Rejecting Mr. Quicksolve

We live in the moment. We live for the moment. We demand instant gratification. We expect immediate access. Think cell phones or the Internet, or better phone calls through the Internet. When we are sick, we take for granted a quick cure. Take this. Do that. You will be fine in the morning.

It is consistent – though completely unrealistic – to have the same expectation when fixing our healthcare system. Legislate a single payer system. Mandate universal health care. Everything will then be fine. To paraphrase Judith Rossner’s 1975 best-selling novel about Mr. Goodbar, we are all Looking for Mr. Quicksolve.

There are problems.
• Mr. Quicksolve does not live here anymore. In fact, he is like George Kaplan in Hitchcock’s classic film North By Northwest: Mr. Quicksolve does not exist (and never did).
• Accepting a quick solution means that we are addressing symptoms not causes.
• Quick solutions do not work and often make things worse.
• Quick solutions take away needed resources from solutions that actually might work.

We are not babies but we sometimes act like them. We need to wean ourselves from magic thinking. There is no silver bullet or secret potion.

In our heads, we know that longstanding complex problems require complex answers over time. In our hearts, we want what we want when we want it…and we expect to get it.

There are numerous things fundamentally wrong with our healthcare system. Right now the media has focused our attention on the financing, as though that were the only problem and worse, implying that fixing it would solve healthcare.

46 million without health insurance. Medical bills a leading cause of bankruptcy. Annual healthcare expenditures approaching 20% of U.S. GDP (over $2 trillion). These are big problems but keep in mind two things.

#1. Even if you could wave a wand and fix the financing [you cannot; no one can], it would not assure you of high quality, easily accessible healthcare. For instance, all the money in the world will not get you health care if there are no nurses or doctors.

#2. Financing does not exist in a vacuum or a silo. It is part of an interdependent system. Changing one part in isolation does not fix systematic problems. It usually makes them worse. Will fixing one bank fix the current economic crisis? If you simply mandate universal health care, without checks and balances, the cost will skyrocket further. If you impose cost controls, access will plummet. No so easy is it?

Healthcare’s problems are not insoluble. I am not and never will be a member of the “consensus of futility.” We can cure healthcare but we must practice good medicine…on Sicko. That means making a diagnosis that includes the causes not just symptoms, treating those causes, and accepting that a cure will takes years to decades. If we accept Mr. Quicksolve’s answer, healthcare will never be right. If we start now, certainly, it will be “right” for our children. If we had started to do it right in the 1950’s, healthcare would be right, right now, for us.

The sooner we stop listening to the seductive Mr. Quicksolve and start curing healthcare, the quicker we will have the healthcare we need.

PS. If someone offers you a solution that will fix healthcare in the short term, that person is: a) A politician pandering for votes; b) A self-styled expert selling books or trolling for speaking gigs; or c) Someone who simply does not understand. In any case, reject their so-called answer because it will not work.

System MD

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