Contemplating the Future

Fred Fortin at The World Health Care Blog:

With the kinds of uncertainty we are now facing in US health care — 2008 elections, unsustainable costs and a growing politics of blame and greed — the future is less about, well, the “future” and more about the present, that is our ability to simply hang on for the ride. Both the pace and unpredictability of what now confronts us makes futurists look more like shamans trying to comfort a nervous patient, than professionals who can help us line up, in some understandable order, the drivers of change.

One thing is for sure, however, any official “futures”, at least for now, are DOA. And we don’t need to pay any futurist to tell us how that story will end since the the plot has still yet to be revealed. Stay tuned.

I completely agree. And I see us continuing to operate in this uncertainty for the foreseeable future.

Earlier in his post, Mr. Fortin says that we, in health care, are very concerned with the future. And I would agree when it comes to bed capacity, workforce needs, addition of programs, or what can easily be summed up as the “normal business” planning issues.

But when it comes to sustainability as an entire health care system, the theme receives little thought, if any, when future organizational decisions are being made. And why should it? All jobs in an organization are based on that specific organization’s sustainability.  It’s the Tragedy of the Commons.  While I believe some organizations are thinking about sustainability, that conversation doesn’t go beyond community or regional borders. So the role of creating a sustainable environment for the entire health care system falls to the government.

And there’s talk of making it happen, but it’s talk. And talk at the highest level breeds inaction at lower levels. Here’s an example: with the current rhetoric of health care reform by presidential candidates, and specifically both Democrats’ plans to cut costs through proliferation of health care IT, why would any hospital, physician’s practice, clinic, etc. even consider making their records electronic at this moment? The Democratic hopefuls both have plans to help organizations pay for it. So unless the investment explicitly helps an organization reduce costs (most likely only large organizations considering the substantial cost involved) in the relative short-term, why would anyone consider it when there is the potential for the government to help pay for it?

Here’s the problem: the wait could go on forever…and doing nothing continues the cycle we’re in.

Mr. Fortin’s post was inspired by a post by Kevin Kelly in which Mr. Kelly says the future doesn’t matter anymore:

The pace of change became so fast that it outpaced contemplation. The future became harder to predict, and exhausting to keep track of. With a long, colorful history of failed predictions, it occurred to almost everyone at once that very little of what we imagined our own futures to be would really happen. So why bother?

While we often contemplate the future of our organizations, the problem is just that—because the future that truly matters is that of the sustainability of our health care system.

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