The Separate Orbits of Medicare and Moore’s Law

written by Eric J. Topol, MD

Today is the 50th anniversary of the Medicare Bill–which transformed health care in the United States by providing insurance for people age 65 and older, irrespective of income or pre-existing medical conditions. Just a few months ago the 50th (gold) anniversary of Moore’s Law was celebrated, which predicted the remarkable trajectory of the computer industry and led to the innovation hub in Silicon Valley. Yet even though these two major forces have grown up together, they barely if ever talk to one another. That’s terribly unfortunate and unwise. But it’s not too late.

Medicare will spend more than $600 billion this year and that number is rising quickly as the 75 million baby boomers reach the age of coverage. Many have projected that Medicare is ultimately headed towards insolvency, unable to meet it obligations, unless something is done. That something could be convergence with Moore’s Law. Its cost curve over the past 5 decades is diametrically opposite to that of Medicare’s.

The law that predicted a doubling of transistors that can be squeezed on a chip every 18 months is what numerically accounts for why we have over 2 billion transistors in our current smartphones. The explosive growth of computing power at exponentially lowered costs had also led to a digital infrastructure that now includes pervasive connectivity, mobile broadband, cloud and supercomputing. As a result, every other sector of our day-to-day lives–financial, telecommunication, retail, travel, and entertainment–have been irrevocably changed. But to date essentially none of these technological triumphs have been leveraged to reduce the cost of health care, no less to achieve better outcomes for patients.

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