— An excerpt from Lawry’s new book, Health Care Nation
by Tom Lawry
“All great changes are preceded by chaos.” — Deepak Chopra
Escape rooms have become quite popular these days. This is a game where people are locked in a room and must work as a team to discover clues, solve puzzles, and accomplish a series of tasks to escape.
In many ways, today’s healthcare system is America’s largest escape room. We’ve locked our most talented health experts and consumers in a labyrinth along with a staggering $4.7 trillion of our own money. The problem is that we haven’t figured out how to escape the maze of convoluted policies, skewed financial incentives, and entrenched traditions that are steering amazing people and 17.3% of our Gross Domestic Product (GDP) in the wrong direction.
Despite these flaws, it’s important to recognize that the U.S. is a global leader in scientific discovery and developing innovative technologies to diagnose and treat disease. It’s also important to understand that health professionals, provider organizations, health insurance plans, and other diverse entities are doing their best to bring those advancements forward.
But here is the rub — the hodgepodge that we call the American healthcare system emerged at different points in our nation’s history, under varied contexts and for very different purposes. This mishmash of systems was never designed to function as a single, coherent system.
The renowned newscaster Walter Cronkite nailed it years ago when he quipped that our healthcare system is “neither healthy, caring, nor a system.”
Whether you’re a Medicare recipient or a health professional, we’re all stuck in the same quandary. We tell ourselves we can and must do better. We just don’t know where to start.
I landed my first job as a junior executive in a major medical center when I was 24 years old. Since then, I’ve spent my career in and around healthcare in America, Europe, and Asia. Whether a neurosurgeon in Charlotte or an herbalist in China, I’ve never met anyone in healthcare who didn’t have good intentions. Everyone wants to be part of a noble cause. They’re in it for the greater good — to foster better health and a better world.
Unfortunately, the complexities of America’s healthcare juggernaut have a knack for leading even the smartest, most well-intentioned people and mission-driven organizations astray. It’s a collective conundrum. It’s no one’s fault and everyone’s fault. And therein lies the crux of the problem: no single entity can shoulder the burden of fixing healthcare. It’s a shared responsibility.
This is one of the reasons we feel helpless to change it. It’s also why we keep getting the narrative wrong on how to “fix” healthcare. This path typically plays out in one of two ways.
The Blame Game
In the grand theater of healthcare reform, we’ve long played the blame game. It’s where we pass the mantle of villainy from one scapegoat to another. Today, it’s “Big Pharma” under the spotlight in the Senate. Tomorrow it might be the payers or the health providers. It’s a well-rehearsed drama, with elected leaders grilling health execs for the cameras, generating headlines and sound bites for the folks back home.
But for all its flair, this blame game is just that — a game. It’s a distraction, a sideshow that fails to illuminate the real issues at the heart of our ailing healthcare system.
Let’s agree that exorbitant drug prices, incomprehensible benefit statements, and bloated administrative costs are big problems. Let us also understand that these are glaring symptoms of a much deeper malady.
Just as treating symptoms without dealing with the underlying cause won’t solve a medical problem, pointing fingers at one group or another, including elected leaders, only serves to obscure the true diagnosis of what’s wrong with healthcare and what needs to change.
We’re all stuck in an escape room of our own making. Good people are trapped in a system devoid of coherence and cooperation.
The tangled web of incentives and disjointed coordination among players in the healthcare delivery system leads to a nonsensical allocation of resources. Quality suffers, costs soar, outcomes falter, and patients are left navigating a maze of frustration.
Railing against the system won’t untangle these knots. Changing the system starts with changing the narrative.
Let’s shift the focus from blame to understanding.
Let’s dispense with the notion of “bad players.” Instead, let’s shine a light on the flawed processes and misaligned incentives driving a dysfunctional behemoth that is impacting our health, wallets, and the strength of a nation.
We won’t fix what’s broken by bashing it. What we need is a collective vision, a shared understanding of the current forces at play, and a commitment to steer healthcare in the right direction.
Understanding what’s driving today’s system is no easy feat. Another step in grasping the intricacies of our healthcare conundrum is to stop asking the wrong questions and start asking the right ones.
The Wrong Question: How Much Can We Save?
Health policy or reform discussions often focus on how changing our approach to healthcare will “save money.” Whether it’s about saving or spending, the fixation on financial outcomes misses the point entirely.
Prevention, for instance, shouldn’t be judged solely on its ability to pinch pennies. It’s about investing in the well-being of our society, not just balancing the books. It’s about the value we all get from the investment we’re making.
A paradigm shift is imperative — one that elevates things like prevention to their rightful stature alongside diagnostics and treatment. We must scrutinize every facet of healthcare through the lens of value maximization.
Does an intervention enhance health outcomes? Are there alternatives that yield comparable or better results at a lower cost?
Evidence speaks volumes. Effective preventive measures, both clinical and communal, stand ready to alleviate the burden of chronic ailments, safeguarding both present and future generations. The toll exacted by preventable diseases, both human and economic, serves as a stark reminder of why change is needed now.
It’s time we chart a new course for healthcare that prioritizes long-term prosperity over short-sighted austerity.
So, let’s change the script. Let’s stop chasing shadows and start shedding light on the real issues. Let’s ask the right questions and, more importantly, let’s find the answers together. That’s the only way we’ll break free from the blame game and build a healthcare system worthy of the name.
Tom Lawry is managing director at Second Century Technology in Seattle, an AI transformation consultant, and author of the new book, Health Care Nation, from which this piece was excerpted.
