A New Prescription for Healthcare Reform – Let’s Hope It Isn’t Taken

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By Jim Murphy

A few years ago we commented on Harvard Business Review’s predilection for proposals for healthcare reform.  In reviewing a “grand prescription for the healthcare industry,” we predicted that in “five or ten years from now there will be another HBR article on this topic” with a different remedy. As it turns out, that prophecy came true even faster.

Amazingly, the new article with the latest proposed dosage has one of the co-authors of its predecessor: Thomas Lee, Chief Medical Officer at PressGaney, as well as TedMed speaker and author. Previously writing with leading business strategy expert Michael Porter, this time he has as partner another Harvard Business School professor, Leemore Danfy.

PressGaney, Harvard Business School, and Harvard Business Review are the number one institutions of their kind in the world. Therefore, it is saddening to say that what it is being sold here is again nonsense that will (fortunately) not be implemented but (unfortunately) will be influential – and no doubt bring the authors more business and perhaps future invitations to write for HBR.

The title and thesis of the article is “Healthcare Needs Real Competition.”  Interestingly, the “competition” mantra has been also cited by Donald Trump.

The problem, the authors (and most people writing on this topic also) say, is that “our healthcare system remains chaotic, unreliable, inefficient, and crushingly expensive.”

Let’s try a few more sentences like that:

“Our educational system remains chaotic, unreliable, inefficient, and crushingly expensive.’

“Our military system remains chaotic, unreliable, inefficient, and crushingly expensive.”

Or even, “Life remains chaotic, unreliable, inefficient, and crushingly expensive.”

So does it follow that “Our healthcare system, our educational system, our military, and life in general, need real competition”?  How about instead:  “Our healthcare system, our educational system, our military, and life in general need real cooperation”?

Imagine all the actors in the healthcare system competing harder. Then imagine them cooperating more. Which seems more likely to improve things?

Well, maybe neither.  The healthcare system is extremely complex.  It is shallow thinking to believe that any one answer – competition, cooperation, concentration, or compassion – is a solution to all its problems.

And what actually is the problem? Isn’t it really that people are not getting quality healthcare and some are still not getting healthcare at all? Isn’t the cause that we have a money-driven system and more focus on money will only make it worse?

The authors end by saying that if their remedy is not is accepted, the result will be “chaotic, costly care of uneven quality, with a growing toll on individuals and the economy.”  Which of course is what they say we have now and, it seems safe to predict, will also be what we have the next time HBR tells us what must be done to reform healthcare.

Jim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Being semi-retired, Jim is willing to provide very reasonably priced consulting, coaching or project work for organizations aspiring to improvement in organizational culture, effectiveness and employee engagement.

Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium.  His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices.  Having produced newsletters for several organizations  and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as well as consulting and coaching.  He is a Senior Research Analyst at MetaView Consulting and Coaching, http://metaviewcc.com/.

www.manage2001.com or email  jim@manage2001.com

This entry was posted in Communication in Healthcare, Complexity in nursing, Democracy NOW, Diversity, Healthy Workplaces, Patient Advocacy. Bookmark the permalink.

One Response to A New Prescription for Healthcare Reform – Let’s Hope It Isn’t Taken

  1. Thanks for your insights, commentary, and links, Jim. I agree that we have a money-driven system and believe that more focus on money will only make it worse. Repealing Obama care IMHO is naive. The ACA basically stabilized a sinking ship and the ship was sinking b/c costs were out of control. Unless repealing it and ascribing to a non-money-making or low-money-making (integral to ACA efforts) system, there will be destabilization of the system and many will suffer. The only silver lining that I see in this is that the ship will indeed sink and we’ll have to build a new one. Single payer is the best option if we want to provide equal quality, access, and affordable healthcare to USA citizens. Do we?

What are your thoughts?