HEALTH CARE VISION
Last week, I appeared at the National Press Club an event sponsored by the Century Foundation, the AARP, and the Commonwealth Fund to discuss health care reform.
In preparing for that event, I came to realize that my vision of a national health policy has undergone refinement since I started my blog a few months ago. So here it is, although in abbreviated form:
- Any national health policy has to be based on the goal of maximizing health, safety, well-being, and productive capacity of all Americans.
- These goals, if achieved properly, will improve economic growth and competitiveness. They will not drain our economy, and we will not need to ration care to achieve them.
To achieve these goals, our health system will have to be based on six principles, all of which need to be followed:
- Americans need to know how to engage in healthy behaviors, and to be in an environment which encourages healthy behaviors in a healthy environment.
- We need universal, affordable, comprehensive health care coverage, and everyone needs to have that coverage.
- Health care plans need to incent healthy behaviors, and disincent unhealthy ones, and to reward high quality care and penalize low quality care.
- Americans need convenient access to the right providers, the right technologies and processes for health monitor and improvement, and the right information. Convenient access includes 7×24 access to the right providers and reasonable waiting times for care.
- The health care system needs to be of high quality and needs the capacity and the processes for continuous improvement, consistent with Six Sigma principles.
- The best quality will be achieved only if there is meaningful competition for providers at the level of primary and specialist care for specific medical conditions, including complementary and alternative medicine.
What are some of the implications of these principles?
- Employer-based systems like ours at Pitney Bowes should remain an essential component of the health care system, even if the rest of the system is reformed. Government-managed systems will generally fail to achieve these goals because decisions will get made on political grounds and will use slow-moving, bureaucratic processes to insulate them from criticism by voters.
- If we focus primarily on coverage, as many politicians have, we will be “rearranging the deck chairs on the Titanic,” and just reassigning burdens of a currently dysfunctional system.
- Plan providers and payers need to understand the behavioral consequences of plan designs, such as the likelihood that higher prescription drug costs for chronic diseases will result in non-adherence to treatment plans by patients and much higher future costs.
- Healthy behaviors are discouraged by such government actions as excessive subsidies for commodities that are integral to low price per calorie of less healthy “junk” foods like snacks and soft drinks, and inadequate subsidies for fruits and vegetables. Agricultural policies have a profound effect on our obesity problem.
- The recent government regulations, which limit wellness incentives by employers, are horribly misguided.
I will have more to say about these principles later.
September 26th, 2007 at 1:56 am
Hi, Mike! Glad to know that you recognize the importance of quality healthcare services, particularly those that follow Six Sigma principles. Keep at it!
October 2nd, 2007 at 3:31 pm
Mike,
In response to your blog on Health care vision, you mention a great deal of many excellent points. I most positively agree that policy needs to change in regard to what is being “fed” to America. The increase in the use of bleached, white flour has been shown to have direct coorelation to the increase in obesity. The use of preservatives and other additives such as unnecesssary food coloring are more than likely causes of other health related occurances. For instance, we (my wife and I) personally have found that our son shows extreme uncontrollable ADHD behavior whenever he consumes “any” amount of Red Dye. It has confused me ever since we found this out that when we go to purchase foods without additives; they cost so much more. Common sense says that the more you add to something - the more it should cost. The policy being pushed by corporate America is make the “good” food cost more, which pushes most people who are dollar conscious (rather than health conscious) to buy food which is not so good for them. Maybe additives should be added to the list of Drugs where they could then be a controlled substance.
However I believe that true health care reform may just be a pipe dream, as the old adage rings most true - Money rules the world… In other words - Sick People are big business to hospitals, doctors, lawyers, pharmaceutical companies, research laboratories, etc…
Thank you for your time.
Rick
October 3rd, 2007 at 4:13 pm
To Rick Kegresse:
I appreciate your thoughtful and passionate comments. While I understand your view that too many people benefit from the current health care or make fundamental reform likely to happen, I think you may be underestimating the fact that every player who benefits also has many negative experiences with the current system.
If the majority of the current players can make a great living improving people’s health rather than treating illness, I believe a coalition for reform can be assembled. It will not be easy or quick, but with the right presidential leadership and relentless focus by reform proponents, it can happen.
– mike
October 4th, 2007 at 12:19 am
Hey Mike, I’m so glad to see that finally someone can see that we do really need a better system. It is high time that our govt. get their act together on the matter before things get to far out of hand. we all can see it is not to far away from that point
October 4th, 2007 at 10:37 am
Mike,
Thank you again for your insightfulness into this much debated subject. I do indeed hope for a future of good health for us all. Keep up the good work.
Rick
October 4th, 2007 at 6:29 pm
Hi Mike, I agree with what you are saying, I just hope we can fix our Health Care system before it’s too late. In that regard, could you help explain the role of Dossia and Microsoft’s HealthVault product in the future of Health Care management. Thanks