Everyone knows (except Washington) that you cannot cure a sick anything – patient or system – without a correct diagnosis. What is the diagnosis for sick, “broken” U.S. healthcare?
Washington apparently thinks that there is not enough money in the system because the Bill they are discussing will add $1 trillion to our national deficit. That means they will have to print even more money.
Washington has also found greedy groups to blame: doctors, insurance executives, drug companies, even the patients, but never the lawyers and never, ever themselves. Might I remind Congress that the largest cost item for U.S. healthcare is the “waste of the middle.”
Both diagnoses – insufficient dollars and greedy group – are wrong. The reason why healthcare is sick is the title of this blogpost. Healthcare claims to be a system but is not. Healthcare has no guiding principles.
Every country with universal health care has two things that the U.S. healthcare does not: System and Principles. Each has a planned-in-advance organized structured process with rules, accepted outcome metrics, and a national medical information technology.
“Jumbo shrimp” and “I’m from the government and I’m here to help” are two widely accepted oxymorons: internally contradictory phrases. “U.S. healthcare system” should be added to the list. In place of a system, we have a bunch of warring tribes all speaking different languages with cultures in conflict and divergent priorities. If you like historical analogies, think Balkan states, Renaissance Italian principalities, or Greek city-states.
Our country has been through a number of tests over 233 years that could have torn us apart. The reason we survived and thrived is our single greatest strength: a clear declaration of principles, one with which we all concur. When we need to ask what to do, we can refer to the documents illustrated above.
What are healthcare’s guiding principles? When contentious issues arise, where can healthcare look for advice? Those were rhetorical questions. U.S. healthcare has no generally accepted principles.
Without its own ‘Bill of Rights and Responsibilities,’ healthcare is rudder-less. It cannot make a decision based on commonly accepted ideals because there are none. Healthcare simply responds to the loudest voice and is forced to react to one crisis after another because it has no game plan, strategy, mission or vision.
To have sustainable, affordable high quality healthcare, we need to agree on principles and create a coherent system based on them.