While a number of changes have occurred, many of the issues of the early 21st century plague health care in 2101. Five things continue to drive health care in 2101. They are the attempts at governing particularly the Medical Insurance Act of 2046 and the Social Reorganization of 2082, robotics/transhumanism, genetic editing/designer DNA, AI and instanet’s impact on “drive through” health care, and pharmaceuticals surrounding the issue of control and free will. The overall effects and outcomes have extended life but more importantly the quality of that life.
One’s health is first noted when designer DNA are combined at conception and followed throughout life. Most concerns can be determined early via individual (designed/designer) health plans developed at birth and followed throughout life. Health care dispensers can be interfaced similar to the drive throughs of fast food of the late 20th and early 21st centuries. AI along with the Instanet has allowed for information to be stored and access nearly instantly. Along with this, the Instanet speed and the HEM (Human Electronic Memory – see Chapter on Education) allows for comprehensive health records to be obtained instantly, reviewed, and combined with current data to prescribe options for your future designer health care.
See other chapters on Personal Assistant and Life Coach - PALC (pronounced “pal zee”) and its effect on managing many daily utility needs such as transportation, scheduling, meals, entertainment, and “housing”.
I discovered this summary of Medical Concerns in a paper written in 2093 by an amateur historian, Juan Cooper. I quote:
Before the Social Reorganization of 2082, the Medical Insurance Act of 2046 again attempted to provide medical care to everyone. The cost of providing integrated health care was at the center of the argument. The fall out of Obamacare of the early 21st century had never been fairly settled. Several new laws were tried but still costs increased and care never really substantially improved. The MIA of 2046 was another attempt to provide an affordable way forward for health care. The cost sharing set the stage for some improvement in care and stabilized the cost increases. The Social Reorganization of 2082 included uniform health care. By 2082 AI and robotics had made much of the health industry easily available to most and allowed an actual cost reduction in providing care.
One of the underlying issues of all the health care debates dating back to the early 20th century is individual free will. This relates to personal responsibility. Before paying for others’ health care those paying demanded that everyone should/must do the things that lead to better health and longevity and avoid doing things they know are unhealthy. Debates mostly avoided this discussion and thus the debate of fairness. While seldom outright discussed, much of the proposed legislation prior to the MIA of 2046 attempted to manage individual behavior following the logic used to tax ingredients of food that was linked to health issues, e.g. cigarette (nicotine) and sodas (sugar). The MIA of 2046 directly addressed this issue along with cost sharing.
The inclusion of one’s DNA review also allowed a more individualized medical plan which allowed the private market to better manage pooled money. Those with better health were still expected to contribute premiums 15% higher than their DNA, health habits, and actual health would require. This “fairness” contribution (fair in that based on your DNA, etc you received better health outcomes than expected and therefore it is only fair that you are better able to contribute) helps pay for the cost of those with worse health outcomes than expected. The U.S. Government through other funds contributes to a high-risk pool. The MIA also limited the private insurance cost outlays to $5M per individual at which time they move to the high-risk pool. This limited the risk of market insurance allowing for lower premiums.
The move toward trans-humanism continues. Nearly every aspect of the human body can be replaced. Some with one’s own DNA grown parts, human and non-human donated parts, and some with more mechanically considered parts. With the intrusive government oversight of several large producers of parts, whether grown or produced, most can acquire a part within days or weeks. With AI aided medical surgery procedures making about 73% of replacements simple and standard procedures, wait times and costs are significantly reduced. These body replacements with their usually included “upgrade” to desired strengths, appearance, etc, the humanness has become difficult to determine. Our human nature of categorizing and sorting, “humanness” joined, racism, gender, and other “discriminatory” categories.
Another argument concerns robotics free will. The argument about emotional free will of robots has become more common in the last several decades. With AI incorporated into many robotics, the long standing argument of at what point does the designer lose ‘control’ of the robot and it then controls itself? At what point does a robot become a trans-human or a trans-human becomes a robot?
Genetic editing is common for those conditions genetic modification has proven to improve or correct. There are a few of these conditions that are extremely prevalent in the population and therefore far reaching in its impact. Diabetes, heart and circulatory diseases, most cancers, and obesity are a few that genetic editing has impacted significantly. However, if you ask anyone in the medical profession, they still acknowledge that humans readily fail to do the things they know are good for them and regularly do things they know hurt or harm them both physically and emotionally. Genetic editing can move one only so much toward a healthier life. With the introduction of PALC, life styles and health habits have improved for those using a PALC, currently about 67% of the adult population.
Research on aging has discovered a number of things that can extend life. Genetic editing for several known aging maladies can extend the life of those with such genetic defects. Worn out body part replacement has helped to extend life. The new designer drugs, medical techniques, and life styles contribute to life extension, but it is one’s general health and avoidance of diseases that kills individuals, that’s the primary driver of extending life expectancy. The average life expectancy for those that are less than 10% trans-human is 96 for men and 98 for women born in 2050. One can add about four years for every additional 10% trans-human. Using all possible techniques for life extension, a human could likely live to 180 or possibly beyond.
Artificial Intelligence and Instanet has been instrumental in stabilizing and even reducing costs to health care. The integration of AI and robotics has replaced physicians doing much of the medical diagnostics and numerous common surgeries. It also has greatly aided in remote medical procedures and diagnostics. Someone, for example an expert in some procedure, etc can instantly “be there” to interact and do via robotics what a physician could do in person. This also works for drive through medical dispersers. Most homes or living areas also has access to Artiphys (pronounced ar-ti-fuss) which are simply AI physicians. They can be accessed anytime of the day. They are available via a simply subscription similar to legal information and attorneys were in the early 21st century. With the Social Reorganization of 2082, they are included with the uniform health insurance coverage.
Psychiatry, while better understanding the chemical functioning in the brain and therefore can better target specific illnesses, still remains more art than science. Individual designer drugs are common. DNA’s complexity still challenges many medical solutions along with unintended consequences of integrating body parts that contribute to transhumanism. Under current laws, specifically related to uniform health insurance, DNA can be used to identify chemical solutions to your illnesses and ailments including mental status. An issue still seriously impacting psychiatry concerns the ‘control’ of individual free will. Certain drugs dramatically increase an individual's susceptibility to suggestion or ‘control’. These drugs and combinations of drugs that produce those effects are one of the few areas where government holds strict regulations.
With the huge progress made over the last 30 years, health care has seen less new ways to maintain and improve health. However, history tells us there will likely be something new to push quality of life and longevity to another level. At this point I am not aware of anything specific that will be the new breakthrough. So at this time I do not venture to make any guesses or predictions.
Insurance such as the uniform health insurance will likely continue to be the main source of funding for health care. Pharmaceuticals will continue to improve lives of anyone remaining with some amount of humanism. Governments will also have struggles with rights based on how we define humans, etc.
Human Electronic Memory still has some advances. There are companies competing to introduce an addition of a chip that will allow data to be directly loaded into the memory instead of passing it though the human mind for organization. This is a little like meshing the now defunct operating systems of Apple and Microsoft together so either one or both in tandem can manage and provide data and respond to requests. Once this is completed, human “memory” could become as effective and efficient as robots and likely AI.
Transhumanism or extending of bionic parts has been accelerating and therefore likely to be an area of concern as nations employ them in new and differing ways. Use and understanding of human DNA, extending of non-human body parts, and machine interactions with the human body (what I would call machine DNA) will progress and may very well mutate into unique forms of “life”. Of all the medical areas this is likely to be the one of most concern to human survival.