Healthcare is an Unprincipled Non-System.

Everyone knows (except Washington) that you cannot cure a sick anything -- patient or system - without a correct diagnosis. What is the diagnosis for sick, "broken" healthcare?

Washington apparently thinks that there is not enough money in the system because the Bill they are discussing will add $1 trillion to our national deficit. That means they will have to print even more money.

Washington has also found greedy groups to blame: doctors, insurance executives, drug companies, even the patients, but never the lawyers and never ever themselves. Might I remind Congress that the largest cost item for U.S. healthcare is the "waste of the middle?"

Both diagnoses - insufficient dollars and greedy group - are wrong. The reason why healthcare is sick is the title of this blogpost. Healthcare claims to be a system but is not. Healthcare has no guiding principles.

Every country with universal health care has two things that the U.S. healthcare does not: System and Principles. Each has a planned-in-advance organized structured process with rules, accepted outcome metrics, and a national medical information technology.

"Jumbo shrimp" and "I'm from the government and I'm here to help" are two widely accepted oxymorons: internally contradictory phrases. "U.S. healthcare system" should be added to the list. In place of a system, we have a bunch of warring tribes all speaking different languages with cultures in conflict and divergent priorities. If you like historical analogies, think Balkan states, Renaissance Italian principalities, or Greek city-states.

Our country has been through a number of tests over 233 years that could have torn us apart. The reason we survived and thrived is our single greatest strength: a clear declaration of principles, ones with which we all concur. When we need to make a decision as a country, we can refer to the documents illustrated above.

What are healthcare's guiding principles? When contentious issues arise, where can healthcare look for advice? Those were rhetorical questions. U.S. healthcare has no generally accepted principles.

Without its own 'Bill of Rights and Responsibilities,' healthcare is rudder-less. It cannot make a decision based on commonly accepted ideals because there are none. Healthcare simply responds to the loudest voice and is forced to react to one crisis after another because it has no game plan or strategy. Healthcare lacks a statement of mission or vision.

To have sustainable, affordable high quality healthcare, we first need to agree on principles and then create a coherent system based on them.

Follow Deane Waldman on Twitter: www.twitter.com/systemmd

Comments

[Jan Cavanaugh]

President Obama appears to be losing the debate on comprehensive health care reform. He ceded the moral high ground and is now mired in "death panels", "Commie baiting", and faces a growing number of citizens in ignorant fear of change. And, unless Democrats elected by clear majority unite to get health care reform done, the President is in a deep intellectual hole. The right or Red conservative side of the debate is hoping to bury him, the left or Blue democratic side in disarray and not able to defend him. A way to victory for Obama is to grant the opposition its hypothesis and make them prove their position: Give capitalists two years to put into place a system of health care that provides coverage to all citizens and legal aliens. The requirements of the health care reform bill Democrats would pass this fall are transferability, no preconditions, universality, and most critically, delivered at a cost per capita that "bench marks" us with other wealthy nations. Since it has been shown that other nations can deliver better care to everyone for less, surely the United States of America can do as well, if not better. Democrats will work with Republicans to make that happen. If capital markets cannot do it, by default according to the health care reform bill signed this fall, Medicare for all will become the law of the land September 9, 2011. And, Republicans will work with Democrats to make that happen.

[TomBrentwood]

The most amazing statistics I have seen is that 59% of Illegal Aliens do not have insurance. Which makes me wonder how do 41% get insurance?

[BLBass]

Debate over those principles and their interrelation is exactly what should be happening as part of forming a major national health insurance plan, but can't because conservatives would rather blow it up to prevent Democrats from using its passage as an electoral tool. An insurance overhaul is insufficient to make a real system for our health care, but it is a way to enforce the principles contained in its establishment upon our current nonsystem, and move our society toward a real integrated health care system.