At a Washington, D.C., symposium last week celebrating the 25th anniversary of policy journal Health Affairs, Princeton University health economist Uwe Reinhardt suggested that consumer-directed health care so far has been code for health savings accounts tied to high-deductible insurance.

“The American health care consumer is like a blindfolded consumer who you shove into Macy’s and ask to buy a shirt,” Reinhardt quipped.

A few days earlier in Philadelphia, futurist James Canton said that consumers already have made their voices heard in health care, just not in ways that fit with a marketing buzzword. “The Internet has transformed the patient/physician relationship,” Canton said during a keynote address at the Medical Group Management Association (MGMA) annual conference.

Still, there is plenty more to come in consumer-driven health care, according to Canton, president and chairman of the Institute for Global Futures (San Francisco) and author of The Extreme Future and other books.

“Citizens have the right to know what their health status is,” Canton said. “That hasn’t become policy yet.”

And that’s not the only thing Canton believes to be changing in health care and medicine.

Canton sees predictive medicine, prevention and health promotion prevailing in American health care by 2015, driven mostly by technology. “The path to personalized medicine is emerging today,” he said.

IT is at the top of his list of emerging trends in health care technology. Others include early detection of diseases, faster drug discovery, disease management, and predictive medicine thanks to better diagnostic tools.

“Predictive medicine will drive medicine below the symptom line,” according to Canton. This is what he called “post-genomic medicine,” where clinicians will be able to head off potential health problems before they actually emerge.

Consumer expectations also will be higher thanks to “distributed, real-time medicine,” Canton said. “More radical, disruptive innovations are coming fast.”

Today we have what Canton called “real-time health IT visualization,” such as CT scans. “Real-time health-IT visualization may create a new ops center,” he said. In other words, future physician practices may feature a diagnostic viewing station with multiple high-definition screens rather than a traditional exam room.

New devices may take the place of broad-spectrum drugs, and more wireless services will create “pervasive mobility.” In fact, Canton expects the medical device industry to grow by 4.6 percent annually through 2015.

Of course, as anyone who works in health-IT knows, technology is expensive. “Who pays for that is the big question,” said Canton. The tug-of-war will come down to three parties: employers, government, and individuals.

Another great debate will take place between expectations of privacy and the need for government or employers to have certain information, according to Canton. “There will be many new stakeholders that will educate consumers how to manage information.”

As if consumers aren’t confounded enough in today’s health care marketplace.

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