SilverBulleits

Dimensions Within Dimensions

Observe how system into system runs,
What other planets circle other suns,
What vary'd being peoples ev'ry star,

                  `from Alexander Pope's Essays On Man

The great thing about even a lightly-read BLOG is that the half-life of an incomplete thought is short.

  Shortly after I posted the thoughts below, my old friend Terry Wommack observed that there's another hugely-important "dimension" (within the 3rd Access dimension that I was waxing upon): i.e., contributing to the coming Access crisis will intense new pressure on supply.  Much as Washington policy-makers may view themselves omnipotent, no stroke of a pen can change the sheer number of Doctors, hospitals, clinics, etc.  Indeed, absent entirely different programs, the current legislation only aggravates the declining incentives for new entrants, new ventures, new...anything--to an increasingly-regulated environment.  And, presupposing for the moment the millions of previously-denied individuals suddenly appear at their doors, today's healthcare players will have no alternative but to, one way or another, divine their own way of rationing their time and treasure.

I've a few more troubling thoughts on the near-zero-sum game we're playing here.  but, I'll stop for now 9and see whether terry and others may like to chime in further)

Othogonal Thinking On Health Reform

A couple of weeks ago, I attended  Singularity University's 9-day Executive Program (highly recommended by the way). And among the myriad facts and insights that I brought back, the notion of adding a dimension to the consultant-revered 2x2 matrix struck me as a timely way of thinking about healthcare reform.

Like most things in nature, a better perception of America’s healthcare challenges and opportunities can be depicted in three dimensions.  The good news continues to come in on the back plane: i.e., an accelerating cadre of medical technologies are dramatically expanding the range of causes & conditions that can be more effectively treated. But, “healthcare reform” bills notwithstanding, severe problems persist in the foreground: i.e., access to the plans & providers of these miracle treatments & tonics could become unavoidably constrained by their spiraling costs.  Sadly, shifting the liabilities (e.g., via insurance regulation or direct government reimbursement schemes) contributes little to the cause of cost containment.

Indeed, some of the most promising predictive, personalized, preventive  and participative (P4) approaches could end up being the most expensive (think genome-maps to custom-designed drugs).  But, on the other hand, “P4” also contains the most potent (albeit largely latent) strategy of all: i.e., inasmuch as common assortments of chronic afflictions (diabetes, CHD, COPD, etc) drive over 80% of all healthcare costs, and inasmuch as half or more of chronic diseases themselves are driven by bad behaviors, the motivation and the means to change behavior represents, by far, our most promising approach!

For reasons alluded to  above, sooner or later, the “motivation” problem will solve itself: e.g., as it becomes increasingly obvious that government cannot, and will not, solve the cost problem (and/or as “access” disparities become more pronounced), millions will begin to seek better solutions.  The active ingredient in that movement will become better information.  And the tools that will then rank among the most popular are more powerful semantic search engines and more serious social networks (comprising individuals able and willing to help one another find better solutions)!

In short, the current debate isn't really about healthcare, nor even its attendant cost.  It's only about who administers how much shared exposure to whom; or, in other words, the current issue begins and ends with access. And, this IMHO is the tragedy of it all: for, unless and until we get at the systemic cost issues, even (nay especially) access will ultimately continue along its expontial path to yet more suffering (not to mention political turmoil)