An aging population, the rising costs of healthcare services, and the likely collapse of the social security system are trends that will affect the future course. These shortcomings will worsen as the pace of medical advances accelerates, throwing more knowledge, more techniques and more drugs at a faster rate than the human mind can incorporate. Physicians will not be able to continue flying effectively without a flight plan. Also if healthcare continues to get expensive in this country then more people are going to get their medical procedure done overseas to get better medical care or a better value on surgical procedures.