Thursday, March 4, 2010

Changing the Health Care Paradigm


The health care system lives in its own little world. It has its list of acronyms and if you ever get a group of health care organizations or health care professionals sitting together in a room they start to talk in a language most of us can’t even begin to understand. They talk about HIPAA, HMO, PPO, HRA, comparative effectiveness, medical homes, EMR, PHI, FFS, FEHBP, MedPAC, and the list goes on. Those in the health care industry seem to understand the terms, some in government make it sound like they understand the terms, and the rest of us have no clue.

Therein is the problem.

We have made this patchwork health care system so confusing and so complex that most of us feel helpless to do anything about it. We have delegated the responsibility for fixing the mess we have to those who understand it- those that created the mess in the first place. We’ve created a Paradigm of Paralysis in health care.

We don’t need to be paralyzed. We can do something about it. We simply need to start to change the paradigm.

In late 2008-2009 Towers Watson and the National Business Group on Health completed a survey of 489 large and small companies throughout the country. They were wondering if anybody was having any success in managing health care costs within their companies.

What they found was not surprising. The best performing organizations (those that experienced less than the 6% average health care cost increase experienced by employers) were taking a broad approach, a strategic approach, to invest in programs and tactics to address the challenges facing their employees and their organizations.

These organizations didn’t just throw-out a health risk assessment to their employees and call it a day. These organizations created the culture, the strategies, the tactics, and provided the investment in resources to make a difference. They didn’t buy-in to the paralysis complex- they took action and changed the paradigm.

We all need to break through the Paradigm of Paralysis and realize we can make a difference- and understand that it’s not the government or the health plans that will ultimately solve the problems we have.

In a recent edition of the Employee Benefit News, Contributing Editor Michael Puck, SPHR compared the psychological barriers we have created in health care to the barriers that existed in the 1950’s with regard to running a sub-four-minute mile. Back then, we all knew it just couldn’t be done. Within 3 years of Roger Bannister breaking the sub-four minute barriers, over 30 other runners accomplished the same thing. The barrier wasn’t physiological, it was psychological.

We need to change the psychological paradigm in health care.

Puck outlines 4 basic components we all need to embrace to break through the Paradigm of Paralysis that exists in health care today:

Commitment- we need to define the vision and mission and gather the will-power to make it happen.

Culture- we need to create and support the environment we will need to accomplish our goals.

Structures- we need to organize the fragmented delivery processes we have today into a system we can understand and provide the results we expect

Resources- we need to effectively provide the resources necessary to accomplish the goals in a fiscally responsible manner.

While those in the health care industry and the government can continue to debate and discuss solutions to our health care crisis they are only contributing to the Paradigm of Paralysis we have today. Those innovative providers, consumers, employers, and entrepreneurs that don’t buy-in to it can do something about it, because they have the commitment to make it happen.

The Paradigm of Paralysis in health care is psychological for most but can be changed. Just look at what Roger Bannister started.

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