A curiosity was all it took, and I was on my way to Antarctica.
I had already made my way north to the Arctic Circle on holiday earlier in this year. At the time, it seemed pretty cool to be able to say, “I’m going to the Arctic Circle.” And it was cool. And really not as cold as you’d think for the middle of winter.
Being there though, a strange new idea began to take shape. I felt the need to travel literally to the other side of the world, to Antarctica. As the thought was gaining momentum, I realized it would be interesting to see the Arctic’s structural opposite: You see the Arctic is really just a massive chunk of ice above the Arctic Ocean surrounded by islands. Antarctica, on the other hand, is a continent covered with an immense ice shelf surrounded by water.
Some might call them ‘polar opposites’. And rightly so.
Antarctica, as a continent, is governed by a 12-page multinational treaty written in large, double-spaced font. It was signed in 1959. The continent is self-governed and self-managed. The legalese of the treaty focuses on freedom of scientific investigation, cooperation, maximum economy and efficiency of operations, free exchange of scientific personnel and information, transparency, furthering common interests, preservation and conservation of resources, and peaceful resolutions of disputes. As such, operations on Antarctica are efficient with many different participants working together to achieve the best outcomes while conserving resources. There is coordination and collaboration across all people on the continent and there is complete transparency in every operation.
Almost the polar opposite of how healthcare is done in America.
Think about open enrollment. For many of you, it’s coming up. Instead of furthering common interests, like making sure our employees know and understand their plan choices, we issue a multitude of documents full of legalese asking individuals to select a healthcare plan. They don’t understand the terminology, how to use the plan, or the variances between plans. But we expect them to make an informed choice. Right?
After a choice is made, we mail an SPD which is meant to contain language that is “calculated to be understood by the average plan participant,” and “sufficiently accurate and comprehensive to reasonably apprise… participants and beneficiaries of their rights and obligations under the plan,” but instead presents as an overwhelming list of definitions and rules. Lawyers struggle with the logic and language of these lengthy documents.
Instead of focusing on cooperation across stakeholders, we’re forced to compete for dollars in the healthcare ecosystem. We’re trapped in a structure that has minimal to no interoperability: Tests are not accepted if not conducted within a specific system. We have disconnects across care delivery, coding and billing; a lack of care coordination across providers; scarcely consistent information and/or education on new best practices; service teams that are non-existent or in some cases, carved out of the process; a lack of a common set of standards, measurements and reporting.
And this list does not even begin to address outside elements that directly impact an individual’s health. As players follow their own business plan, operate within their own distinct corporate structure, and work to corral the greatest number of customers, they do so at the patient’s expense. If pharmaceutical company ‘A’ can create drug ‘X’ that treats condition ‘Y’ before pharmaceutical company ‘B’ can, then they’re ahead of the game. However, if there was free exchange of scientific personnel and information, it is conceivable that the two pharmaceutical companies could work in tandem with the goal of creating the highest quality drug at the lowest price that would deliver the patient the best outcome and both would profit from its timely release. As would the patient.
If preservation and conservation of resources were important, we would not have over $750 billion dollars in annual healthcare waste. The problem is multifold. It includes, but is not limited to: the discarding of new and gently used equipment; dispensing a month or more of medication at a time; ‘expiration date’ misnomers; unnecessary treatment; quantities of medications exceeding the amount prescribed; errors; misuse of care access points; lack of individual responsibility and preservation; administrative inefficiencies. The list is long. Even simply standardizing billing practices across all stakeholders with a single modernized system would simplify, automate, and eliminate waste.
To achieve maximum economy and efficiency of operations, the adoption of a universal, standardized, and useable system for storing and retrieving patient data is paramount; one that all providers can access and amend in a timely fashion, leaving them more time for patients. An easily accessible health record with a patient’s entire life history, regardless of what facility that individual has visited, should be the norm by now, not still the goal.
If transparency existed, consumers would know before entering the system what the total cost of care would be for a service, what their specific out-of-pocket costs would be, where to go to get the best care, and what exactly their insurance covers. Providers would be more cognizant of not only the care they provided, but also the quality of care delivered by their referral partners and the facilities in which they practice. Competition would give way to mutually beneficial partnerships with standardized quality measures for everyone engaged. Within the health system itself, physicians and other caregivers would have some awareness of the cost of the goods and services they provide and take that information into consideration on a patient-by-patient basis. Each one of these steps would improve quality of care, productivity, and likely, reduce costs across the entire system.
If all the varied players could work together to make the healthcare ecosystem simpler and more collaborative, like scientists and researchers across the world have been doing in Antarctica for the last 60 years, stakeholders across the spectrum would be better off. And just maybe, if we’re lucky, we would see improvements in quality of life, quality of care, and reduced costs across the entire healthcare system, leaving us time to focus on the simplicity of something like a Gentoo penguin in Antarctica.
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