Questioning Healthcare Capitalism

Umair is yet again making me think.  This time about the US decision to rapidly deregulate healthcare in the 1980s.  The results, summarized by the following two charts, seem to be pathetic.




Thşs path does not seem sustainable.  The US healthcare sector will have to shift courses.  Will it be able to?  Umair suggests the following.  I am not sure if this is the prescription but it seems like a step on the way.

Here are seven priorities for 21st century healthcare institutions.
I've found that a simple "Six W's" framework can be a powerful tool for
igniting institutional innovation. Let's use it to reconceive a
healthcare industry built to create thick value: authentic, meaningful,
sustainable value.

Why is payment made? For better, fairer health outcomes, not prescriptions.

What is paid for? Micro-scale services, not "product."

When is payment made? After better health outcomes have been realized.

Which uses is payment put to? Innovation investment significantly outstripping marketing expenditure.

Where is payment made? Directly to those who provide services (aka, doctors) at the local level.

How is payment monitored, enforced, and negotiated? Through local, personal connections, not anonymous, impersonal transactions.

In what way are resource allocation decisions made?
Jointly, locally, and participatively, through ubiquitous, publicly
accessible information about products and services.

The constructive capitalism meme that Umair has been cultivating resonates quite a bit with me.  I like his idea of thick value and recognize the possibility that striving for thick value may (will) create a new kind of economic structure for the 21st century.  However, some areas such as energy, automotive and healthcare are starting off at such a disadvantaged position that the effort to shift courses will have to be immense.

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