The Trump administration has a laudable goal: to make America healthy again. This would entail improving nutrition and care to address chronic diseases so Americans can live longer and healthier lives.
Unfortunately, despite spending more than other nations, having more advanced technologies, and having some of the world’s best caregivers, we are not able to take full advantage of these benefits because of the misaligned incentives that pervade our health-care ecosystem. In our system, providers and insurers often profit when patients require more treatment, not when they are and remain healthy.
Misalignment leads to several negative results. One example is the disparity in life expectancy that can be as high as 20 years between counties in the U.S. In California, wealthy counties like Marin have a life expectancy of 85 while a host of poorer rural counties generate far worse outcomes. Another effect of misalignment is inefficiency, leading to hundreds of billions in wasteful government spending and $150 billion in health-care administrative costs alone. Lack of alignment also precludes the technological integration that AI and massive amounts of data have brought to other industries. Finally, we saw the tragic effects of misalignment during the COVID-19 crisis, which exposed how unprepared our system was for a large-scale health emergency.
To fix these problems, we need health care that gives providers incentives to improve access and outcomes, making care more preventative and proactive. Getting this alignment will require improvements in both the public and private sectors. On the regulatory front, the General Catalyst Institute has just issued a white paper with specific policy recommendations that the Department of Health and Human Services can start implementing in the next nine months to get the government moving towards health-care transformation.
The recommendations call for more innovation that would lead to faster learning, which speeds up transformation. To do that, the government could develop regional health-care innovation “sandboxes” that will allow health-care experimentation at the local level. These sandboxes can be advanced through existing waiver authorities and help generate what is known as the flywheel effect: insights from system-wide efforts can help players evolve faster, while new applications drive additional system improvements. This continuous exchange builds momentum, making change easier and more sustainable.
Regulations also have to be changed so that patients can own their health data and share it across providers, rather than dealing with multiple medical portals that don’t communicate. Doctors and insurers need incentives to focus on prevention and proactive health management. The government needs to lower regulatory barriers that make it unreasonably hard for innovative companies to disrupt incumbent players that have zero incentive to cooperate with new entrants, and as a result, are not working in the best interests of the patient and consumer.
With such regulatory changes in place, the private sector could do even more to promote and accelerate change. No one company can bring about true transformation. Instead, we need an ecosystem of companies that can work together to help keep people healthy in an affordable way that is accessible to all. An innovative regional health ecosystem could incorporate new technologies like AI and use it to make the system more efficient, affordable, and effective.
Such an ecosystem could replicate and scale best practices, while reducing the burden on individual health systems to develop their own bespoke transformation assets. Different companies engaging in radical collaboration across an ecosystem can tackle different parts of the health-care challenge. For instance, if thousands of hospital systems used AI sepsis detection tools, they could identify warning signs hours earlier than usual, saving tens of thousands of lives and reducing costs by keeping patients out of intensive care.
One promising technology is an operating system designed specifically for health care. Just like DOS revolutionized personal computing by creating an accessible platform for users, a health-care operating system could break down data silos, allow for faster insights to identify more effective and efficient practices, and promote the adoption of those improved practices quickly and seamlessly.
Another promising application is a new health insurance interface to make health care benefit management simpler. This interface could make it easier for people to take their insurance with them when they change jobs so they feel less trapped in unsatisfying situations just for health care. Portability also means people could see the same doctors for years, rather than finding that their new insurance doesn’t cover their regular providers. Creating an ongoing relationship between patients and providers gives providers an incentive to care about long-term patient health.
When the new technologies prove their value, they can be adopted across the system. In this way, by 2030, we could have a blueprint for what works and then spend the next decade scaling the proven technologies across our entire health system.
The goal is a collaboration between the most advanced and promising technologies with caregivers who are directly treating patients. Each iteration can bring about better results, reducing unnecessary costs and improving access to all. Replicating this model across 10 to 15 regional platforms can allow the flywheel of intentionality and exploration to take our health system to the next level, to make health care accessible, proactive, and affordable, and truly fulfill the promise of making America healthy again.
The opinions expressed in Coins2Day.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Coins2Day.
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