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Yesterday, I stood on stage at the historic Egyptian Theatre in Boise, Idaho, presenting a keynote on the future of generative AI in medicine. As I looked out across the audience, I couldn’t help but think back to another moment that took place just a few hundred miles west.
In 1998, at Oregon Health & Science University, I presented a different talk on the future of healthcare. At the end I wandered the halls and saw a sign on the wall that remains etched in my memory. In big, bold letters, the top line read: “Cost. Access. Quality.” And below it, in small font: “Pick any two.”
That was the best we could do at the time. We could improve quality and expand access, but only by spending more. We could cut spending but inevitably would have to reduce access, quality or both.