At $2.4 trillion per year and 18% of the U.S. gross domestic product, the healthcare industry is seriously out of proportion with the U.S. economy. Seven out of ten personal bankruptcies are now attributed to healthcare cost. Yet, the more money we spend on healthcare the greater the inefficiencies and the lower the quality.
President Obamas platform for healthcare reform originally spoke to improvements in quality, reductions in cost and greater accessibility to care. This sequence has been lost in an effort to provide coverage to an additional 47 million people in the U.S. If we try to include 47 million more people into an industry with run-away costs and decreasing quality, two things will happen; the system will implode with astronomical cost and the quality of care will reach new lows. We do not have enough care providers in this country to serve an additional 47 million that will now seek greater access to care. This is the plan being debated in Congress and this is the reason it would bankrupt the U.S. economy even faster than the faltering current system. In business you change processes, reduce inefficiencies, measure and automate operations before any attempt to scale. Every industry that has undergone transformation over the past fifteen years took very methodical and measured approaches. In all cases, quality and productivity rose as costs fell. What do we know about healthcare today; costs are rising as quality and productivity decrease. This is a fundamental lesson for our President and Legislature. Healthcare will not be transformed in one year or by an ambiguous bill. It will be transformed by aggressive, measured and continuous milestones each building upon each other, maybe taking a decade or longer. It took us 50 years (or more) to get in to this mess, it cannot be fixed by one President and one Congress in one catch all bill, no matter how well intentioned.
Right now we do not know the precise shape healthcare is in. Most of the vital patient records are in pieces of paper in doctors offices and hospitals, and those that are in electronic format are in isolated on hard drives in physician offices and medical facilities. In the 21st Century 90% of all transactions in healthcare are done by phone, paper or fax. The first step in healthcare transformation is the aggressive adoption of electronic records and transactions. This will allow us, for the first time, to measure true clinical results, financial profiles, performance and utilization. Right now, we really dont have a clue. After we start measuring what we have then we can begin prioritizing initial areas to overhaul. Eventually, we will start reaching critical mass where efficiencies are achieved through automation and outcomes of diagnosis, treatments and best practices that can be measured and enhanced.
Healthcare reform is not solely about insuring more people. This alone is an equation for the lasting failure of our system for generations to come. Prioritize to achieve higher quality and lower cost targets before opening the gates of accessibility. Our transformation strategy and budget should be based on yearly milestones not vague and rushed bills. As a testament to this effort the President and every member of Congress should be required to participate in the healthcare plans proposed. Its time to walk the talk! If we strive to create world-class healthcare programs, our Congress should be the first to “live” these programs.
Industries drive transformations based on competitive pressure. We innovate relentlessly because that is how we lead and how we survive. Industries create wealth with very strong measures of quality and efficiency. Free enterprise is the backbone of this country. It is industry, not government, that will transform healthcare. Too much government intervention increases overhead, reduces competition, does not increase wealth creation and ultimately increases costs which are bourne by us the American people.
Industry shares the vision of a better healthcare system. The difference is in the ability of industry to deliver a much more pragmatic, measured and ultimately faster approach to effective transformation.
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