Dear POTUS (President of the United States):
My name is M. Healthcare. You are holding a "Summit" to discuss me and my illnesses but I will not be there. You have only invited my parts: legislators; economics experts [look where they have gotten us!]; drug companies; hospitals; doctors and nurses. Systems thinking emphasizes the need to consider a system as a whole not separated into neat little separate packets. Your summit without me is like treating the liver when the whole body is sick and no one knows why.
With respect sir, as my healer the summit is guilty of malpractice. You are claiming to fix (heal or cure) me and that requires practicing evidence-based medicine. The good doctor must first establish the diagnosis - the cause(s) of my illness - and then direct treatment at those causes. Treating symptoms only palliates - it makes the patient feel better, temporarily.
As I am not party to the discussion about me, I can only judge from what I read in the media. It appears as though the meeting of my "parts" is already planning to treat one of my symptoms (millions lacking health insurance) without even identifying the cause of that symptom. Proper treatment requires therapy aimed at the why. Otherwise, you produce a fix that fails.
Even if you could somehow give health insurance to everyone, this would neither stop nor even slow down the upward cost spiral. How does throwing more money at me make healthcare cost less?
As my doctor, you need to know the causes of my symptom known as out-of-control-costs. The most obvious is confusion ("micro-economic disconnection") between my parts: the one who consumes is disconnected from the one that pays. Next there is the bloat: I have a huge bureaucratic machine in my belly that gobbles up food and does...nothing, except take up space. Also, I am bloated by millions of pages of rules that hamstring any attempt at efficiency. I am cross-eyed. I look at the wrong things: watching the outcomes I don't want and not paying any attention to the things I should watch. Finally, there is my paranoia (really! they are out to get me) which makes me behave defensively and that too raises costs.
Your summit about fixing me discusses none of these causes. It focuses only on treating one symptom: financing. Even if you could magically give everyone health insurance, and ignoring the cost to the next generation, would that solve the following problems: lack of nurses and doctors; medical errors and avoidable deaths; a failed medical malpractice system; and an increasingly unhealthy population? The clear answer is no!
I also noticed that your stimulus package includes all sorts of money given to my parts, like electronic medical records; beefing up HIPAA; and money for research, particularly cost effectiveness studies. While some may be good ideas taken alone, the result will not help me. This is more piecemeal work that never cures the patient: like putting cream on a rash but not treating the infection causing the rash.
ARRA (2009) stands for American Recovery and Reinvestment Act: an effort to bring us out of the present financial recession/depression. This effort has nothing to do with healing a sick me. Yet 20% of the Act and billions of dollars are for me. Why?
Finally, I notice that you look at me funny, as though I am a bother, a painful cost item, instead of what I am. I - M. Healthcare - am maintenance and restoration of critical infrastructure. The primary asset you have Mr. POTUS is my part called people. They create all the productivity of our nation. Their health should be viewed as an investment for the future, not a burden in the present.
I am sick and you are my doctor. To heal me, you need to practice good medicine: identify all the reasons why I am sick and treat them based on evidence, not logic, personal opinion or popularity polls. That will mean a totally new me, not just a change in one of my parts.
Thank you for your time and consideration.