Bruce Sterling in his less than concise critique (it was originally a speech, via Boing Boing) of Web 2.0 at Webstock likens the 2.0 movement to the current perils of the financial world and literally says “The way we ran the world was wrong.” But the speech touches much more than Web 2.0. Here’s the pertinent health care quote:
The American health system is a market failure — and most other people’s health systems don’t make much commercial sense.
And now that the world’s problems (plentifully laid out in the speech) are coming to a head, change is coming:
I’ve never seen so much panic around me, but panic is the last thing on my mind. My mood is eager impatience. I want to see our best, most creative, best-intentioned people in world society directly attacking our worst problems. I’m bored with the deceit. I’m tired of obscurantism and cover-ups. I’m disgusted with cynical spin and the culture war for profit. I’m up to here with phony baloney market fundamentalism. I despise a prostituted society where we put a dollar sign in front of our eyes so we could run straight into the ditch.
The cure for panic is action. Coherent action is great; for a scatterbrained web society, that may be a bit much to ask. Well, any action is better than whining. We can do better.
I’m not gonna tell you what to do. I’m an artist, I’m not running for office and I don’t want any of your money. Just talk among yourselves. Grow up to the size of your challenges. Bang out some code, build some platforms you don’t have to duct-tape any more, make more opportunities than you can grab for your little selves, and let’s get after living real lives.
Opportunity arises in difficult situations and that opportunity is most definitely upon us. The world needs an abundance of selfless problem solvers, health care too. “The cure for panic is action.”
Taken in sum, our health care system is one big mess.
A closer look reveals a series of problems that together create it.
Looking microscopically we find the root causes of those problems.
These microscopic problems are only tiny in view of the big mess. Microscopic problems are where individuals, small teams, and organizations can have significant impact on positive health care transformation.
It’s the sheer power of crowds. A lot of people working on a lot of problems create a lot of solutions.
Easier said than done. That’s why we need an agenda. That’s why we give rewards for demonstrating success.
The New York Times reported on such an idea. InnoCentive is an open source solution finder. The platform brings together seekers and solvers. Seekers post problems. Solvers solve them for a cash prize.
From the article:
That specificity is crucial to InnoCentive’s operation, people who have studied the company say. “If you say, ‘find me a cure for cancer’ it may not work,” Dr. Lakhani said. But if problems can be “decomposed” into what he called modular questions, like “find me a biomarker for this condition, these questions may be more tractable.”
InnoCentive has a global health category. One seeker has broadly asked for “improvements to the United States health care system.” That won’t work.
A dedicated platform should be created that focuses on specific improvements to the health care system. Strategies to increase care coordination. Communication improvements on medication directions. Measures to better the process of medication reconciliation.
The list is endless. But taken together, the power of the solutions would make a significant positive impact.
This sounds oddly familiar: “The neediest customers, however, don’t have a lot of money to pay for help. People with no savings, lots of debt and many questions may not be able to pay…”
Maybe their solution is something to consider for health care. And it kind of sounds like this.
A very interesting article at Wired.com from Portfolio.com about the conundrum created by a policy tool meant to encourage pharmaceutical companies to research and develop “orphan drugs.”
The Orphan Drug Act grants orphan drug status to pharmaceutical companies and “is designed to encourage the development of drugs which are necessary but would be prohibitively expensive/un-profitable to develop under normal circumstances.” Past developments have included drug treatments for such conditions as cystic fibrosis and multiple myeloma.
The result can be high-priced treatments for rare conditions. From the article:
Politicians say they are not opposed to drug companies earning strong returns on the costs of researching innovative drugs, and understand the high prices of many medications. But they are investigating whether some companies are price-gouging, concerned more about executive stock options than about running innovative companies.
But the sometimes prohibitive costs of orphan drug treatments is, as you may have guessed, too expensive—to the point where insurance companies may deny payment. The article provides an example of an already-developed drug that jumped from a cost of $1,600 per vial to $23,000 per vial after it was granted orphan drug status.
There’s some perfunctory pharmaceutical company decisions resulting from the orphan drug status that you can read about in the article.
But here’s the interesting part. The prohibitive cost of the orphan drug spurred a doctor to search for lower cost solutions. And he found one with comparable efficacy.
Curiously, though, he found that the price hike “was one of the best things that could have happened.” Why? “Because we found something better and cheaper.” Far cheaper, it turns out. “We spent a few days going through all the medical literature, looking for what works, what doesn’t.”
The cost of the alternative treatment? $15.
Childhood obesity is a big problem.
Richard Simmons, he of Sweatin’ to the Oldies fame, is doing his part by testifying before Congress on ideas to combat childhood obesity on Thursday.
His personal contribution, from USA Today:
He says he is developing a reality TV show in which he’ll help children and families lose weight. “It’s going to show Americans that it’s possible to realistically lose weight, be happy and go on to other goals,” he says. “It won’t be an angry show with screaming and yelling. Just teamwork. No competition. It’s about saving lives.”
We’re well under the three year mark for when the first Baby Boomers will be eligible for Medicare in 2011. A short seven years later, in 2018, the trust fund that pays Medicare bills will go broke. We have some issues, creeping quickly, that we clearly need to deal with.
Maybe it starts with personal responsibility for your own health. Municipalities in two foreign lands have made that task easier—no gym membership required.
PSFK brings us a trend of Boomers in Hong Kong working out in public parks. Making this happen in the United States may be another story, “While it seems to be possible to grow older and remain an active lifestyle in China, being elderly in western society at the same time predetermines you to be totally passive.”
They also link to an article (pdf) about the first playground for senior citizens in Berlin.
The good folks at PSFK provide some pictures at Flickr.
Why stop there? How about work out facilities in parks for all ages. Now if we could only figure out to get people away from Seinfeld reruns and days-long sessions of Guitar Hero…
Hotels.com has a great commercial that shows a man being carried to his room by the hotel staff. A little confused, the man looks up and asks whether he is receiving special treatment because the hotel knows that he will write a review of his experience. One of the men carrying him looks up and candidly responds, “yes.”
What a novel idea! A service delivery industry responding in a positive way to consumers who are aware and critical of their experience. Could this be possible in a hospital setting? The answer is unequivocally YES! My guess is that administrators, physicians, and other members of the hospital elite would argue with me: after all, what do patients know of the complicated processes that go on in a hospital? Capacity is maxed out, nurses are overburdened, and physicians are already carrying more than a full schedule of patients. Oh yeah, throw these aspects of a hospital stay in with the fact that patients wouldn’t know or understand the procedures or terminology that are being thrown around and the situation is ripe for patient frustration and unhappiness, right? Wrong.
A person is always more intelligent than he or she is given credit for, and there needs to be accountability for a bad experience resulting from a delay in treatment, complications from treatment, or just plain poor treatment from clinicians. Websites like healthgrades.com, revolutionhealth.com, and ratemds.com need to be utilized by health care consumers who can voice their hospital experience, good or bad.
Right now, health care consumers treat health care as a commodity, something for which there is no qualitative differentiation across the market. But, the truth is that health care is NOT uniform. There are good physicians and bad, there are good nurses and bad, there are clean hospitals and dirty hospitals, there are efficient hospitals and inefficient hospitals, etc.
Empowering the health care consumer by expanding his/her knowledge of a given health care setting would hold caregivers accountable and, just maybe, lead to physicians and/or nurses carrying their patients from the lobby to their rooms because they know that patient will write a review describing his or her experience at the hospital.