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)