HCR -- The System is not the Problem

By John Ballard

The problem is how we use the system and what we expect it to do.

With nearly 30 years� experience, Joe Flower has emerged as a premier observer on the deep forces changing healthcare in the United States and around the world. As a healthcare speaker, writer, and consultant, he has explored the future of healthcare with clients ranging from the World Health Organization, the Global Business Network, and the U.K. National Health Service, to the majority of state hospital associations in the U.S. He has written for a number of healthcare publications including, the Healthcare Forum Journal, Physician Executive, and Wired Magazine. You can find more of Joe�s work at his website, imaginewhatif.com, where this post first appeared.

 

 

This guy explains health care in a manner that even a Republican should understand. His approach is simple. Think of a car. It's function as what my Dad always called "reliable transportation" is separate from it's function as social commentary, creature comfort, status symbol or fashion statement. Strip away all the rest and the real reason for a car is to transport people from A to B. And thanks to taxi services and other forms of transportation travelers don't even have to own a means of transport. They only need reasonable access. Same is true of health care.

And using the driving metaphor, look at this...

A Word about Systems

Do you know how many people died in car crashes in the United States in 2010? 32,000. That�s the lowest number since 1949. That�s impressive, but wait: It�s far more impressive than it sounds at first, because people in the United States drove about 10 times as many vehicle miles in 2010 as they did in 1949. In other words, if you drove a car or truck in 2010, you were 10 times more likely to live through each mile you drove than your father or grandfather was 60 years ago.

Why? Are we better drivers? Nah. Seatbelts, airbags, tougher DUI laws, breathalyzers, graduated licensing for teenagers, anti-lock braking systems, better highway designs, crash barriers, rumble strips, median barriers, steel-belted radial tires that don�t blow out, crumple zones, better bumpers�system tweaks that work, that make it 10 times as hard for even a terrible driver to kill himself or you.

It�s the system, not the individuals. We have only started on the thinnest little wedge of that kind of thinking about healthcare. That kind of thinking will take us way beyond �evidence-based medicine� to what is coming to be called �evidence-based health.� Evidence-based medicine does everything necessary to stabilize diabetic shock patients, gets their blood sugar under control, gives them the right prescriptions and sends them home. Evidence-based health goes home with them, if necessary, does whatever it takes to find out why they were in shock in the first place, what it takes to make sure that they fill the prescriptions, eat better, get good advice and don�t end up back in the ER in a month.

Before going to Flowers' website, check out this post at The Health Care Blog.