Over the last 50 years, every U.S. president has worked, in some fashion, to address healthcare spending while improving the fundamental healthcare conditions for those in need. As healthcare leaders we often think in terms of three- to ve-year plans. But if we think about the next 50 years, it brings into question ‘what’ and ‘how’ the investments we’re making now in our communities — whether new facilities, programs or initiatives — will impact the public by 2064.