By Kim Bellard
My friends, we are as explorers of yesteryear who are on the edge of a well -known continent and look to the vast ocean in the hope of finding new, unspoilt, better countries about it. Admittedly, we may have destroyed the continent behind us, but certainly things will be better in the new countries.
In the metaphor I am thinking of, the well -known continent is our mess of a health care system. For all protests about the US that have the best health care in the world, that is clearly not true. We don’t live that long, we have more chronic diseases, we kill each other and ourselves at alarming rates, we pay a lot more, we have too many people who cannot afford care and/or cannot get any care, we have too much care that is not effective, inappropriate, or even harmful, and we spend far too much on administration.
We Don’t trust The Healthcare System, WE Don’t think The quality of care is good, we have one unfavorable opinion We think so It fails us. The vast majority of us think it should be fundamentally changed or completely rebuilt. That’s what we want to flee, and it’s no wonder why.
Over the horizon, the 22 is about that metaphorical ocean in the distanceND Century Healthcare System. We hope, we hope, be as a magic. It will be more important, more effective, more efficient, more efficient, more proactive, less invasive, more affordable. We do not know exactly what it will look like or what it will work, but we have seen what we have, and we know that it can be better – much better. We just have to come there.
This leads me to the next part of the metaphor. I recently read a great quote from the deceased nature writer Barry Lopez, from his posthumous book of essays Embrace fear of the burning world. Mr. Lopez complains: “We are looking for the boats that we never built.”
The boats do not come to save us, to transport us to that idealized 22ND Century Healthcare System. Because we never built them. Because we still Do not have the courage to build them.
We have never built a system to guarantee universal coverage. We rely on a mix of coverage mechanisms, each struggling with its own problems and still leaving around 25 million people without insurance-and that is before the 10-20 million who are expected to lose cover because of the “large, beautiful account” plus the tens of millions that are “sub-invested.
We have never built a system that was fair remotely, just like we never did for housing, education or employment. Money matters, ethnicity is important, geography -important. Discrepancies in the availability of care and in results clearly appear for each of these and more.
We have never built a system that, above all, praises patients. We have postponed to doctors and hospitals, they did not call them when they gave our substandard care or when they charged us too much. Now the health care of a “noble calling” has been transferred to a job and wealth creator. A recently New York Times analysis Found among other things:
- Healthcare is the largest employer in the country;
- In 1990, health care was not the largest employer in every state; Now it is in 38 states;
- We spend more on health care than on groceries or housing.
Choose your favorite target: Private Equity companies Buying entities in health care, companies with a profit motive that get profit from our care (or nominal “non-profit organizations” that do the same), the stable Healthcare Corporatization. Throw favorite boogeymmen such as health insurers, PBMS or Big Pharma. Somehow it’s about the money, not us.
The adage about great technology comes to mind: we are not the customer, we are the product (or,, As I have written beforeWe are just the NPCs.).
We have never built the systems to make administration easier. So many codes, so many rules, so many types of insurance, so many silos, so many managers. In the meantime you have undoubtedly seen the graph of the growth of managers versus clinicians in our health care system and you are aware that about a quarter of our health care will go to administration. It doesn’t have to be, it shouldn’t be, but administrative bloat Get worse, not better.
We have never built the systems to follow our health or risks well.
From waste water monitoring to following diseases/outbreaks to adverse effects of medicines for recipes, medical devices, we rely on random methods that do not leave us effective warning systems. The various public health mechanisms that we had were miserable not -full of covid prior to Covid, crashed (and were burned) during Covid and are now cheerfully distanted.
The worst of everything is that we have never built a system to keep track of which care really works. Of course, there are gold standard controlled studies that have to do that, but many care that is delivered is not based on such studies, the effects of such studies last years to penetrate the practice patterns, and practitioners have not really been checked to ensure that they deliver the “right” care or in the “right” way. We submit to care, we pay for that care, without really knowing whether it is the care that we should receive or from the person/institution that it should give to us.
Shame us and the system that allows all this.
Without building all those boats, we will not come to 22ND Century Healthcare System that we want and earn.
Of course, there is a lot of exciting technology that will help make things Garlic More like a 22ND Century Healthcare System. Ai, robots, genetic adaptation, nanobots, smart cells, synthetic biology and more – these are all exciting and will all be useful in those 22ND Century Healthcare. But they don’t take us to 22ND Century Healthcare System that we should get. They will just take us to a smooth, more expensive version of the one we have.
You may have seen that a few weeks ago the 50one birthday of the first release of Jaw. One of the most iconic lines was the reaction of the Chief Brody when he first stood out the size of the shark that he and two companions stuck a glimpse, foolish: “You need a larger boat.”
When it comes to taking us to 22ND Century Healthcare System that we would like, we also need a larger boat – and we are starting to build it better now.
Kim is a former emarketing -exec at a large blue plan, editor of the late & complains Tinctuur.ioand now regular THCB employee
#larger #boat #health #care #blog