Health care encompasses a large ecosystem of goods and services. It includes physician offices, hospitals, diagnostic laboratories and radiology centers, physical therapy offices and pharmacies. It also includes drug companies, group purchasing organizations and pharmacy benefit managers. In the largest sense, it even extends to the insurance industry and the corporate healthcare systems that comprise most of what we think of as the health care system.
It is a complex, multi-layered and very expensive system that is uniquely different from all other industries. Its uniqueness is due in part to the fact that it deals with a matter of life and death, both of which are deeply personal and emotionally charged. As such, it is subject to a wide range of political and ethical issues that are far more intense than any encountered in other industries.
Nevertheless, in spite of these differences, the system must be responsive to patients’ needs, desires and legitimate expectations. This can only be accomplished if all stakeholders are free to use the tools of the marketplace to create a more efficient, fair and high quality system.
To that end, the slew of government regulations must be repealed, and the free market allowed to unleash the powerful forces of competition and innovation. This will require that all stakeholders are provided with meaningful information so they can better manage their health care needs and choices. Such information must be released in a timely fashion so it is useful and valuable to consumers.
In addition to this, the medical profession should be free to engage in its true mission: healing and curing people. The current bureaucratic and self-serving structure has eroded the professional’s ability to do its job. It must be rebuilt to enable a true culture of service, compassion and empathy.
Finally, the system must be designed to provide high-quality primary care. This will require fundamental change in the allocation of existing resources and new investment in a different paradigm of care. For example, it will be necessary to refocus the use of prospective payment systems and capitated programs toward a comprehensive and coordinated approach to primary care. It will also be necessary to address workforce policies to assure a sufficient number of family physicians and other primary care providers in each community. This will be an enormous undertaking, but one that is essential for a truly healthy and just society.