Health and Society, Healthcare in America
Amir Bagherpour PHD | May 2016

Health Care in America

A Primer On the Future of Our Healthcare System


giStrat forecasted the next three to five years of the healthcare landscape in America.

This future can be defined according to three dimensions: cost, quality, and access. Additionally, preventive care presents a way to increase access and quality while lowering costs, but it faces some challenges in its realization.

We examined each of these elements and found we are likely to see the following:

  • A substantial increase in health care quality

  • A slight decrease in cost per capita with significant opposition within the health care industry

  • A substantial increase in access to healthcare, while opposition to universal coverage decreases

  • No significant improvements in preventative care without a major push to change patient attitudes

View the full report here.



Hospitals and care providers across America confront the future of health care with uncertainty. National health expenditures account for over eighteen percent of the U.S. GDP, equaling $3.5 trillion—or approximately $8,000 per capita – and are rising.

In spite of these costs, the United States ranks 37th among the world’s health systems according to the World Health Organization (WHO).

The Affordable Care Act (popularly known as Obamacare) passed with three broad goals known as the Triple Aim:

  • Improve health of populations
  • Improve patient experience and care
  • Reduce per capita healthcare costs

The degree to which these aspirational goals can be accomplished remains uncertain.

Looking Ahead

The future of health care can be defined according to three broad dimensions: cost, quality, and access. In our analysis we identified the determinants and factors driving future cost, quality, and access in America.



Our analysis revealed clear trends on each of the four main drivers affecting the future of health care.


There will be a substantial increase in the quality of health care within the next four to five years. Our findings indicate the following determinants of quality will significantly improve in this time frame: effectiveness, safety, timeliness, and patient-family centeredness. In spite of these improvements, our findings suggest the United States will witness an increase in political and social tension regarding the quality of health care.

The graph below shows how positions will evolve in the next few years. We see a trend toward the right of the status quo – indicating a movement toward preferring increases in quality – as time evolves.

For more information, including current graphs of current positions, download the full report.


Evolving positions on quality


Costs per capita will slightly decrease in the next three to five years as a result of continued pressure from state governments, federal agencies, small businesses, large corporations, insurance companies, senior citizens, and the middle class working population. 


Evolving positions on cost


Access will substantially increase in the next three to five years in terms of eligibility, type of care, and degree of care. The simulation also indicates that opposition to universal coverage under the Affordable Care Act will substantially decrease, most notably among senior citizens and state governments.


Evolving positions on access


giStrat’s impact model projections indicate that patients and providers want to improve preventive care. Despite these aspirations, impact model projections suggest that we will likely not observe significant improvements in preventive care in the next three to five years when considering the perceived tradeoffs between cost, quality, or access. In order to improve preventive care measures, there must be an active effort to convince a majority of both providers and patients to prioritize lowering cost over increasing access.


Simulating the Future of Health Care through Agent-Based Modeling

Senturion is a software tool that incorporates computational analytics with behavioral theories from the fields of psychology, political science, and microeconomics to anticipate political outcomes. Analysts have utilized Senturion for more than 450 projects for the Department of Defense and intelligence community with an 85% accuracy rate and 200-plus projects at the State Department with over a 90% accuracy rate. In modeling stakeholder preferences, the simulation assumed that stakeholder bargaining is a function of an actor or group’s position on a particular issue. Our analysts also calculated the weight actors attach to each issue and the actors’ relative influence.

Share this project