First Steps Down A Long Road

Why not dream big? Apollo-moon landing big. A goal of the United States should be to have the best healthcare system in the world – one that provides all of its citizens with the absolute best available healthcare resources. As President Biden pushes for long-overdue infrastructure investment, a world-leading healthcare infrastructure should be part of this – not just quality physical facilities available to all communities, but a true integration of fair, efficient and proactive healthcare into our culture and economy.

Dr. Vivian Lee, in her book The Long Fix, recognizes the devastating effects of healthcare disparity and proposes a concrete action plan for bringing healthcare equality to communities across the United States. In the U.S., aggregate health care costs are close to $4 trillion dollars a year. Approximately 10% of our citizens do not have any health insurance or coverage, and millions more are deemed underinsured. According to Dr. Lee’s research and supporting data, 20% of all medical care is unnecessary, while 30% of every healthcare dollar is immediately lost to waste. She notes that medical errors are the third-leading cause of death.

Ultimately healthcare equality requires a cohesive community of health insurers, physicians and pharmaceutical companies working collectively. To create momentum in the push for healthcare equality, the low hanging fruit should be picked in the short term. Two of the least costly remedial measures proposed by Dr. Lee are: the introduction of a preventive healthcare culture across the United States through education and incentive; and the more effective deployment and sharing of already-existing healthcare resources.

More comprehensively, requiring the healthcare industry to run as a pure business in which supply and demand is truly addressed, and in which technology is used to efficiently deploy resources can lay the ground work for an ever-improving system. For example, while pharmaceutical companies spend millions to compel the use of branded drugs, cheaper generics readily exist in many instances. As Dr. Lee suggests, in the same way Costco uses its power to heavily negotiate supplier prices, Medicare, the Veterans Health Administration, and Big HMOS should use their collective power to materially negotiate drug prices.

Other concrete steps that can fuel the drive to healthcare equality include:

* reducing medical mistakes by using management models similar to those in other industries like manufacturing and aviation;

* building data-driven tools to allow for sharing of unused resources across communities; and

* providing big-health entities, such as Medicare, with the tools necessary to measure the efficacy of drugs, and incentivizing them to use their collective bargaining leverage to demand drug pricing based on effectiveness.

It is important that there is no pride of authorship – the U.S. must study international models of care, identify what works and incentivize all players in the healthcare industry to adopt necessary changes. U.S. policy should reward and incentivize technology innovation. Technology companies big and small should receive tax incentives to devote substantial portions of their research and development resources to the integration of their products and know-how in the healthcare sector. Even as the Covid pandemic comes under control, the lessons learned from the united push to solve problems quickly should not be abandoned. Lessons should be learned not just from the failures that allowed the pandemic to catch us by surprise, but from the successes we had in adapting to it – from telemedicine applications, to the streamlining of FDA and other regulatory roads that must be traveled for drug and treatment approvals.