Healthcare in the U.S. historically has been reimbursement driven. This resulted in efficiency in healthcare delivery: high utilization, lowest cost delivery. With the move to value based delivery, population management and outcomes are rising in importance. Again, driven by reimbursement.
Efficiency and Efficacy drive heathcare. The holy grail.
Then along comes a pandemic and shows the brittleness of this system. There is no resiliency and the healthcare system is overloaded and financially under water.
Why?
First off, the healthcare systems goals are not aligned with national goals of the well being of the population. Just in time makes it worse, as there is no reward for supply chain redundancy, or ICU beds surge capacity, or staffing surge capacity. Covid-19 also shows the uneven distribution of healthcare delivery to rural and economic disparity made worse by the lack of a Federal strategy (or execution), and resulted in thousands of preventable deaths. And future preventable deaths.
What's the answer? I don't know. But we need to seriously have a discussion about what the future of healthcare in the U.S. should be, and not a headlong rush back to the old status-quo.
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