Tuesday, July 26, 2011

Financial Stability and the Healthcare System

This post is a little off the beaten track for me. But it is important because in the debate over financial responsibility, we must remember the social obligations that we owe each other as members of the same community..

On Sunday, my wife was warded to critical care in a Baltimore hospital where I met some of the most wonderful doctors and nurses.  These individuals, especially the nurses, perform their very difficult duties in the midst of human devastation, maintaining a composure with a compassion that is very difficult to comprehend (I was a total wreck).  I also witnessed similar things in the ER, where she was first admitted.

Throughout this experience, I have come to see the incredible technological and human capital resident in the U.S. healthcare system.  It is no exaggeration that it is the best in the world. In part, I believe it is the high value that Americans place on human life, hence the willingness to spare no expense, even at personal sacrifice, to preserve it.

I believe that in the long term continuing technological innovation, business process re-engineering, and increases in medical knowledge will allow the U.S. healthcare system to continue being the best in the world without the predicted financial burden that many have suggested (forecasts of future states almost always do not consider future innovation).

In the short term, however, given limited resources, trade-offs are inevitable.  This is a very difficult thing to discuss because I wanted, and in fact did receive, the very best care for my wife, regardless of expense.

While the trade-offs should always be honestly recognized and discussed by our lawmakers, I believe that citizens should have direct voice in the making of such tradeoffs within their communities.  For Americans, healthcare is too personal for decisions to be made only at the top.  For example, the healthcare reform package passed by Congress was not the result of an exhaustive national conversation but the product of special interests and sales pitches by politicians and lobbyists.  If there ever was a time for a national referendum on an issue affecting future generations, it is now.


  1. This is such an important topic. And being in the unique position of being the dean at the business school which is connected to one of the top medical schools in the world puts you in a great position to address this.
    How can we more conversation on this and less gridlock in congress? Also, do you think if congress had to get insurance on their own, that they would act differently?

  2. My personal view is that the conversation must occur outside the beltway. Congress is too far invested in the special interests on this issue.

    The conversation should take place between patients and their advocates, healthcare providers and community leaders in the communities whether healthcare access and costs are poorly matched.

    Such communities can encourage entrepreneurial solutions to healthcare access, whether in the form of buying groups, subscription plans, wellness pricing (rather than procedure pricing), the use of distance technologies, and so on.

    The one thing going for us is that neither patients or doctors is happy with the current system. Too much resources are spent on administrative procedures, defensive medicine, and overhead from insurance reimbursements, malpractice insurance, and so on. Perhaps if doctors and patients could talked to each other openly and honestly, we would converge to solutions that work for each community without the one-size-fits all mentality of the politicians and insurance companies.

    If Congress has to get insurance on their own, I think it would illustrate the inefficiencies in the system but won't motivate a solution if it meant they had to acknowlege the special interests that are keeping the system in place.