Taming the Healthcare Beast

In his book Being Mortal, Atul Gawande describes the challenges families face working with the healthcare system.

Gawande, a Harvard surgeon, explains: “The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that medicine has had an incorrect view of what makes life significant. The problem is that it has had almost no view at all”.

To paraphrase Gawande, we spend a sixth of our economy on a healthcare system that acts as if it has lost sight of what it means to be human.

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The adage “Every system is perfectly designed to get the results it gets” is a commonly used description of why healthcare is failing.

But in seeking a solution, it is important to remember that all aspects of healthcare are not failing. In fact, parts of the healthcare system have enjoyed decades of well above average financial returns.¹

Understanding these areas of shining success is the key to understanding the failure of the system.

The following factors work behind the scenes to synergistically create both the system’s high margins and the suboptimal results for patients and employers:

Research is frequently designed, funded, and written by pharmaceutical, medical device, and food companies,
Lobbying of government officials has been estimated to yield a 50-fold return on investment,²
Direct to consumer advertising is both ubiquitous and effective,
Physician reimbursement is often higher when recommending a more expensive rather than a more efficient mode of treatment,
Some “quality standards” serve industry rather than patient interests. This intrusion into the patient/physician relationship has eroded physician morale,³ and
Commercial interests have successfully integrated non-scientific bias into the content of medical education.⁴

These six factors have successfully protected the industry from efforts to improve the value of healthcare. They are also behind many of the daily frustrations of hard-working healthcare professionals.

Taming a beast may be a great show for the circus, but because of the synergies noted above, taming the rising costs of healthcare by taking it on directly has been been a failed strategy. Our solution at Switch starts by staying out of the cage.

Breakthrough To Better,
Carl

¹A Case of Dr. Jekyll and Mr. Hyde by Carl Myers, MD MBA
²The Pharmaceutical Industry’s Profitable Stranglehold
³Time Out – Charting a Path for Improving Performance Measurement
⁴A Historical Perspective of Pharmaceutical Promotion and Physical Education

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Switch Conversations informs business leaders on the “whys”
behind healthcare ineffectiveness and how we can help.

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