Our legislators are describing the proposed healthcare reform as "keeping what works and fixing what doesn't work." I'm concerned that they are taking a simplistic view. Our healthcare system is such a complex, tangled, and flawed conglomerate of silos, it needs to be scrapped, including Medicare and Medicaid.
The existing healthcare system does not work precisely because it is a system of silos. Silos foster self-absorption, disparate goals, redundancy, and poor communication. Cobbling together existing silos with bandaids is doomed to cost a lot more than supporters of the current proposal anticipate, and will not solve the underlying problems.
I'm pragmatic enough to realize that scrapping and building from scratch may be an impossible task for our lobbyist-run government, but now is likely the only time we have a chance to "do the thing right." We need to build an efficient new integrated system managed by a private non-profit entity. We have experts in this country who can accomplish this—just look for proteges of Dr. W. Edwards Deming (http://deming.org/).
To President Obama and the Democrats in the Senate and House: You've got the majority, why not use it maximally? However this turns out, the Democrats will be blamed, so show some courage, audacity, and leadership—go for the best possible solution. Short of that, go for a solution that provides a clear path to an efficient integrated system in five years. On the off chance that you think the current reform proposal provides a clear path to an efficient integrated system . . . think again.
No comments:
Post a Comment