The recent and ongoing debate on Healthcare highlights a problem that is prevalent throughout organizations, governments, and society in general. The problem is with the thinking process, or should I say, lack of a thinking process, and an almost myopic and emotional focus on addressing only the outcomes of a process.
In Healthcare, we are constantly told that the “system” is broken, it doesn’t meet the needs of patients, and there are too many people who can’t afford healthcare. People not being able to afford healthcare is a problem, so, as some are presenting, the solution is to provide those people with health insurance (the mechanism which they receive it doesn’t matter), then we will have solved the problem of people not being able to afford healthcare. But what does this solution really solve? What is being done to drive the costs of healthcare down? What is being done to improve the quality of the delivery of healthcare to better meet the needs of the patient? What is being done to fix the broken “system”? And it is broken.
The issue is the solution proposed does not address the reasons as to why people can’t afford healthcare. Lack of insurance may be one of the reasons, but it’s certainly not the only reason, just maybe the easiest reason to address to a frustrated public that wants to see “results.” The problem is that to truly address the reasons healthcare is unaffordable means we need to dive into the system and determine what is driving costs from the moment a patient enters a physician office (or earlier) until they settle their bill (which may be covered by insurance). If the output is unaffordable care, we need to focus on the inputs that are driving these outputs. Healthcare is a very complex model, with physicians, providers, insurers, pharmaceutical companies, and medical device suppliers all functioning as independent groups (often times, required by law to do so). To fix the outcome of our current system, we need to focus on the inputs these entities provide and the interrelations that exist.
Years ago in manufacturing, when an organization had quality problems, the solution was to simply put more quality inspectors in to monitor the product. Well as anyone who’s been involved in manufacturing knows, “you can’t inspect quality into a product.” Organizations that tried this quickly found it was unaffordable and not sustainable – they had to go fix the inputs of the process to truly improve and sustain quality. The logic has nearly universal application, whether it’s manufacturing, healthcare, technology, etc. : to fix the outcome, focus on (control) the input.
The outcomes of a process are very important, and measure how effective the process is performing, but if one wants to improve the process, it is the inputs that must be addressed.
Let me know your thoughts!