What will health and health care look like in the United States in the year 2032? It is a complex question, particularly given the immediate challenges facing the U.S. today. We really could improve health and health care in this country over the decades to come. However, there is a good chance that we could also spend more than we can afford on an American population whose health continues to decline.

Alternative scenarios of the future can help us understand such uncertainties. Scenarios are stories describing how the future may unfold in different ways. They help us view the dynamic systems around us in more complex terms. That accept uncertainty, and then clarify and challenge the assumptions about what we can do. We have carried many assumptions with us from the past that constrain our thinking about options for the future. While the future is inherently uncertain, scenarios help us bound that uncertainty into a limited number of likely paths. We can then explore the uncertainty to find the opportunities and challenges that might otherwise surprise us. People and organizations who work with scenarios find more creative options than those who develop plans based only on the past and present.

To find these more creative options for health and health care, the Robert Wood Johnson Foundation engaged the Institute for Alternative Futures (IAF) to develop a set of four scenarios of health and health care in 2032. The purpose of these scenarios is to help leaders in health and health care apply a futures perspective to their own work, and to access the kind of creativity and dynamism that can lead to surprising success.