The Revolution In Our Assumptions About Healthcare
by Joe Flower
Everything we do about healthcare is governed by our underlying assumptions - and those assumptions are changing. Every traditional assumption we had is not merely whithering away, it is in the process of being turned on its head. Here are what I believe to be some of those traditional assumptions, and the assumptions toward which we are headed:
Traditional Assumptions
- Ill health is an unpredictable "Act of God."
- We pay for the treatment of disease and trauma as if they were accidents unconnected to anything we do or know.
- Our clients are "patients" (that is, to refer to the Latin root, "sufferers," passive victims).
- Our contact with them is episodic, high intensity, low touch.
- Doctors are independent and self-sufficient carriers of information and judgment.
- Health care is something you pay for Ń and those who canŐt pay get less of it or none at all.
- Health care is event-driven - it begins when a problem arises. So cost management in health care is event-driven.
- In the healthcare industry, our job is to treat people with trauma, and people whose diseases that have reached the acute, symptomatic stage, through dosing and cutting, if they have the right paperwork - and our success as a business is measured by the number of warm bodies in our custody on any given evening.
Future Assumptions
- Much of ill health will be predictable, capable of being prevented or managed.
- We will pay for that prediction, prevention, and management because it is easier, cheaper, and more humane.
- Our clients will be our partners in managing their own health.
- Our contact with them will be lifelong, low intensity, high touch.
- Doctors will be much more a part of a team, and they will work imbedded in a matrix of information.
- One way or another, we will all pay for everyone's health care - not necessarily because it is a "right," but because, like national defense and the interstate highway system, it is the only workable solution, and by far the cheapest one.
- We will manage costs through population health status improvement, and through prospective medicine - the prediction, prevention, and management of disease in individuals.
- Our job as an industry will be to raise the health of the population - and our success as a business will be tied to that increase in health
Many of these assumptions are clearly not true today, are not shared across the industry or by the public, and may take as much as a decade longer to become shared. But we appear to be headed in that direction.
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