Most smart hospitals have a list of Big picture social and demographic trends on some spreadsheet or board document. They'll keep an eye on these trends to anticipate their impact on our bottom line, our case mix, etc.

Two trends that are sure to be on all of these lists - the baby boomers & the diabesity pandemic are both have their coming-out parties. In the US, there are 77 million baby boomers (25% of our population!) 70 million people are obese or severely obese.

A lot has already been said about how these trends will impact our society. "Diabesity" is now the single greatest contributor to chronic disease, which makes up 75% of the healthcare costs. (And it's not just an American thing, though we lead the way with Australia). I heard our Surgeon General speak at a conference. He shared that President Bush was once asked at a press conference, "what's the single most dangerous threat to American life?" Surprisingly, he didn't say terrorism - he said obesity.

The Boomers are coming! The Boomers are coming! They'll demand better, more customized, more expensive, and simply more healthcare "their way" than ever before.

Tie this into all the talk about rising healthcare costs - medicare going bankrupt in 2019, 1 productive worker for every 2 retired "non-productive" citizen, Ford cars having $1,800 of healthcare costs built into each one (versus $200 for Toyota's), the potential collapse of the entire American economy. Blah blah blah - so much has already been said, I don't feel like I need to add to it.

The question for us on the front lines is this: what's a hospital to do? No nation has ever faced this double-whammy of the greying and widening of our population at such a pace. How will we (or should we at all) reconfigure our hospitals services to cater to boomers? Will there be hospitals who invest in "Centers for Chronic Disease?" even though the effectiveness of such centers might actually stunt hospital growth? Even if you don't want to make such a large investment, wouldn't it be smart to place strategic bets into treating diabetes, heart disease, and stroke? What "boomer product" is your hospital developing right now? Is your chronic disease programs equipped for the next 15 years?

Picture your hospital in the year 2020. 70 is the new 50. The Diabesity generation is having diabese kids. The "wealthy diseases" prosper further. There are diabetes institutes, healthy heart centers, and Centers for Preventive Medicine adjacent to every Wal-Mart. Do these centers have your hospital's name on it, your competitor's, or some national brand?