The American healthcare system is the industrial equivalent of “The Blob that ate…” pretty much anything in its path. It keeps growing from 6.9% of GDP in 1970 to 17.9% of GDP in 2019 – an approximate 160% increase. During that same period, real household incomes went up by a little less than 50%, largely driven by increased participation of women in the workforce. That means everyone in the family working, just to keep from falling even further behind.
So, yes, you guessed it. More and more of Americans’ paychecks went to this amoeba-like creature that seems to be consuming everything, leaving less behind to buy shoes for the kids, put food on the table, buy gas for the car, or — god forbid — put money toward retirement. Meanwhile, there is more than ample evidence that the system just isn’t working for a lot of people. And, little of what is being done today to “transform” the system will lead to the kind of fundamental change needed to really make a difference in the lives of healthcare consumers.
How does the system actually work? What the changes are being proposed or are already in the works? What effects do those changes really have? How can things be done differently? And, how are they being done differently in other places and with better results?
This column is about that. Because, after decades of advising the industry I’ve become more convinced than ever that much of what the healthcare industry does is more about growing bigger and bigger, not shrinking it to a size that Americans can afford, with the results they deserve. And, I’m more convinced than ever that nothing short of a radical re-thinking of how we approach healthcare will be needed to turn things around.
A warning for the faint-of-heart. I’m notoriously blunt, and direct — which means I call it as I see it. So, prepare for burst bubbles and skewered sacred cows (but, I promise no cows were actually hurt in the writing of this blog). No prisoners will be taken. I only ask that you be equally direct in any responses and share the questions you have. The stakes for the American consumer are just too great to do otherwise.