By KIM BELLARD
Just lately in The Washington Submit, author Daniel Pink initiated a sequence of columns he and WaPo are calling “Why Not?” He believes “American creativeness wants an creativeness shot.” As he describes the plan for the columns: “In every installment, I’ll supply a single thought — daring, shocking, possibly a bit jarring — for enhancing our nation, our organizations or our lives.”
I find it irresistible. I’m all in. I’m a “why not?” man from method again, significantly in terms of well being care.
Mr. Pink describes three core values (within the curiosity of house, I’m excerpting his descriptions):
- Curiosity over certainty. The world is unsure. Curiosity and mental humility are the simplest solvents for unsticking society’s gears.
- Openness over cynicism: Cynicism is simple however hole; openness is troublesome however wealthy.
- Dialog over conversion: The last word dream? That you just’ll learn what I’ve written and say, “Wait, I’ve received a fair higher thought,” after which share it.
Once more, kudos. One may even say “transfer quick and break issues,” however the bloom has come off that exact rose, so one may simply say “take probabilities” or “assume completely different.” Possibly even “dream huge.”
Across the similar time I noticed Mr. Pink’s column I occurred to be studying Adam Nagourney’s The Times: How the Newspaper of Record Survived Scandal, Scorn, and the Transformation of Journalism. Within the early 1990’s The Occasions (and the remainder of the world) was struggling to determine if and the way the Web was going to vary issues. Mr., Nagourney stories how writer Arthur Sulzberger (Jr) realized the impression could be profound:
One doesn’t must be a rocket scientist to acknowledge that ink on wooden delivered by vehicles is a time consuming and costly course of.
I.e., opposite to what many individuals at The Occasions, and plenty of of its readers, thought on the time, the newspaper wasn’t the bodily object they have been used to; it was the knowledge it delivers. Which will appear apparent now however was in no way then.
Which brings me to well being care. Opposite to what many individuals working in healthcare, and many individuals getting care from it, may assume, healthcare just isn’t docs, hospitals, prescriptions, and insurance coverage corporations. These are merely the ink on wooden delivered by vehicles that we’re used to, to make use of the metaphor.
And it doesn’t take a rocket science to acknowledge that what we name well being care at present is a time consuming and costly course of – to not point out usually irritating and ineffective.
Why not do higher?
I additionally thought of well being care when studying Mr. Nagourney’s ebook when he described the battle between the journalism facet of the corporate versus the enterprise facet: was the newspaper in regards to the articles it revealed, with the promoting simply there to assist them, or was it actually an promoting platform that wanted the content material the journalists created to carry eyeballs to it? In healthcare, is it about serving to sufferers with their well being, or is it a method to offer earnings to the folks and organizations concerned of their care?
I.e., is it in regards to the mission or the margins?
Should you assume that’s too cynical, I’ll level to Matthew Holt’s great article in The Health Care Blog arguing that many hospitals techniques are actually basically hedge funds that occur to offer some care, whereas additionally creating scads of wealthy executives. Or to how an precise hedge fund is buying a hospital. Or to how, certainly, personal fairness corporations are buying up health care organizations of all types, regardless that many consultants warn the principle impression is to boost prices and adversely impression care. Or to how Medicare Benefit plans may be better at delivering insurer profits than quality care.
I might go on and on, however it appears clear to me that healthcare has misplaced its method, mistaking the way it does issues from what it’s speculated to be for. If healthcare has develop into extra about making a small variety of folks wealthy than about making lots of people more healthy, then I say let’s blow it up and begin from first ideas.
There’s a “Why Not?”
Mr. Holt’s “Why Not?” is to take a measly $38b from the $300b he estimates these hospitals are sitting on, and make investments it in main care, such because the Federally Certified Well being Facilities (FQHCs). Major care wants the cash; the hospitals/hedge funds, not a lot. Amen to that.
A pair years in the past I proposed a fair wilder thought: let’s give each doctor $2 million – possibly even $2.5 million – yearly. We are saying we worth them, so let’s reward them accordingly. The caveat: from that they’d must pay for all of their sufferers’ well being care wants – referrals, prescriptions, hospital stays, and many others. I posited that they’d negotiate significantly better offers with their compatriots than we appear to have the ability to do. A number of particulars to be labored out, however it falls into the “Why Not?” class.
Right here’s one other audacious Why Not: it’s fairly well known that CEO to employee pay ratios have skyrocketed from a modest 20-1 within the 1960’s to one thing like 344-1 now. There’s no proof I’ve seen that the ratios are any better in healthcare. Since no career in healthcare is extra revered and relied on than nurses, I suggest – possibly making it a situation for receiving any federal funds — that no healthcare group ought to have an govt compensation to nurse compensation ratio that exceeds 20 (and I do imply compensation slightly than wage, to keep away from the bonus/inventory shenanigans that executives have relied on).
If that sounds low, I’d pity the chief who needs to argue with straight face that he/she is greater than twenty occasions extra vital than nurses. I wager they couldn’t discover many sufferers who’d agree, or any nurses.
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Should you work in healthcare, you need to ask your self: is what I do the ink, the wooden, or the supply truck, or is it really integral to what healthcare needs to be in 2024? Should you assume your job needs to be extra about well being and fewer in regards to the enterprise of well being, why not make it so?
And the remainder of us needs to be asking ourselves: is the healthcare we get nonetheless the equal of a print newspaper? We don’t must be rocket scientists to acknowledge that, in 2024, we needs to be anticipating one thing higher – cheaper, sooner, extra interactive, extra private, and rather more impactful.
Why not, certainly?
Kim is a former emarketing exec at a significant Blues plan, editor of the late & lamented Tincture.io, and now common THCB contributor
