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In caring for you, how will the doctor of the future reconcile the demands of efficient practice with the need to keep current on a torrent of new therapies and medical technologies? As the cost of health care rises and the ranks of the uninsured increase, what should our society do--and who will pay to do it? Are we prepared to limit our access to medical procedures in order to relieve the pressures bearing down on Medicare?
These are hard questions, and not only because they involve the substance of medical science. They engage our private concerns about wellness and mortality and our civic concerns about public policy. In speaking of health care, we bare both our personal and our political perspectives.
In that respect, the evolving state of health care has much in common with other major issues at the end of this century and the start of the next. How will conducting business over the Internet change the look of urban streetscapes, and affect our social interaction with our fellow citizens? What kind of politics will we have, and what are the prospects for democracy? With national boundaries becoming ever more porous and populations ever more diverse, will Americans finally regard one another equally across their historic racial divide?
Another thing these issues have in common, beyond their complexity, is the certainty that Harvard people will be involved in framing the questions and pursuing the answers. We learned just how true this was when Harvard Magazine began last fall to convene a group of faculty members and alumni to talk about changes in health care. We were easily able to identify distinguished scholars, physicians, business people, and analysts of ethical issues, all deeply knowledgeable about the structural transformation of medicine--an embarrassment of riches. Those whom we contacted all agreed to be part of a freewheeling conversation on the future of health care. The result of that vigorous discussion--the first in an occasional series of articles examining major issues on our agendas, private and public--appears in "The Future of Health Care," where you are invited to join the debate.
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We can also see the next century's agenda unfolding in the realm of scientific inquiry. Harvard's new centers for studies in genomics and proteomics and the behavior of "mesoscale" materials and structures (see "Big Thinking About Science") suggest, among other things, how new technologies can be applied to the search for knowledge. These initiatives also indicate the increasingly interdisciplinary nature of fundamental research. And they assure those of us who have just gotten comfortable with words like "Internet" and "megahertz" that our vocabularies will remain challenged. Most significant, of course, are the prospects for better understanding of biology itself, of ailments and their alleviation, and of the physical principles whose applications promise to make our lives still more satisfactory and productive.
~ John S. Rosenberg