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Is Healthcare Exploitative And Extractive?

I've had this post sitting around in draft form for far too long and it's time to get it off my chest.

Several years ago, MSNBC commentator Dylan Ratigan interviewed Umair Haque, author of The New Capitalist Manifesto: Building a Disruptively Better Business, founder of Bubblegeneration, Director of the Havas Media Lab and blogger at the Harvard Business Review. Though the topic wasn't healthcare, there was much for healthcare leaders to ponder.

Haque draws a clear contrast between productive wealth and destructive wealth.  Both count toward Gross Domestic Product (GDP) but only the former really contributes.

Says Umair,
"It’s easier to make money in the short-term through exploitation and the extraction and much more labor intensive with a higher failure rate and a much greater degree of challenge to actually advance and create something that is new and different and differentiates in its creation of value. “So to me, this is a crisis that is about failing to create real value, but it is a crisis of our institutions. And it’s a crisis that is of things like GDP and corporate profits, and the ways in which we measure and conceive of income. And so to really get to grips with this crisis, I think we have to begin by taking a cold hard look at those things,”
A 'cold hard look' at income and value-creation in health care is likely to be all of that AND a little bit uncomfortable. The short-term thinking. The fee for service-driven decision making.  The inward-looking, edifice-focused ways we define terms like 'health' and 'success.'

Maybe you don't think of health care as "exploitative" or "extractive?"  What else would you call a willingness to amputate a diabetic's foot while letting the underlying disease process continue apace?

Yeah I know, we're really, finally, truly getting serious about fixing stuff like that.  And though it's been part of every community needs assessment and strategic plan and QI/QA/PI target since, oh, 1965, things have changed. No more business as usual. This time it's different. We mean it. Really.

Or at least we mean it so long as Medicare guarantees us extra payment for meaning it.  Or the payers give us part of their risk pools for doing it. Ahhh, the sweet smell of success.


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