Before imagining what Houston’s health care landscape may look like in 2040, let’s contemplate a time some of you may remember all too well: The polio epidemic that swept our country six decades ago.

Children were the most vulnerable to the crippling disease. Our nation, filled with dread and lacking a vaccine, tried to halt the highly contagious virus by closing public pools and parks, shutting off public water fountains, canceling school graduations. The March of Dimes raised money for a cure, posing youngsters fitted with leg braces and crutches in fundraising appeals.

It's no coincidence the dime bears the image of President Franklin D. Roosevelt, who was stricken with the disease at age 31.

In 1952, Harris County had the highest rate of polio in the nation. The outbreak was so severe that the region was selected as a test site for gamma globulin, an antibody-rich blood product doctors hoped would serve as a preventive measure. In one of the earliest placebo-controlled civilian trials in America, thousands of apprehensive parents agreed to have their children inoculated. The pioneering medical study provided a temporary weapon against the disease, and set the stage a few years later for the announcement of the Salk vaccine, which along with the Sabin vaccine, eventually eradicated polio from most countries in the world.

The public health legacy of conquering polio resonates today as many believe disease is now optional, that in another 30 years, with enough focus and funding, medical research can, and will, end most major health problems.

What lies ahead? A vaccine to prevent HIV/AIDS? Interventions to eliminate diabetes and other chronic diseases? A cure for cancer and Alzheimer’s?

I certainly hope so. In the decades to come, medical research undoubtedly will continue to alter the way care is delivered. Illnesses, like polio, will be conquered. But, the principal changes will be in how health care is funded, in the increased engagement of patients in their own health status, and in the greater involvement of employers in maintaining the health of America’s workforce.

As I look ahead 30 years to consider what may be in store for Harris County, I envision hosts of vaccines, interventions and cures, discovered by our dedicated medical and scientific communities. However, I foresee wellness and prevention of illness at the forefront of health care, with the emphasis on primary care, rather than acute or critical care. This not only makes for good clinical outcomes but also is fiscally responsible.

In 2040, medical insurance premiums are based on measurable lifestyle factors, such as the use of tobacco, alcohol and illegal drugs, body mass index, blood pressure and glucose levels, and the frequency and duration of exercise, underscoring that patients are allies with the medical community regarding their own care.

Physicians, health centers, clinics and hospitals receive financial incentives for helping patients achieve and maintain excellent health.

To provide continuity of care, protect patient safety and help contain costs, all health care providers use electronic medical records.

Three decades from now, employers insist that a wellness culture be an organizational priority.

Every neighborhood has a fitness center for all ages, with employer and/or government-sponsored financial incentives for regular attendees.

Medical equipment companies offer cost-effective, advanced scanners that will identify and detect both chronic and acute medical conditions and diseases at their genesis to help avoid future expensive clinical interventions.

Pharmaceutical companies efficiently produce a variety of medications specifically designed for a person's genetic distinctiveness.

The majority of medical school graduates are primary care providers and receive extensive training in improving and maintaining the health status of their patients. Medical and nursing schools graduate a variety of mid-level providers who are integral members of a health care team.

All hospitals are predominantly intensive care facilities, with the ability to respond to the demand for trauma services, and are strategically placed throughout our community.

In the year 2040, provider success in health care depends on how effectively and efficiently a medical team is able to successfully, clinically manage patients.

The polio epidemic had sweeping cultural and societal effects, bringing changes in government oversight of vaccine development and surveillance of clinical trials, in the design of lab facilities and in the nature of physical rehabilitation. Those who were afflicted by polio and survived became a political and social force, pushing legislation to bring about a more consumer-oriented approach to health.

Changes, some of them sweeping, await our community and our nation as health care reform measures take hold. We can be assured that the reforms will have a resounding impact on Harris County, promising to fundamentally alter the way health care is financed and delivered.

Like the way local medical communities met the challenges of the polio epidemic of the 1950s, we will survive and become stronger, more efficient, practice evidence-based medicine, and deliver high-quality healthcare for our patients.

David Lopez is president and CEO of Harris County Hospital District