According to the Centers for Medicare and Medicaid Services, per capita spending by state and local governments will rise from about $1,000 in 2010 to almost $1,800 in 2019 – an 80% increase in ten years.

Wrestling with this tremendous burden will require targeted programs that will manage disease and the many ailments of an aging population in a cost effective way.  We will need innovative programs that not only respond to healthcare needs, but which help individuals manage their own health and wellness in such a way as to reduce their overall claims on health services.

According to data from the Sheps Center at UNC Chapel Hill, everywhere in the U.S., including in North Carolina, the demand for physician services will outstrip supply, with rural areas facing particular difficulties. This gap will be met in part by the increasing use of nurse practitioners, physician assistants, and other allied health professionals, but to close the gap completely, we will need to innovate around how technology can deliver health services, the use of non-physicians in the delivery of care, and new models of workforce preparation.

The increase in costs will also be made more manageable, and health outcomes improved, as the major providers of healthcare ramp up their initiatives around quality and best practice. However, our state can — and should — be the leader in the design and implementation of reimbursement systems which tie payments to evidence based practices and health outcomes.

None these challenges can be met unless patients take ownership of their own health and behaviors, and their role seriously as informed consumers.  Education – starting with the very young and continuing to the elderly – is vital for our citizens to take ownership and responsibility of their own health. Otherwise, any innovation will be swamped by the declining health of a population that doesn’t understand their own responsibility for their health and wellness.

In addition, business also has to play an important part, understanding that a healthy workforce has a substantial impact on the bottom line, and that this can be fostered by workplace wellness and insurance programs that emphasize quality as well as price.

It can be difficult to think of our health collectively, as it is ultimately an individual circumstance. However, if North Carolina can think about its health in broad terms and put the policies in place to support healthy living, we can increase the quality of life for each of our citizens and put North Carolina in better financial shape.