This document discusses macro trends that will impact the future of the US healthcare system. It outlines how the economy, demographics, personal lifestyle/behaviors, technology, and policies will shape the system. The economy faces rising costs from preventable healthcare use, chronic conditions like obesity and cancer, and maintaining services. Demographics show growth in the elderly population requiring more care. Lifestyle issues like obesity and smoking from 1/3 of children and 2/3 of adults may increase costs. Technology can improve communication between patients and providers through devices. Policies must expand the system to meet growing needs and provide equitable, affordable coverage.