Whether or not healthcare insurance reform proceeds in Congress, true healthcare reform is proceeding.  Its sources are molecular medicine, medical automation, and telemedicine.  At the heart of molecular medicine is predictive, targeted, preventative care for the individual-so called “personalized medicine.”  PriceWaterhouseCoopers estimates that market now stands at about $232b, and in five years will reach $450b.  As one observer put it, this amounts to “mass customization.”   Telemedicine makes it possible to put a $2,700/day hospital bed into a patient’s home for around $150/day-creating, in effect, a hospital without walls.  It releases geographical constraints, and enables wireless wellness.  Critics assert reimbursement is a major obstacle; but if the bottled water industry can market Americans a per capita consumption of 21 gallons per year of a largely unnecessary product, maybe someone can figure out how to promote a really useful one.

While both molecular medicine and telemedicine pick up momentum, medical automation already is here-except it isn’t.  Healthcare is the last industry to benefit from automation, after it transformed every other sector in a material culture called “the good life.”  Still, outside healthcare, the information age is underway-with electronic sensors for systems control, CAD directed manufacturing, mathematical modeling and dynamic simulation for strategic decision making,  Inside healthcare-in every detail from handling a single cell to running a dispersed services network-automation offers vast economies that, in effect, bridge to molecular medicine and telemedicine for true healthcare reform.