If you thought the health world in 2016 was interesting, then you’ll probably love the health news coming out in 2017.
“This could be one of the wildest years in healthcare ever,” Kurt Mosley, vice president of strategic alliances at Merritt Hawkins consultants, told Healthline.
The political fight over whether and how much to repeal the Affordable Care Act (ACA) will most likely dominate health news this year.
However, issues such as the approval of new drugs, the implementation of new marijuana laws, and the battle over new restrictions on abortion services will be high profile.
In addition, there is expected to be some important clinical trials for Alzheimer’s disease drugs, more advances in cancer treatment, and the first payments from the 21st Century Cures Act.
Plus, technology will increase the availability and uses of things in the medical industry such as 3D printing, wearable technology, and telemedicine.
Healthy political fights
The new 115th Congress was sworn in today and already Republican leaders are discussing plans to dismantle the healthcare law known as Obamacare (ACA).
Vice President-elect Mike Pence is scheduled to meet with GOP congressional leaders on Wednesday to discuss the repeal of the ACA.
At the same time, President Obama will gather with Democratic congressional leaders to develop strategies on how to save at least portions of his signature healthcare law.
During the president’s term, the GOP-controlled Congress several times sent legislation to repeal Obamacare to Obama’s desk. Each time, the president vetoed the measure.
That will change on Jan. 20 when President-elect Donald Trump takes the oath of office.
Trump said during the 2016 campaign that dismantling the ACA would be one of his top priorities.
How much of Obamacare will be gutted and how quickly it will be dismantled are uncertain.
Trump has said he favors keeping the ACA provision that prohibits insurance companies from denying coverage to people with preexisting conditions, as well as the statute that allows children under the age of 26 to stay on their parents’ health coverage plans.
The big question, Mosley said, is whether the Republicans will retain the ACA provision that requires all Americans to purchase health insurance.
Without that mandate, Mosley said, the insurance system simply won’t work because younger healthy people won’t sign up. Those enrollees help balance out the more expensive older and less healthy insurance recipients.
Jack Needleman, Ph.D., chair of the Department of Health Policy and Management at the University of California, Los Angeles (UCLA), Fielding School of Public Health, agrees.
“The industry will collapse without it,” he told Healthline.
In addition, Republican leaders are now talking about potential changes to Medicare, the health program for people over the age of 65.
However, Mosley and Needleman said major changes in healthcare programs that are enacted this year probably won’t take effect for at least a year if not three years.
Needleman said the biggest changes may actually occur in employer-based insurance plans, which cover about 55 percent of the population.
Needleman said consumers can expect premiums as well as deductibles and co-payments to rise in 2017.
The UCLA professor also expects environmental issues such as climate change and regulations on the coal and oil industries to be big health issues this year.
He said the short-term effects of air pollution and water quality can be respiratory conditions and water-related illnesses such as the ones that affected residents of Flint, Michigan, in 2016.
The long-term effects include cancer and other life-threatening diseases.
“The environment is a health issue,” Needleman said. “These, I think, will have consequences.”
The other major political fight will probably center on Republican attempts to further restrict access to abortion services.
There are already plans in motion to eliminate federal funds for Planned Parenthood operations as well as the adoption of new regulations such as the “heartbeat” law in Ohio that limit when a woman can seek an abortion.
Cancer, HIV, Alzheimer’s
Scientists will be active in virtually all fields of disease research, but there’s expected to be a lot of activity in three arenas in particular.
This will be the second year of the cancer “moonshot” project headed by Vice President Joe Biden.
It will also be the first year of funding under the 21st Century Cures Act, which was approved by Congress and signed into law last month.
The program provides $4.8 billion to the National Institutes of Health (NIH) over the next 10 years.
That money will be used to fund research for cancer, Alzheimer’s, and other diseases.
Dr. George Demetri, professor of medicine at Harvard Medical School, and a member of the board of directors of the American Association for Cancer Research, told Healthline he expects to see advances in genetic-based research involving T cells and other mechanisms.
He said technology could also be developed that would move cancer cells and other unhealthy organisms into the human body’s “trash can.”
Demetri also expects the debate to continue over the effectiveness of immunology therapies vs. the cost of these treatments.
Dr. Robert C. Robbins, president and chief executive officer at the Texas Medical Center, expects to see more success from treatments that utilize the immune system.
