinician burnout. This situation is a result of several factors, including the demanding nature of healthcare jobs, the aging population of healthcare professionals, and the long-term impacts of the COVID-19 pandemic, which has significantly strained healthcare resources and personnel. As healthcare organisations struggle to cope with these challenges, there is a growing trend towards outsourcing and offshoring, especially for administrative functions like billing, coding, and claims processing.
Outsourcing critical functions can lead to discrepancies in service quality, especially if the outsourced services lack the same level of oversight or expertise as in-house teams.
However, the move towards outsourcing and offshoring is not without potential consequences. While it can provide short-term financial relief and operational benefits, it also raises concerns about the long-term implications for job security and the quality of care provided. Outsourcing critical functions can lead to discrepancies in service quality, especially if the outsourced services lack the same level of oversight or expertise as in-house teams. Furthermore, this trend could exacerbate existing disparities in healthcare, particularly affecting the quality and availability of healthcare services based on financial capacity. As wealthier healthcare organisations may be better positioned to invest in outsourcing strategies, there is a risk that smaller or underfunded facilities may struggle to maintain service quality, potentially widening the gap in healthcare access and quality across different socio-economic groups.
The future of CRISPR in healthcare, especially with the United States Food and Drug Administration's (USFDA) approval of CRISPR/Cas9 gene-edited treatments, is set to revolutionise the management of genetic disorders. The application of this technology, exemplified by treatments for sickle cell disease, involves complex procedures and targets patients’ hematopoietic stem cells to compensate for genetic deficiencies. While this represents a significant advancement in personalised medicine, offering hope to those with severe conditions, it also brings challenges related to complexity, cost, and accessibility. These therapies, potentially costing up to US$2 million per patient, underscore significant disparities in healthcare access and affordability, particularly in low-income countries where most patients with conditions like sickle cell disease reside.
Developments in CRISPR technology, such as prime editing and epigenome editing, are expanding potential healthcare applications, offering more flexible and precise genome editing and altering gene expression without changing the DNA sequence.
Developments in CRISPR technology, such as prime editing and epigenome editing, are expanding potential healthcare applications, offering more flexible and precise genome editing and altering gene expression without changing the DNA sequence. However, the real-world implications in the developing world remain a concern. While these technologies promise novel treatments for a range of genetic disorders, their high costs and complex administration could further widen the global healthcare disparity gap. As such, while CRISPR/Cas9 gene editing marks a new era in medical science, its benefits risk being confined to affluent societies unless global efforts are made to make these treatments more accessible across diverse economic landscapes.
Throughout history, healthcare has often been a privilege of the affluent, a trend that continues into 2024 despite technological advancements. Historically, medical practices were based on unproven ideas until the scientific method revolutionised medicine in the 19th century. However, the rise of private, for-profit medical schools and the focus on profit over patient care marked a shift in the healthcare industry. Today, despite significant advancements, the healthcare system often grapples with the challenge of ensuring equitable access. This trend is reflected in the modern healthcare landscape, where innovative treatments and technologies are often accessible mainly to those with financial means, perpetuating healthcare as a rich man's game. As we look to the future, we must consider if adopting models like Tesla's open-source approach, which revolutionised the electric vehicle industry through a focus on long-term vision and collaborative innovation, could offer a pathway to more equitable access in the healthcare sector.
Oommen C. Kurian is Senior Fellow and Head of Health Initiative at the Observer Research Foundation
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Oommen C. Kurian is Senior Fellow and Head of Health Initiative at ORF. He studies Indias health sector reforms within the broad context of the ...
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