[Lee Myung-ho's Future Preview] The Future of Healthcare Opened by Disease Prevention

Compliance with Daily Quarantine Measures such as Masks and Handwashing... Continued Decrease in Total Medical Expenses
Management through Health and Prevention... 10-Year Extension of Healthy Life Expectancy
Smart Healthcare including Health Monitoring... Need for Digital Medical Reform for Disease Prevention

Contrary to expectations that medical expenses would increase due to the spread of COVID-19 during the pandemic, the total health insurance medical utilization, including total medical expenses, actually decreased. Although additional medical expenses for COVID-19 treatment and testing occurred last year, the number of patients, number of visits, and total medical expenses all declined. Health insurance medical expenses had been increasing by an average of 9.5% annually over the past three years, but last year saw a mere 0.3% increase, which is 9.2% lower than the previous average. While the main reason was patients reducing hospital visits due to COVID-19, it was also due to a significant decrease in respiratory diseases and others as a result of adherence to daily preventive measures such as wearing masks and hand washing. Of course, psychiatry was the only field where the number of patients and inpatient/outpatient days increased, reflecting the phenomenon known as COVID-19 blues. This has highlighted the importance of hygiene and prevention in health.

According to a report by a global consulting firm, effectively managing health through healthcare and prevention worldwide can reduce disease-related cost burdens by about 40% and extend healthy life expectancy by 10 years. It is predicted that by 2040, this will contribute $12 trillion (an 8% increase) to the global GDP and enable an additional 0.4% annual growth. While the global labor force growth rate was 1.8% annually over the past 50 years, it is expected to slow to 0.3% annually over the next 50 years. Increasing healthy life expectancy can be a more effective economic growth policy than any other. In fact, over the past century, health improvements in developed countries have contributed about one-third more to economic growth than education. Despite the high effectiveness of health improvements, much medical spending is not directed toward health improvement, especially prevention.

In 2015, less than 3% (2-4%) of healthcare expenditures in OECD countries were used for prevention. Of the preventive spending, 50% was for health monitoring programs such as health checkups and dental exams, 25% for health promotion, and less than 10% each for vaccinations and screening programs. A preventive medical expenditure share of about 3% is insufficient to cope with the increasing chronic diseases. Chronic diseases refer to conditions or illnesses that are long-lasting or difficult to recover from. Chronic diseases such as diabetes and cardiovascular diseases are mainly caused by poor diet, lifestyle habits, and lack of exercise, and are characterized by being difficult to cure. Not only are the diseases hard to cure, but habits are also hard to change. Therefore, they account for the largest proportion of medical expenses.

Increase in Medical Expenses Due to Aging and Urbanization... Even Developed Countries 'Struggle'

In the UK, 70% of total medical expenses are concentrated on 30% of the population with chronic diseases. In Korea, as of 2017, the number of chronic disease patients accounted for 33.6% of the total population, or 17.3 million people, and the annual medical expenses for chronic disease treatment amount to 28.2 trillion won, which is 41% of the total medical expenses of 69 trillion won. By 2030, chronic diseases are expected to account for 75% of all deaths. Globally, the number of diabetes patients among chronic diseases is predicted to increase by 48% to 623 million by 2045. China will have as many as 114.4 million, India 72.9 million, and the United States 32 million, making diabetes the number one disease worldwide. Developed countries are struggling due to increased medical expenses caused by various adult diseases, chronic diseases, and cancers related to aging and urbanization. As of 2017, the ratio of current medical expenses to GDP was highest in the US at 17%, followed by Japan at 11.1%, and the OECD average at 8.8%. Particularly, Korea's medical expense growth rate is steep, with the ratio of medical expenses to GDP rising sharply from 5.9% in 2010 to 6.9% in 2016 and 8% in 2019.

Ultimately, preventing chronic diseases can significantly reduce medical expenses and extend healthy life expectancy. The problem is that since chronic diseases stem from lifestyle habits, people do not feel the need for active management until the disease develops. Generally, obesity accompanies physical changes but is not perceived as serious. It is important to respond to abnormal signs before they develop into diseases through regular health checkups. Even an annual checkup can detect diseases before they progress, but it is difficult to lead to lifestyle improvements and prevention. The best approach is daily health monitoring. Recent advances in digital technology have made what was once considered abnormal now possible. Smart healthcare technology is rapidly developing. By integrating digital technologies such as big data, artificial intelligence, the Internet of Things, and cloud computing, an era of intelligent services that enable real-time monitoring and management of individual health status and personalized treatment is approaching.

Although real-time monitoring is ideal, there had been skepticism about its feasibility and effectiveness. The question was how effective small wearable devices (mainly smartwatches), not hospital medical equipment, could be. COVID-19 confirmed the usefulness of smart healthcare and real-time monitoring. Multiple research teams were able to detect subtle changes in body temperature, heart rate, and heart rate variability 2-3 days before COVID-19 symptoms appeared using smartwatches, predicting infection with 90% accuracy. Compared to other methods such as nasal swab tests, this early detection is advantageous and effective in preventing secondary spread because it can be checked during daily life without going for testing.

Advancement of Preventive Medicine Through Smart Healthcare Should Be the Future Direction of Medicine

Of course, the technology used at this time was big data and artificial intelligence. By analyzing observational data from many ordinary people and patients, patterns of changes in bodily rhythms caused by COVID-19 were identified. This is expected to open a new era of early diagnosis. It has been proven that if sufficient daily biometric rhythm data can be collected through various portable and body-attached devices equipped with multiple measurement functions, including smartwatches, early diagnosis of diseases is possible. Not only smartwatches, but also attaching sensors to toilets for stool and urine analysis, adding facial and skin change detection functions to mirrors, collecting skin tissue from toothbrushes, and equipping devices for micro blood collection and analysis could turn home bathrooms into health checkup facilities.

Everyone knew prevention was important, but the difficulty of preventive methods is now likely to be solved by digital technology. Investing budgets in smart healthcare for prevention before diseases develop and require huge treatment costs can be effective in maintaining health and reducing costs. The era when telephone prescriptions temporarily allowed due to COVID-19 were considered remote medical care is long gone. It is now time for a transformation to digital medicine that prevents diseases through routine monitoring of bodily rhythms.

Lee Myung-ho, Planning Committee Member, Yeo Si Jae Foundation

This content was produced with the assistance of AI translation services.