In fact, he told Healthline, he wouldn’t be surprised if some of these therapies begin to be used to treat rheumatoid arthritis and other autoimmune diseases.
“I can see it playing out in other facets,” he said. “We’re starting to see results that are encouraging.”
Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, told Healthline he doesn’t expect anything ground-breaking to happen in 2017, but there will be developments that will “significantly influence cancer research” in the future.
There may also be some hopeful developments in the search for a cure for Alzheimer’s disease.
Keith Fargo, Ph.D., director of scientific programs and outreach, medical and scientific relations for the Alzheimer’s Association, told Healthline he expects to see more interest in the tau proteins that form in the brains of people with the disease.
He also notes that information on a number of clinical trials will be released in 2017.
Fargo also expects to see more focus on lifestyle factors such as diet and exercise as ways to prevent dementia.
There is also some optimism in the treatment of HIV and AIDS.
This past week, Intarcia Therapeutics Inc., announced that the Bill and Melinda Gates Foundation is investing up to $140 million in a tiny implantable drug pump the company is developing.
The pump holds six to 12 months’ worth of medicine. Company officials said it’s designed to deliver microscopic doses continuously, which could help prevent people in Africa from becoming infected with HIV.
This announcement came a week after the National Institute of Allergy and Infectious Diseases revealed the first large-scale clinical trial of the injectable drug cabotegravir.
The experiment will examine whether injections of the drug every eight weeks can protect men and transgender females from HIV infection.
Prescription drugs, marijuana
2016 was a slow year for the approval of new prescription drugs.
Last year the FDA gave the go-ahead to 22 new medicines for sale.
That was the lowest number since 2010 and well below the 45 drugs that were approved in 2015.
That may change in 2017.
In addition to research funds, the 21st Century Cures Act also streamlines some of the drug approval process for the FDA.
This has sparked some concerns from critics who fear some pharmaceuticals could be put on the market before they’ve been thoroughly tested.
The opponents also note the opioid addiction crisis that hit the United States last year.
Marijuana, on the other hand, saw a healthy approval process last year.
On the November ballot, eight states approved new laws legalizing the drug.
President-elect Trump has sent mixed signals on whether he will interfere with the marijuana laws in these states as well as others that made pot legal in recent years.
Consolidations and mergers
Last year, a wave of consolidations hit the health industry.
This year the nation might experience a flood of divestitures.
Mosley said we might see hospitals and other entities sell off some of their acquisitions to nonmedical entities, such as venture capitalists, to help balance their books.
“I think a lot of hospital systems are licking their wounds,” he said.
There will be two big proposed mergers in the insurance industry that will make news in 2017.
The American Medical Association (AMA) last year announced its strong opposition to the consolidation of Anthem and Cigna as well as the merger of Aetna and Humana.
In addition, federal officials filed legal action in July to block the mergers.
The federal court trial in the Aetna-Humana case began in early December. A decision is expected later this month.
Other business decisions in 2017 may be influenced by the move to more value-based healthcare.
That is a system where medical professionals are paid based on the quality of the care they provide as opposed to the volume of care.
In its annual report released last month, PwC’s Health Research Institute predicted the shift toward value in the healthcare industry will dominate trends in 2017.
All this maneuvering, Mosley added, may convince some doctors to hang up their stethoscopes.
“A lot of doctors may say they were trying to hang in there, but they just can’t,” he said.
Technology and other advances
Like it did in 2016, technology is expected to make some health headlines in 2017.
Robbins said wearable technology may have a big year after cooling off a bit in 2016.
The Texas Medical Center executive said he expects devices such as the Apple watch and FitBit to make a comeback.
Robbins said you might see more implantable nanotech devices that act more like life coaches for their wearers.
He said the technology will be more advanced and the data will be transferred onto a person’s electronic medical records.
He said his institution is already doing this with Apple products for people with chronic diseases.
“I think it will become more interactive without the patient having to do so much,” he said.
Robbins added you can also look for more advances in 3D printing and genome sequencing.
He also expects telemedicine to advance.
In particular, that technology may no longer be limited to a patient-doctor call.
Robbins said you may soon be able to use your cable television to dial up a medical professional if you become ill in the middle of the night.
All of this new technology, he noted, will require information to be automatically downloaded onto electronic medical records.
In addition, hospitals and other medical institutions will need to collaborate better.
Robbins said Texas Medical Center has discovered its 57 different entities need to work together.
“We’re seeing it happen here already,” he said.