Extrapolation is a wonderful thing. It is also a dangerous thing. Now how, you may wonder, can something be both wonderful and dangerous at the same time?
On the one hand, extrapolation is the wisdom of dreamers. Alexander Graham Bell had the uncanny ability to foresee that his invention of the telephone would ultimately change the way people communicate. Unfortunately, Western Union, the leading telecommunications company at the time, was unable to imagine Bell's invention becoming ubiquitous and turned down the opportunity to license this new technology.
In a similar vein, Digital Research, the leading company making software operating systems for microcomputers, turned down the chance to make PCDOS for IBM's new PC. Bill Gates was either clairvoyant or lucky (or both) and extrapolated the vast potential of signing a marketing agreement with IBM to provide DOS (since morphed into Windows).
Now what about health care costs? It's at 13 or 14 percent of GDP and growing. If, as they say, "the present trend continues," just how high do we extrapolate the costs of health care will go? Twenty percent? Fifty percent? Will someone bid one hundred percent? Will the health care industry give birth to the next Bell Telephone or Microsoft?
In this case, we see that extrapolation doesn't really work. This is where extrapolators tend to get into trouble. At some point, no matter how beneficial (or harmful) higher spending on health care might be, the costs will have to be capped. Or, as my mentor used to say to me when I was a cardiac surgery resident, the bleeding always stops-one way or another. Our nation can only hemorrhage so much in health care spending before the bleeding stops.
So, for you clairvoyant souls among the reading audience, a summer essay question: "At what point will health care spending plateau, and what are the implications for patients, payers and providers? How will it affect us?" Your homework assignment is to spend a couple of weeks at the mountains or the seashore this summer with friends and family, and take a few spare moments during that respite to contemplate the answer to this terribly important question.
Have a wonderful and thoughtful summer. 
