6. Designig the future

The ethical aspects were covered by Ignasi López, of the "la Caixa" Foundation. “There are many challenges to tackle. Ethics is important in a health-based citizen approach but it isn’t the only challenge. We can’t forget about involving other stakeholders or open science,” he reminded.

He believes the values underlying responsible research and innovation “seem to be a good guide for the self-reflection process to make research and innovation in health more open and transparent.” Other pending challenges are the many barriers to the acceptance of advanced technology for healthy ageing. Tony Prescott, of the University of Sheffield, named privacy, trust, functionality and value added, cost, and suitability and ease for daily use, among others.

“If we’re talking about the elderly’s perception of technology, the relationship is complicated and ambivalent: technology can help promote participation in society, but it can also exclude and stigmatize them. The reason is that, generally, technology isn’t neutral and exists within complicated social relationships,” he warned.

Finally, Totti Könnöla, of the Insight Foresight Institute in Madrid, went over three possible scenarios for 2030. As he indicated, the perfect situation would be for the government to move into a supervisory role, overseeing healthcare results and enforcing compliance with soft methods. Their direct intervention in healthcare (and funding it) would be significantly reduced, except in the case of acute illnesses.

In the second scenario, considered transitional, social gaps in terms of access and trust remain. And the role of healthcare-related governmental institutions and basic funding mechanisms haven’t changed, but rising costs are, de facto, eroding universal public coverage.

The third and final scenario would be one in which the responsibility for a healthy society is shared. In this case, although healthy attitudes and behaviors are predominant, the acute management crisis would lead the government to retain, increase control, directly fund and produce all healthcare services. This helps reach high levels of public funding for healthcare expenditure with little or no trust in the private sector.

“Governance in personal healthcare ecosystems is transforming: all stakeholders have a role to play. To grow the ecosystems, we have to think in terms of platforms and accept the disruption. And federate and coordinate them,” he concluded.