Wednesday, January 2, 2008

Consumer-driven care, Herzlinger - Remaking American Health Care, Part 2, The Consumer-Driven Solution

In my blog before last, I described how George Halvorson, Kaiser CEO, would remake health care. That blog drew mixed opinions. Some top-down corporate control was bad. Others said it was about time doctors engaged in systematic improvement programs from on high.

Halvorson advocated a national system-wide data-driven revolution comparing how well doctors and hospitals perform, focusing on improving care for major chronic diseases, then allowing payers to bid on who performs best in terms of costs and outcomes. You can read details of his proposal in Health Reform Now! (Wiley, 2007).

At the end of my blog, I asked how you, America’s practitioners, thought of Halvorson’s approach.

Now I would like to ask how you react to another proposal, this one by Regina Herzlinger, Professor of Business Administration at Harvard Business School and author of Who Killed Health Care? (McGraw-Hill, 2007)..

Here’s what she said in an August Wall Street Journal piece “Where Are the Innovators in Health Care?”

“Luckily there is a solution, but there is only one: consumer-driven health care. Let’s take back our $2.2 trillion from the entrepreneur-suppressing status quo and allow consumers to reward those entrepreneurs who lower costs by improving health. Until we control our own health-care system, the entrepreneurs who could reform it – and it make our lives better – will continue to look elsewhere for opportunities . Who can blame them?”

She is referring to the 20 or so doctors enrolled in her “Innovating in Health Care” course at Harvard Business School. She says thy’re “ruefully driven to earn MBAs once they realize they innovate better as an entrepreneur than as a doctor.”

In “Who Killed Health Care? she argues health insurers, general hospitals, employers, the U.S. Congress, and academics have “killed” health care through a complex web of rules and regulations. What is needed, she says, a consumer-driven health-care system that will unlock those shackles to bring about a much-needed entrepreneurial revolution that will lower costs, improve care, and expand choice.

Do you agree?


Gary M. Levin said...

In an article posted on "The HealthCare Blog the causative factor is dumped at the feet of the AMA. Brian Klepper in a guest article discusses this in full at

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