The Macro View: Population’s Effects

PSFK had this a few weeks ago and and I saw it again yesterday from Richard Florida.

19.20.21. stands for 19 cities in the world with 20 million people in the 21st century.

The project: “19.20.21 is a multi-year, multimedia initiative to collect, organize and better understand population’s effect regarding urban and business planning and its impact on consumers around the word.  This 5+ year initiative will deliver results via 5 channels: web (including mobile), television (broadcast and cable), print (magazines, books and atlases), exhibits and seminars (virtual and onsite).”

Most of the people in the world live in cities, and by the end of this century many more will.  19.20.21. will conduct case studies on 19 cities around the world with populations of 20 million+ (only two in the U.S.: New York and Los Angeles) to study the effect of this population shift.

The site says “Any company with a focus on globalization will find the patterns and explanations in 19.20.21. indispensable.”

There are many items on the site that will impact on your life.  It’s worth looking at.  I can’t help but ask the question: how is this going to change health care?

While much of health care consumed by Americans is hardly international, that trend is growing.  Some dignitaries come to the U.S. to receive care.  Both those trends will have an impact: people are leaving to receive comparable care in other countries and as health care systems develop in other nations, fewer dignitaries are receiving care here.

This population shift will increase the specialization of American health care, especially in urban areas, as we strive for competitiveness on the global front (“we have the best health care in the world”).  It’s also going to force smaller hospitals in less densely populated areas to change their operations as well.  Maybe we’re moving to the Porter model of health care, where (real) competition reigns, care is delivered in patient-focused practice groups, and smaller hospitals deliver primary care and refer to the specialists at the large institutions.

Anyway, this is the start of the debate.  Any reform in the country needs to target the population’s needs at least 10 years from now…because it’s going to take us that long to figure out what we want; and add five years to that…to account for the “how” of implementation.

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