In my last post, I discussed how Dr. Atul Gawande proposed that our country should “not swap our old system for a new one, but build a new system on the old one.”
Arguing a contrary position in her article “Disruptive Innovation, Applied To Health Care,” Janet Rae-Dupree believes that “the country needs to innovate its way toward a new healthcare business model – one that reduces costs yet improves both quality and accessibility.” Ms. Rae-Dupree supports this contention not by referring to some liberal health policy ideologues, but rather to several business school academics and recognized healthcare economists.
She begins with Clayton M. Christensen, Harvard Business School professor, who introduced the term disruptive innovation as “an unexpected new offering that, through price or quality, turns a market on its head.” Disruptive innovation is exactly what we need to reinvent healthcare right now. By applying the key elements needed for this reinvention, mainly new developments in technology and a departure from the fee-for-service, provider-centric healthcare business model, we’ll be better poised to focus on individual patient needs, rather than playing whack-a-mole with illnesses.
Critical advances in technology and medical research will allow us to better define diagnoses more precisely and allow nurse practitioners and other clinicians to handle routine ailments without relying on the expensive “intuitive medicine” processes currently in use, according to Ms. Rae-Dupree. This shift in responsibilities will free up physicians to focus on those cases which truly require their level of expertise.
As noted in the article, Princeton University economist Uwe Reinhardt believes such a new business model would create “a continuum of care that would follow patients wherever they go in an integrated system.” Thus, care providers could “stay on top of preventive measures and therapies which are most effective.” Mr. Reinhardt points to Kaiser Permanente as an example of an integrated healthcare system that represents disruptive innovation, as the incentive is to keep patients healthy rather than overtreating for conditions for which it will not be reimbursed.
Ms. Rae-Dupree also cites Stanford economist Alain Enthoven and his belief that integrated systems “are the disruptive innovation we need to turn loose on the rest of America.” He proposes “letting consumers choose between traditional fee-for-service plans and less expensive integrated systems, then letting consumers pocket the difference in premiums.”
Now there’s an idea that should appeal to the free-market, status quo advocates. Let’s put the choice between the two models to the test and allow consumers to make a decision based on enlightened economic self-interest.
After all, isn’t that the foundation of our free enterprise system?