Designing New Paradigms
“We are called to be the architects of our future, not its victims.”
This quote starts off a new book by one of The Center for Health Design’s newer board members, Joe Flower. Joe is one of those really interesting people you just love to hang out with and talk to over a long dinner. His interests are diverse, his knowledge deep, and he can carry his end of a conversation on a broad range of subjects ranging from healthcare reform to ocean tides, and everything in between.
In Joe’s new book “Healthcare Beyond Reform: Doing it Right for Half the Cost,” he surmises that healthcare in America as it exists today has two very distinct personalities. On the one hand, we have a system of remarkably thoughtful caregivers in innovative organizations that make miracles happen every day. On the other hand, we have a system full of unnecessary suffering, and bankruptcy leaving millions of Americans in poverty and imposing an ever-growing burden of costs on the entire country.
It’s a problem we all know is there but have, in many ways, started to accept as the result of the sheer size and complexity of our healthcare system.
Joe’s book lays out the details of a plan that could help to rejoin these two disconnected personalities of today’s healthcare system to create one that provides better healthcare at less cost to all. It’s an audacious statement, to be sure, yet one that Joe sees as entirely within our reach.
What makes this book so exciting is that the ideas within it are much more than hypothetical. There are examples throughout our healthcare system of achieving better outcomes and more consistent care, delivered to a broader group of individuals at lower costs. (The Kaiser Health Policy Report also has many stories on the challenges healthcare is facing, particularly one-off pilot programs proving to be hugely successful, mostly in underserved populations.)
The challenge is how to leverage these successes and replicate their results nationwide.
Joe makes the point that the answer to the dilemma is not a political one. This is very important, especially with a major national election here in the United States now just a few months away. The healthcare reform act is a political hot button and reform can help to accelerate change, but a permanent solution to this problem cannot be legislated; the transformation has to happen from within the system itself.
In his opinion, the answer is economic. “We are getting what we’re paying for in healthcare,” he says, “but we’re paying for the wrong thing.” As the system is set up now, we, as consumers, are paying through our health premiums and taxes for a lot of “things”: tests, procedures, devices, drugs, etc. What we should be paying for is the outcome we’re looking to achieve: “health.”
Those of us who live in Northern California, where Kaiser Permanente has a strong presence, probably experience “ah-ha” moments every time we hear one of its radio ads or see one of its commercials that focus on healthy lifestyles and preventative medicine—its key word being “thrive.”
All of this sounds like common sense when it’s laid out in black and white, but clearly there is not one simple solution to dramatically transform a system as complex as healthcare. Solutions will be found through new business models that change who gets paid and what they get paid for, in everything from healthcare plans to physicians, including healthcare suppliers.
Consumers will need to have a voice but so will employers who take on the responsibility of selecting the health plans that make up the options offered to their employees. They have the voice to speak up for coverage that engages the consumer and focuses on outcomes and quality of health, rather than purely focusing on restoring health once it’s been compromised.
As the community of people responsible for the healthcare facilities that will house whatever our healthcare system looks like in the future, from the technology-laden intensive care unit to the home environment that will increasingly support our healthcare needs, we need to not only pay attention to this conversation but also take part in it.
In the end, every one of us will be touched by the decisions made both from a career standpoint and as consumers, as well. There is no more compelling argument to have a voice.
Debra Levin is President and CEO at The Center for Health Design. For more information on The Center for Health Design, please visit www.healthdesign.org.