The coming year is being considered as a watershed for healthcare in the United States. Affecting hospitals, insurers, employers and patients alike, it is hoped that the convergence of market and political forces will lead to changes that will benefit patients and make the health system sturdier.

In its annual review of the top concerns for health executives and policy makers, PricewaterhouseCoopers' Health Research Institute has identified nine burning health industry issues for 2009 as follows:

1. Healthcare will be hit by the Economic Downturn

• Hospitals and health care service providers e.g. family physicians, dentists, will be faced with bad debts and there will be a decrease in elective procedures.

• There's been a change health organizations' investment portfolios. The payer mix is moving away from commercial insurers because of  a decrease in enrollment and premium revenue.

• Charitable donations and investment income have dropped, capital investments for IT, facilities and equipment have come to a standstill.

• The biotech and pharmaceutical drug companies' valuations have plummeted, potentially decreasing their ability to attract additional capital.

2. The Underinsured will a bigger challenge than the Uninsured

• The population of those qualifying as underinsured is growing a lot faster. For instance, there's been an increase of underinsured by 60 percent since 2003 reaching an estimated figure of 25 million adults.

• They pose a challenge because in many cases they can't or won't pay the high deductibles and co-pays for the services they require.

• It's quite a possibility that business operations will come to depend upon technology and processes prevalent retail, banking and credit industries to effectively manage the underinsured.

3. Big Pharma will take up M&A for making a drug pipeline

• As a consequence of decreasing pharmaceutical revenues and a drop in new drug approvals, the Big Pharma is looking forward to acquisitions of smaller biotech firms to boost the drug pipeline.

4. The new buzzword is “Prevention”

Drug makers, regulators and nonprofit benefactors will give an impetus to prevention, hotting up the market for vaccines. Regulations to curb harmful health behaviors such as those against smoking and use of trans-fats in foods could surface.

5. Genetic Testing will become Affordable for the General Population

• In a year's time, as costs drop, the direct-to-consumer market for genetic testing will open up. Consequently, people will be able to buy their personal DNA maps and be able to identify markers for specific diseases, e.g. Alzheimer’s.

• Research will explore the effects of genetics on pharmaceuticals and bring about the era of customized medicine.

6. Social Networking on the Internet will be a Powerful Health Extender

• Technology will enable an increased patient-to-patient interaction over social networking platforms and change how healthcare is experienced by consumers, including the electronic health records as they've become more common.

7. For Hospitals Getting Paid will be linked to Performance

• Medicare, Medicaid and insurance companies are increasingly basing reimbursement to hospitals on performance.

• Alongside performance, documenting it, too would be essential, as with the approval of the CMS - The Centers for Medicare & Medicaid Services (CMS), a proposed new index: the total performance score will be in place.

8. Employers will link Incentives to Wellness Programs
 

• More employers will give incentives to employees to boost responsible health behaviors and participation in wellness and disease management programs. Because the success of these programs is heavily dependent on active employee participation.

9. A Major Resource Investment will be needed for ICD-10

• Slated to begin in 2009, the process of conversion to a new International Classification of Disease code sets will be a costly affair for health organizations. But because it will lead to better diagnosis, decisions and reimbursement it will have long lasting benefits.

The medical marketplace is no exception and challenges abound for it too, and since the industry comprises many sub-sectors, each one of them will be faced with different issues to deal with, for instance surgical instruments (viz. root elevator, surgical brushes, retractors, physiotherapy equipments (viz. dumbbell, body massager, weight bench), or hospital supplies such as toilet roll, surgical blades, wipe, anesthesia equipment viz. anaesthesia vaporizers, capnographs, carbon dioxide analyzer, diagnostic equipment such as ear thermometer, stethoscopes, digital BP monitors or baby weighing scale markets will be affected differently.