Category: Health Care Transformation

Let the designers handle health reform

Consider the success of all reform efforts up to this point before you write this off as “creative mumbo-jumbo” or something of the sort:

The current emotional uproar has revealed that the debate over health care is about much more than mere economics alone. To be certain, much of the positioning relates to financial exposure. But when you listen to the town hall meetings, you hear the debate is supercharged with emotion. Understanding those emotional needs of the various stakeholder constituencies is what will make it possible for designers to design positive experiences from process, financial, and emotional perspectives.

By employing a full designer’s toolkit of methodologies, designers would understand and analyze our health care system and arrive at insightful solutions that go beyond logistics and economics. (Fast Company)

The reform conversation is going to continue to spiral until believable emotional refutations are constructed to combat emotional beliefs.  Only then will we be able to move onto rational discussions with those who are actually interested in discussing.  The majority of Americans will happily exclude those who are for nothing but a single-payer system or a completely free-market approach.  There is success to be found in the middle…with designers.  Sign me up.

Sharing private medical information

Having yet (we’re all going to need care eventually) to be a patient of significance in health care, I’m extremely appreciative of individuals who share their private medical information.  There have been many and the collective good will improve awareness, medical science, and health care as Jeff Jarvis explains in his Guardian column:

By revealing my cancer, I realise benefits, and so can society: if one man’s story motivates just one more who has the disease to get tested and discover it, then it is worth the price of embarrassment. If many people who have a condition can now share information about their lifestyles and experience, then perhaps the sum of their data can add up to new medical knowledge. I predict a day when to keep such information private will be seen by society as being selfish.

Collectively, we will use the internet’s ability to gather, share and analyse what we know to build greater value than we could on our own. That is the principle of transparency that I want companies and governments to heed: that openness in their information and actions must become their default, that holding secrets only breeds mistrust and robs them and us of the value that comes from sharing.

The growing business presence in health care

Last week’s Wal-Mart health care announcement was another step in its progressive image-altering effort (or just a shrewd business move).  It also happens to be a big deal.  And not just on the employer mandate front.  Or on the partnering with a union issue either.  Or how the move increases the likelihood of reform.

It’s a big deal because it signals the rising influence of business in the day-to-day delivery of health care.  From The Wall Street Journal:

The company says it supports the employer mandate because all businesses should share the burden of fixing the health-care system. Wal-Mart also said the mandate will only work if it is accompanied by a government commitment to rein in health-care costs that is guaranteed.

“…all businesses should share the burden of fixing the health-care system.”  Not the burden of paying for health care, but the burden for fixing the system.  Why not?  Health care, on the whole, has proved year after year its ineptitude for fixing itself, its inability to reduce the cost of care, or at the least, prove its increased value.  The annual dollars business spends on health care gives it the right to muddle.  Business needs health care reform.

The second sentence in the WSJ paragraph above is the how: a guaranteed reining in of health care costs.  Whether that’s possible is irrelevant, it’s going to happen.  Reducing reimbursement is a cost cutting mechanism: CMS leads, private payers follow.

Business has efforts in place to improve quality.  Improving efficiency and distribution of resources is a logical next step.  It’s not necessarily a bad thing.  It just is.  (It may even be welcomed.)  The impact on decision making at the delivery level will be significant.

Let’s start over.

Morgan Clendaniel makes a lot of sense.  Enough incremental garbage.  One way or the other, do something that is going to have an impact:

So, we need to forget free-market solutions, forget the public option. Enough marginal change. If someone is sick, they should get treated. Let’s accept that as our starting point and then figure out how to pay for it.

This is, of course, totally naive and politically nonviable. It also happens to be the right thing to do, and I’m confident that with enough smart people in the room, we could find a way to treat everyone. It’s really hard to argue that because something is too difficult to implement, we have to let people die, but that seems to be the point to which we’ve gotten ourselves.

It’s so smooth.

What health system does this describe?

One-stop shopping. Fully integrated hospital medical staff. Immediate access. No technology or quality gap. Competitive prices. A focus on service.

Not ours according to Dr. Josef Fischer.  He is decidedly on point:

Unless physicians, surgeons, hospital administrators and health insurers get together to control costs, I fear that the health-care industry in the United States will rapidly continue down the same path as our indigenous manufacturing industries. If we do not take this issue seriously, if we keep repeating the old, inaccurate mantras about the lack of quality medical care abroad, we will lose our competitive advantage. Not only will fewer foreign patients come here for medical treatment, more of us will go elsewhere.

It’s still, and always will be, about the costs; required reading

More care, worse outcomes.  Misaligned incentives.  Complete ignorance of the macro view.  Buckets of waste.  Gaps in medical education.  Lack of coordination and accountability.  Solving health care locally.

In other words, Atul Gawande’s most recent dispatch in “The New Yorker” is, in my opinion, required reading.  A snippet:

When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes.

Unshackle insurance

Corporate America spends more on health care than it earns in profits.

Hadn’t seen that before.  But, for the reason above (and several more), it is striking how much business wants to continue to involve itself in the provision of health care insurance coverage.  It feels like more of a “the way we’ve always done it” sort of conclusion as opposed to a distrust of government, taxes will increase argument.  But health care expenditures go up, up, up and will continue to do so even with yesterday’s announcement.

Insurance coverage that follows people as they job hop/strike out on their own would boost American productivity.  Short-term plans are annoying.  COBRA too expensive.  And individual insurance purchasing not rewarded by employers.

A new normal

Some say that our economy is on its way to a slow recovery.  Well that’s good.  But are we returning to?  How it was before we knew that geeks with formulas were messing with assumptions of risk?  Likely not (help us, please!).  But memories are short…

influx asks:

What happens if instead of waiting for normality to return, we are lurching forward towards a new normal that looks nothing like the old one?

Have you thought about that?  The reality of this stuff is staggering (and impactful on already-faltering business models).

influx continues:

The future is not about producing less or more of what you currently make or do, but re-thinking it all.

Now is the time to discover and imagine what those new things could be and there’s probably never been a better time to do this. Across whole categories people are applying a very critical eye and filter to determine what’s wrong and excessive and what feels precisely right.

Familiar concepts like price, value and quality are all in the process of being re-defined and re-thought.

Simply assuming the same old rules apply is naive and misguided. Every single brand should be out there learning and trying to work out what can make them relevant for this new future. For anyone involved in thinking strategically and/or creatively about these challenges, these should be very exciting times.