Personal Accountability

So this week’s question from the Washington Post RX Blog was:

The Senate Finance Committee passed a bill containing its version of the health-care overhaul. Are you satisfied with this bill? What does it miss?

My response is below.

There's a long road ahead for health-care reform -- five bills to be
merged and countless hours of debate still to come. A lot could change
over the course of the next few months, and the content of the final
reform bill is likely to vary from any of these individual bills. The
question we need to keep asking ourselves is whether reform will drive
the kind of wholesale transformation needed for the industry and
consumers -- the kind we've seen in banking, travel and other service
industries. Ten years ago, we wouldn't have imagined that people would
do so many things themselves. Technology and business model innovation
enabled new types of services -- putting consumers in charge,
dramatically changing engagement and economics. Imagine the
possibilities for new services in health.

Taking this into account, what's needed is a new 'health delivery'
framework that drives value, rewards experimentation, puts consumers in
charge, and enables innovation--essentially changing the attitudes,
beliefs, and behaviors of everyone involved in health delivery. We all
have to be prepared to work together in different ways.

We have an opportunity now to move the traditional healthcare business model in a new direction:

• Shifting the value of healthcare from treating people when they are sick to finding ways to keep them well (allowing physicians to focus on and be accountable for outcomes vs. volume)

• Transferring the management of routine diagnosis and treatment from highly-skilled professionals to newer, more efficient/convenient, and cost-effective delivery methods like minute clinic,
  self-serve, nurse practitioners -- so doctors can focus on using their
  skills in the most effective way possible (allowing physicians, health
  systems, and 'new entrants' to be accountable for value and innovation)
  

• Encouraging consumers to
  make better lifestyle choices. We need to help them engage in their
  health differently, be wiser purchasers, and understand the trade-offs
  involved.

At the end of the day, the ultimate success of health-care reform
will depend as much on how we will work together and change our
behaviors as on the legislation ultimately passed by Congress and
signed by President Obama. I applaud the administration for shining the
light on health care as it has never been done before.