Medical
Innovation – Let the Market, Not the Politicians Decide
The
market economy as such does not respect political frontiers. Its field is the
world.
Ludwig
Edler von Mises (1881-1973), Human Action
Market
competition is the only form of organization which can afford a large measure
of freedom to the individual.
Frank
Hydeman Wright (1885-1974), Freedom and
Reform
November
16, 2012- When I
started Medinnovation blog in November 2006, medical innovation was very
much on my mind. I had just finished a
book Innovation-Driven Care: 34 Concepts
for Transformation (Jones and Bartlett, 2007). I was hot on the subject
of clinical innovation.
But cataclymic events intruded –
the deep economic recession 2008, Obamacare passage in 2010, collapse of social welfare programs in
Europe.
In the course of writing 2550 blogs to date, my attention has shifted to profound transformations in medical practices, government interventions into clinical freedoms, electronic information technology revolution, role of physician and American culture on these monumental events, and how physicians are adjusting to what’s transpiring out there, much of it beyond their control.
In the course of writing 2550 blogs to date, my attention has shifted to profound transformations in medical practices, government interventions into clinical freedoms, electronic information technology revolution, role of physician and American culture on these monumental events, and how physicians are adjusting to what’s transpiring out there, much of it beyond their control.
Out of these chaotic
happenings has emerged the idea of organizing my daily blogs into a series of
little books with the omnibus and immodest title of New Voice of Health Reform: Rhyme, Rhetoric, and Reality (Medinnovation
Press).
- Rhyme
because
there often seems no rhyme or reason for what’s happening and events are
so harsh and complex they do not lend themselves to straightforward prose.
- Rhetoric
because the political and management talk is often so
abstract and lofty that it deosn't truly indicate what’s taking place
on the ground.
- Reality because someone needs to bring these complex and sometimes chaotic events into a sharper focus to which we can all relate.
It isn’t easy to
separate the wheat (the realities) from the chaff (the rhetoric) in the complex
adaptive world of medical and healthcare affecting every American. Ideologic posturing confuses everything. The fact that Obamacare was strung out over
ten years with nothing much happening from 2010 to 2014 in order to sell it for
less than $1 trillion when its true cost from 2014 to 2024 was $2.6 trillion
complicated matters.
In describing what’s
happening, I have found it useful to
apply these principles (borrowed from Edgeware:
Insights from Complexity Science for Health Care Leaders (VHA, Inc, 1998).
- Recognize reforming health care is complex and doesn’t lend itself to sweeping innovation by centralized government or fragmented markets.
- Do
not try to spell out in detail what needs to be done because no one is
smart enough to know.
- Acknowledge
that outcome data has a place but must be balanced against intuitions,
needs, and motivations of patients and physicians.
- Go to
the edge of clinical events to see what works and is affordable.
- Deal
realistically with the paradoxes and tensions of change which will never
please all of the people all of the time.
- Know that multiple actions must be tried
to see what direction to take before one proceeds with some grandiose
scheme.
- Listen
to gossip, rumors, conversations, and dissent before taking subsequent
actions.
- Look
for simple systems that work independently before incorporating them into
an integrated complex system.
- Mix cooperation with competition, realizing that independent entrepreneurs are going to strike out on their own.
In any event, out of this
thought process has emerged a series of little books on health reform. One is
done, and others are in production.
These include:
- Physicians, Poetry, and
Humor - Health
reform, being a human thing dependent on human foibles and behavior, is
much too serious to be taken seriously all of the time.
- The
Physicians Foundation , New Voice
of Medicine -Through
its national surveys, white papers, and research grants, this organizatihn has shown a bright
light on what’s really happening out there to physicians.
- The Physician Culture
and the American Culture- Their Affect on Health Reform.
- Primary
Care and Specialty Care – Their Roles and Evolution in Health Reform.
- Medical and Health Care
Innovation. Parallel but Not the Same.
- The Information Revolution and Medical Records – and the Patient-Physician Relationship.
Tweet: Health reform calls for a complex adaptive system and requires both govenment and market responses with an emphasis of human freedoms.
To purchase Physicians, Poetry, and Humor, click on this link http://netondemandbooks.com/obd/selfespress/obd0000001090 and enter your credit card information.
To purchase Physicians, Poetry, and Humor, click on this link http://netondemandbooks.com/obd/selfespress/obd0000001090 and enter your credit card information.
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