Using health information dating from the Civil War, researchers have arrived at some intriguing conclusions about the "environmentally induced change to human physiology" which has led to a steady increase of healthier longer-lived people in developed nations. A University of Chicago economics professor presented the study findings during a recent health care symposium in Phoenix. The remarkable findings identified the existence of a synergism between technological and physiological improvements which has produced "a form of human evolution that is biological but not genetic, rapid, culturally transmitted and not necessarily stable."

Only a handful of the nation's medical schools now teach molecular science, but soon doctors without this education will be on the road to obsolescence. Scientists are looking deep into the genetic code to find an answer in the molecules to the riddles of disease diagnoses and treatment. Variations within the molecular structure of genes, called haplotypes, may explain why a drug helps one patient but triggers an adverse reaction in another. When fully understood, haplotypes will play a leading role in diagnosis as well as prescription.

The airline industry provides a gloomy metaphor for health care, according to Brandeis University economist Stuart Altman, who spoke at a W. P. Carey School of Business symposium recently. With hospital care dominating the growth in health-care costs, institutions that can focus on the patients and procedures covered fully by insurance will be robust. Hospitals that serve the poor and the uninsured will falter – like big airlines committed to providing ubiquitous service, even in unprofitable markets. With the baby-boom generation aging into high utilization, pressure on the system will only increase. Altman outlines the hard decisions ahead.