Kim Bellard
My friends, we are like explorers of the past standing on the edge of a known continent, looking at the vast ocean, hoping to find new, unspoiled, better lands. Yes, we may have destroyed the continent behind us, but it will certainly be better on new land.
In the metaphor that comes to my mind, the known continent is our confusion about the healthcare system. All protests about the US having the best health care in the world are obviously untrue. We don't live that long, we have more chronic diseases, kill each other and kill ourselves at an amazing rate, we give more, we have too many people who can't afford to care and/or cannot access care, we have too many care, ineffective, inappropriate, and even harmful, we spend a lot of money on management.
We don’t trust the healthcare system, we think its care quality is good, we have a negative view of it, we think it fails us. The vast majority of us believe that it should be fundamentally changed or completely rebuilt. It's no surprise that this is what we want to escape.
On that metaphorical ocean, in the distance, on the horizon, is 22ND Century Healthcare System. We hope it will be like magic. It will be fairer, more effective, more efficient, more aggressive, less invasive and more affordable. We don't know what it looks or will work, but we've seen what we have and we know it will be better–better. We just need to get there.
This brings me to the next part of the metaphor. I recently read a book by the late nature writer Barry Lopez Embrace the burning world fearlessly. Mr. Lopez lamented: “We are looking for ships that have never been built.”
These ships did not come to save us, transport us to the ideal 22ND Century Healthcare System. Because we never built them. Because we still There is no courage to build them.
We never set up a system to ensure universal coverage. We rely on big grocery stores that cover mechanisms, each struggling with its own problems, still leaving about 25 million people without insurance – this is the 10 million people expected to lose coverage due to “big and beautiful bills”, as well as tens of millions of people.
We have never built a system that is out of reach, like we have never done in housing, education or employment. Money is important, race, geography. The differences in the available care and outcomes clearly show the differences in each of them.
We have never built the most important system. We postponed doctors and hospitals and they wouldn't call them up when they gave us substandard care or were accusing us too much. Now, health care has transformed from a “noble call” to a creator of work and wealth. recent New York Times Analysis findings (among other things):
- Healthcare is the largest employer in the United States;
- In 1990, health care was not the largest employer in any state. Now in 38 states;
- We spend more on health care than groceries or housing.
Choose your favorite goals: Private equity firms purchase healthcare entities, for-profit companies profit from our care (or engage in the same “non-profit”), stable healthcare corporatization. Put in your favorite boogeymen, such as a health insurance company, PBM or a big pharma company. One way or another is about money, not us.
A proverb about large-scale technology comes to mind: we are not customers, we are products (or, as I wrote before, we are just NPCs.).
We have never built a system that makes management easier. So many codes, so many rules, so many insurance, so many silos, so many administrators. So far, you have no doubt seen the growth charts of administrators and clinicians in our healthcare system and know that one quarter of our healthcare $ is managed. It doesn't have to be like this, it shouldn't be like this, but management inflation is getting worse and worse, not better.
We have never established a system that properly tracks our health or risks.
From wastewater monitoring to tracking disease/outbreaks, to prescription drugs, and medical equipment’s adverse effects, we rely on random methods that keep us from effective warning systems. The various public health mechanisms we have implemented were funded without funds before Covid, crashed (and burned) during Covid and are now compensated.
Worst of all, we never set up a system to track truly effective care. Of course, there are some gold standard controlled studies that should do this, but a lot of the care provided is not based on such studies, the impact of which takes years to penetrate into actual practice patterns and there is no real monitoring of practitioners to ensure they provide the “right” care or provide it in the “right” way. We obey care, we pay for it without really knowing the care we deserve or the people/institutions we should provide to us.
Shame on us, and the system that allows all of this.
Without building all these ships, we wouldn't have arrived at 22ND The century healthcare system we want and deserve.
Of course, there are a lot of exciting techniques to help with things look More like 22ND Century Healthcare System. AI, robots, genetic editing, nanorobots, smart cells, synthetic biology, and more – these are all exciting, all of which will be useful 22ND Century Health Care. But they won't let us go into 22ND We deserve the century healthcare system. They will only take us into the smarter, more expensive version of the version we have.
You may have seen a few weeks ago it was 50Th Anniversary of the initial release jaw. One of its most iconic lines is the reaction of Chief Brody, when he first glimpses of his and two companions’ shark-sized hunting foolishly: “You need a bigger boat.”
When it comes to us 22ND We should want the century healthcare system, we also need bigger boats – we better start building it Now.
Kim is the former emarketing Exec of the main blues program, late editor and regret tinture.ionow regular THCB contributor
