For various reasons I will be turning my professional attention to the health care industry in 2009. So as part of that initiative I have started reading Redefining Health Care by Michael Porter and Elizabeth Teisberg. This is a dense tome but absolutely required reading for anyone interested in understanding how we got into the current mess. Here's the short version, we are in this mess because the HC industry is structured in a manner that promotes perverse competitive behavior instead of competition around patient value. The competition in HC is all about shifting costs so that somebody else pays. Its a zero sum game and it need not be.
In a well functioning market, for example computer electronics, we have all witnessed quality improve and prices fall. In HC we spend more for less. We have all seen the numbers that show this so there is no need to belabor it. The important and profound service that Porter and Teisberg have provided is a precise identification of the root cause. Until we build a system that provides incentive to increase the value provided to a patient for a specific medical condition over the life of its treatment we will continue to go around in circles and slowly bleed to death from a cost perspective.
Of course, as incredibly important as root cause analysis is, we still need a viable way forward. Fortunately, as far as I can tell, Porter and Teisberg's work have gotten the attention of important stakeholders and therein lies the reason for hope. P&T also provide suggestions and a framework for policies that may help resolve the mess, but I am currently only in chapter three of about 500 pages. I believe that the Obama administration is listening and as an optimist, I am confident that we will innovate our way out of a mess that we all created. I have seen the enemy and it is us. But we are also the ones that will conquer the enemy because we seem to rise to the occasion when our lives are on the line.
It is time to lead, follow, or get out of the way. If all you want to do is whine and complain then take a hike. We need new thinking but we don't need naysayers who don't have a thing to contribute to the conversation.
Happy New Year! It is time to Rock n' Roll.
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