One More Thing…

We talked to wonderful people while writing the new book, We CAN Fix Healthcare in America: The Future is Now. ¹ One powerful result of those conversations, whether talking to wealthy families or community advocates or big-time CEOs, was to name health disparities the 12th disruptor in Steve Klasko's list for the demise of the old system:

12. Never again be satisfied with any healthcare disparities based on race, creed, religion, sexual orientation, socioeconomic status, gender, or planet of origin.

Remember that a “disruptor” is transformative if we take advantage of that rapid change to create an optimistic future.

Here's the difficult algebra to unravel: to many people, health disparities are the end stage of a long equation of discrimination starting too early. Tough algebra, as one interviewee told us: “If every institution in this society is at war with young black men, from schools to courts to police, why should we trust healthcare?” As a result, unraveling that equation requires a new algebra. Ending health disparities will take enormous work throughout the intersection of economics and race.

-Rev. Dr. Martin Luther King, Jr.

But we felt the massive disruptions in the system today begin to offer an opportunity for change in healthcare delivery itself:

• Healthcare in your neighborhood, bringing health home (from bench to the bedside at home);

• Population health with incentives for a community's health;

• The understanding that love is great medicine and isolation is deadly;

• Telehealth to reach around the barriers of transportation;

• Systems thinking to realize that only a system-wide strategy can overcome the iron triangle of cost, access, and quality; and

• Selecting physicians of the future, because when you change criteria for entry to measures of empathy and meaning, you get a more diverse class.

None are enough alone. But we felt that these disruptors are actually opportunities for change in the difficult algebra that equals disparities in healthcare. This message was clear in the interviews that we conducted for the book. Many talked about the remarkable capacity of American medicine. But even wealthy family caregivers noted that the care they get is not available to all:

“The USA is the best place in the world to be sick … if you have insurance.”

“Everybody doesn't have the same access. The wealthier you are, the better care you get. There are too many excuses.”

And when Steve talked with civil rights legend Andy Young, the message was strong: Injustice in healthcare is inhuman. But disruption is possible. Change is possible. “Don't get mad. Get smart.”