If health care is a basic fundamental right – and I believe it is – then we have to make it a fundamental service that’s available to everyone. We’re fortunate in this nation to have some of the best elements of health care – exceptional and committed medical professionals, the latest technology, and groundbreaking research – on the globe. But what America has in place today is really not a system. Our “system” is made of many disparate parts that work and often act independently. And, a person’s health care experience varies drastically depending on where you are, when you need care, how you approach that care and what resources you or your family have. It’s a different story for every entry you may make (or try to make) into the “system.”
We need to change the overall “system,” because it’s not working well for anyone today. It’s not doing the right things by all patients. It’s not doing the right things by all caregivers. And it’s certainly not doing right by the individuals, businesses or organizations that are paying for it through their own dollars or through tax dollars (which are really still “our dollars”). It’s just not working and it truly needs to be addressed in a timely, complete and meaningful way.
There are more efficient and integrated ways to provide care that are not only smart economically, but they’re also smart from a quality and a safety perspective. For example, I believe in a system where doctors, hospitals and all qualified providers are paid for how well we do our jobs – not just for “doing things.”
We have to recognize that we can’t control every outcome and we can’t cure every patient, but we can control whether or not we provide the best possible medical care. And if the right clinical steps are taken in the right sequence, then the patient will have the best possible outcome. That’s what we need to encourage through research, education, policy, payment, practice and individual and professional expectations.
Part of the solution is tied to how doctors and hospitals are paid. If you make everyone’s pay contingent on doing the right things and a patient’s outcome, it will lead to better coordination between the people who are caring for that patient. Everyone involved will have a stake in the quality and cost of the care. This approach would cement the disparate parties of the health care (doctors, payors, hospitals, labs, imaging providers, etc.) to function as a cohesive system for the good of the patient and the health (both physical and financial) of our country.