What apparently started as a defensive maneuver against the portent of Amazon.com entering the health and wellness marketplace is now to be ruled upon as to whether or not the purchase of Aetna by CVS is anti-competitive and will be quashed by anti-trust regulators. But before evaluating the fairness aspect of this proposed sale, is there any chance CVS/Aetna could be a net positive for the health of many Americans? Today’s article in The New York Times noted that the deal could reshape the health industry.

In attempting to imagine the future of health care I frequently think about things like telemedicine having the potential to dramatically improve the patient experience AND results. Telemedicine is only in its nascent stage, but its adoption and growth will be key factors in delivering better care at lower costs. Simply stated, it has to and will be part of the future of the delivery of patient care. For what it’s worth I feel the next health frontier is a subcutaneous implanted chip that will record and provide data regarding changes in your moment-to-moment health condition. That future world will have no more Fitbits or portable trackers that you wear. The tracker of the future is implanted under your skin.

At the same time when I think of the multitude of CVS locations (nearly 10,000) and the utility of being quite close to where many people live (in a 2016 report 76% of Americans live within five miles of a CVS location), a CVS/Aetna merger has the potential to create a very different relationship between the patient, health insurer, and point of care delivery.

Keep in mind that Americans are living longer and there are more and more people living actively (and not so actively) beyond age 70 each year. The relationship between baby boomers and those even older and their doctors and insurance companies has been in a constant state of flux for more than thirty years. What I think is important to keep in mind is that people over 50 are accustomed to going to SEE the doctor and won’t nearly be as good candidates for telemedicine as Gen Xers and all those younger than them. Yes it’s about technology to a degree but more about behavior and what’s comfortable and understandable. I admit that not everyone will be as willing and interested as am I about new technologies as they apply to our health.

Most Americans know where the local CVS is located. That CVS and Walgreens are principally responsible for the demise of locally owned pharmacies is both true and well documented, but the horse is long out of that barn and things are not going to back to the kindly old pharmacist who knows you and your entire family’s health history.

Having doctors on the premises at the pharmacy is a bigger deal than one might think at first. Saving a trip, making things more convenient AND delivering professional care for patients is a smart idea and could revolutionize care and in particular elder care in the United States.

Should it be approved, I am concerned that I am being naïve to ignore that without sufficient competition the CVS/Aetna combination will ultimately be able to charge whatever it wants and be less motivated to provide high quality service. But as yet I am not willing to throw the baby out with the bath water and I am truly interested in the deeper exploration of how the combination of CVS and Aetna might be beneficial to the health of Americans.