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Biotechnology will drive medical breakthroughs that will enablethe world's wealthiest people to improve their health and increasetheir longevity dramatically. At the same time, geneticallymodified crops will offer the potential to improve nutrition amongthe world's one billion malnourished people.
- GLOBAL TRENDS 2015:A Dialogue About the Future With Nongovernment Experts
December 2000http://www.dni.gov/nic/NIC_globaltrend2015.html 
Science and Technology
 Fifteen years ago, few predicted the profound impact of the revolution in informationtechnology. Looking ahead another 15 years, the world will encounter more quantumleaps in information technology (IT) and in other areas of science and technology. Thecontinuing diffusion of information technology and new applications of biotechnologywill be at the crest of the wave. IT will be the major building block for internationalcommerce and for empowering nonstate actors. Most experts agree that the IT revolutionrepresents the most significant global transformation since the Industrial Revolutionbeginning in the mid-eighteenth century.
Biotechnology
 By 2015, the biotechnology revolution will be in full swing with major achievements incombating disease, increasing food production, reducing pollution, and enhancing thequality of life. Many of these developments, especially in the medical field, will remaincostly through 2015 and will be available mainly in the West
and to wealthy segmentsof other societies
. Some biotechnologies will continue to be controversial for moral andreligious reasons. Among the most significant developments by 2015 are:
•
 
Genomic profiling—
by decoding the genetic basis for pathology—will enablethe medical community to move beyond the description of diseases to moreeffective mechanisms for diagnosis and treatment.
•
 
Biomedical engineering
, exploiting advances in biotechnology and "smart"materials, will produce new surgical procedures and systems, including betterorganic and artificial replacement parts for human beings, and the use of unspecialized human cells (stem cells) to augment or replace brain or bodyfunctions and structures. It also will spur development of sensor and neuralprosthetics such as retinal implants for the eye, cochlear implants for the ear, orbypasses of spinal and other nerve damage.
•
 
Therapy and drug developments
will cure some enduring diseases and countertrends in antibiotic resistance. Deeper understanding of how particular diseasesaffect people with specific genetic characteristics will facilitate the developmentand prescription of custom drugs.
 
•
 
Genetic modification—
despite continuing technological and cultural barriers—will improve the engineering of organisms to increase food production andquality, broaden the scale of bio-manufacturing, and provide cures for certaingenetic diseases. Cloning will be used for such applications as livestock production. Despite cultural and political concerns, the use of geneticallymodified crops has great potential to dramatically improve the nutrition andhealth of many of the world's poorest people.
•
 
DNA identification
will continue to improve law enforcement capabilities.
http://www.dni.gov/nic/PDF_GIF_global/globaltrend2015.pdf  
Bio-Tech Meets Info-Tech:
Perspectives on 21st Century Health Care
by Konrad M. Kressley
 
March 3, 1998
This is the seventh in aseries of articleson what to expect in the next millennium. If you've read prior installments, you know that technology trends are the principal forcethat augur future developments. Humanity is now experiencing the so-called "ThirdWave" or Information Age launched by the invention of computers. These thinkingmachines are important not only for themselves; they enhance and transform othertechnologies as well. The resulting advances touch all aspects of our lives, includinghealth care. Using the context of 21st century demographic and economic trends, let usattempt to forecast central issues to be faced in the next century. A word of caution: thisarticle does not seek to describe or laud specific medical technologies, you can get thatfrom
 Newsweek 
or
Parade
magazines.
Recent Developments in Health Care
Before we turn to the future, it might be instructive to review developments that led to thecurrent state of the U.S. medical industry. Until approximately mid-century, health carewas essentially a small business based in the homes of individual physicians. Hospitalswere charitable or community institutions. Then, the twin forces of insurance coverageand modern medical technology transformed black-bag medical practice into a corporateindustry. To begin with, the economic boom after World War II translated into higherwages and benefits for industrial workers. Health insurance was one of those benefits.With an insurance card in a wallet or purse, individuals essentially handed physicians,
 
hospitals and other medical specialists a blank check, which translated into the bestmedical care available. Remember that medical procedures are different from other goodsand services, where the customer shops for price and quality. Here the doctor determineswhat you need and how much it will cost. It was not unusual for patients to get more thanthey needed. Since the late sixties, government Medicare and Medicaid programs mademore people eligible and pumped additional money into the system.The same era witnessed a technological revolution in medical care. Advances inmicrobiology, chemistry, engineering, and electronics were incorporated into medicalscience. For instance, kidney dialysis became possible with the development of filtermembranes, gastroenterology flowered with the invention of fiber optics, and heartpacemakers came into existence with miniaturized electronics. While technologyinnovation is a common thread of contemporary history, the experts agree that theavailability of private and government health insurance money accelerated the pace of high-tech medicine. In the process, health care became extremely profitable. Competitionfollowed. Now private-practice physicians and community hospitals are being sweptaway by corporate medical conglomerates organized along industrial lines for efficiencyand profit. You might say that health care is finally catching up with the businessmainstream where stores, restaurants, auto service shops and nearly all other enterprisesoperate on a large scale and are organized into regional, national and even internationalchains. Now it's health care's turn for the corporate makeover with all the down-sizing,mergers, acquisitions and financial acrobatics that come with it.So what does this mean for you, the health care consumer? First of all, start thinkingabout health in economic terms or how folks can maintain optimum health at a minimumprice. Currently, fee-for-service private physicians are being replaced by managed-carefacilities called Health Maintenance Organizations (HMOs). Employers, privateindividuals or insurance companies pay fixed monthly fees for a total package of medicalservices. The operation turns a profit when the fees exceed actual expenditures on theHMO's clients. Assuming that there are many competing HMOs, you can shop aroundand pick one with the best reputation and lowest fees. At the same time, the HMOsmaximize profitability by enrolling healthy clients and keeping them in tip- top shape sothey won't need costly medical procedures.It sounds like a win-win situation. Everyone is motivated to save money and stay healthyat the same time. The HMOs, particularly, encourage wellness by emphasizing regularexams, preventive care, and educating clients about a healthy life style, all of which isgood for them anyway. So what's the problem? First, managed care organizations steeraway from folks who are likely to need frequent and extensive medical care.Consequently, those with the greatest need are often denied coverage and left to fend forthemselves. Secondly, managed care involves a system of rationing, where all possibleafflictions have a coded price tag that the health care provider is loath to exceed. Thatmakes good sense to the corporate medical executives, but can be quite frustrating for anindividual whose life depends upon an organ transplant or other costly procedure.
The Changing Face of Disease
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