I do have concerns about how easy it is for some specialists to create a gravy train for themselves by simply requiring regular 'assessment' visits for patients under their care or observation at what seems to be a ludicrous rate for five minutes of their time.

In the UK there is an ombudsman that people can report their concerns to, but what then? - How anonymous is the patient really and how significantly do they compromise their relationship with what is actually a small pool of people who all know each other and are subject to the pressures of their professional clique's members?

How can this be improved, because even if they are sure that they are being overcharged and poorly treated there is still an incentive for patients not to go up against the medical establishment?

Pricing transparency is one thing which can help, but if there is a departure from the 'expected' level, then what? Is the right thing to do simply for the patient to always assess the rate vs service and report anything which is an outlier without concern for potential downstream consequences from their specialists? Or does pragmatism prevail, even if it perpetuates poor behaviour by the medical professionals?

Since then things have advanced hugely - both in biochem and in computing - and I was curious to see what might have been done. Also, hard science is fundamentally pattern recognition, isn't it: it requires that given the same inputs, the same output is consistently delivered.

1. The aging population in many societies with the associated adjustment of services in some economies including medical and care homes, perhaps also reduced economic growth rates and strain on savings and pensions. Rise of the robo-attendant? Increased 'retirement estate' mode of living? 2. Medical advances to deal with age-related disease (telomere studies, stem cells, advances in treatment of alzheimers, cancer, arthritis, deterioration of eyesight, hearing and teeth, new prosthetics etc). 3. Increased wealth concentration - a natural outcome of capital accruing a faster rate of return than labour (see Piketty), and associated with reduced per capita and overall productivity. How to preserve high standards of living for the wealthy and increase the standards of living for the less well off whilst dealing with the tensions with the potential to turn this into a zero sum game. 4. Technological advances which may increase productivity, including AI and robotic process automation. Perhaps further labour shedding associated with the increasing automation of 'thought' and 'creativity' (i.e. brought under the remit of capital).

And of course a raft of other things... Plenty of opportunity and risk ahead.