The Democratization Of Health Care: Building Sustainable Communities

With competing crises dominating the daily news, the public may not be aware that healthcare policy is losing its way and that a new path forward is urgently needed. Recent news about healthcare policy has covered the cost of care, who would be reimbursed for what, and who would be able to afford access to care. The public should be concerned about this state of affairs. The health system emerging from these policy deliberations will be designed to meet financial objectives rather than to grow into an integrated, community-based learning system that delivers quality care while innovating quickly and rapidly, deploying novel therapies that promote community well-being.

The federal government is the nation’s largest single payer of healthcare in the United States, yet it has no coherent plan or strategic vision beyond developing and executing alternative payment models. [Footnote 1] It seems to interpret payment reform as the most urgent innovation, and it only incidentally invests in innovative therapies and devices. Indeed, some in government bemoan medical innovation as a driver of cost. [Footnote 2] There is little evidence that policy makers recognize that investment today could reduce cost and improve outcomes tomorrow or that we should reward novel therapies and system designs because we are working toward a comprehensive vision of healthcare in which managing population health is a component of building sustainable communities. The government treats the impact of its reimbursement models on human lives (short and long term) as a hidden variable that is neither measured nor disclosed, or it reduces life to a present-day financial value and determines that required therapies that exceed that value are not worth the investment. These alternative payment models are blind to the paradigm shift that is before us — the convergence leading us toward building sustainable communities. Read Full Article