Wednesday, April 25, 2012

Innovation at the Health Care Intersection of Politics, Health Reform, and Medicine

Why not three cheers? On the other hand, why any cheers at all?

Irving Kristol (1920-2009), American Journalist and Columnist, Three Cheers for Capitalism (Basic Books, 2009)

He that will not apply new remedies must expect new evils; for time is the greatest innovator.

Francis Bacon (1561-1626), Essays: On Innovation (1625)

April 25, 2012 -  In two weeks, May 9, to be precise, I will be attending a major meeting of leading national innovators in Washington, D.C.   The nation’s  capitol is where politics, health reform, and medical practices intersect.

That intersection is where I hang out in Medinnovation Blog and in my books.  As I approach the innovation crossing, I find myself asking the $1 trillion questions: From where will the next big health care innovation come?  And will this innovation or combination of innovations solve the country’s health care woes?

  • ·Will it be government  acting alone?  I don’t think so.  Government isn’t good a innovation. It has too many conflicting constituencies to satisfy. It more interested in good intentions rather than results.  It can never shut down a program once launched, for it can always keep running on taxpayer money. Anyway, for the moment at least, it trapped into partisan gridlock,  The Supreme Court and the Election could break the impasse, but there is no promise of that.  
  • Will it come from the private sector? Maybe.  The bets now seem to ride on the information technology tiger.  Apple is on a wild upward ride, and 30%  to 50% of physicians are said to own IPads, along with 10-20% of the population at large.  “Instant connectivity” and “total transparency” seem to hold promise of “perfect information,” whatever that is,  but the promise  of  perfect information at one’s fingertips is widely held to the key for unlocking  and unleashing the health innovation beast.
  •  Will it spring from the hearts, minds, and actions of denizens of the health care world – health buyers, hospitals, physicians,  other health professionals, and the seemingly endless parade of health care suppliers and companies  that make up the medical industrial complex.  That sector is divided between those who would go it alone without government help and those who depend heavily on government largesse.  Besides, as things now stand,  government pays for roughly 50% of care,  and cares, in one way of another for 110 million of 320 million Americans.   The Centers for Medicare and Medicaid are by far the single biggest payer,  and government still dictates the pace and extent of events.
  •  Will  innovation be incremental or sweeping?  Will it emanate from the minds of visionary entrepreneurs, like Steve Jobs, or the bowels of major corporations , like Bell Laboratories, Intel, GE, Google, Microsoft, 3M, IBM, or big health care institutions , like Kaiser, Geisinger , the Cleveland Clinic,  Mayo, or Hopkins?  Will the Election produce a GOP sweep and a market-driven incremental system with shopping across state lines, national tort reform,  tax credits for all, Medicare and Medicaid vouchers, and savings accounts at the workplace for everyone. Or, out of frustration, will be at last opt for single-payer?
I do not know.   I suppose a victor will emerge from the political demolition derby now occurring at the intersection of politics,  health reform, and medicine.  I am riding in the physician-driven car, but other cars may well have more mass, momentum, and money protecting them from destructive impacts.    I suspect in our capitalistic,  conservative society the winning car  will reside in the center right section of the  intersection, with imprints of  both government and private manufacturers.

Tweet:  Innovation may solve  some of our health woes, but innovation alone will not convert adversaries, and time will be the greatest innovator

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