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Archive for March 6th, 2008

Take a look at Sen. Tom Daschle’s latest note on his approach to improving health-care.

His summary of his ideas focuses mostly on exposing more data to people (transparency). This is the only workable strategy because it doesn’t assume any particular one cause for the cost of health-care nor any specific solution to one identified cause. In a sense it is not a strategy but an improved framing device (aka context) to let each type of consumer of the system (all companies, organizations, politicians, individuals) come up with better solutions for their particular, and ever changing, situations.

Take a look at the comments now.

Mono or Nearly Mono Causes of Health-Care Costs Cited:

  • existence of insurance
  • existence of free markets
  • bad health choices by consumers
  • cigarettes
  • alcohol
  • human greed
  • politics
  • government
  • medicare
  • medicaid
  • old people
  • young people
  • poor people
  • insured people
  • rich people
  • drugs
  • iraq
  • growing lifespan
  • ….

And the solutions proposed are one fix solves all.

Here we arrive at the true “crisis” of the situation.  Consumers of the system suffer from monocausilitis.  This approach is not unique to health-care.  We all suffer from this in some way in our jobs, families, religion, business.  One Cause, one solution, utopia.

“If only we did X…”

“It all started because…”

This is the basis of “markets” (and, no, not just financial markets).  Each node in a market can suffer from monocausilitis and the market proceeds with selection by consequences in a non-monocausilitis way.  Complexity emerges from simple rules at the nodes.  If nodes’ approaches are reinforced by consequences, those nodes’ approaches persist.  Others extinguish. Consequences can be measured by all sorts of different exchange units (dollars, shiny objects, sunlight, water, food, sex – more generally “energy”).

With that in mind, consider the current, and very complicated, health care context.  It is the “way” it is based on consequences.  And it will only change based on strategies tested by consequences.

If we desire more rapid improvement, more strategies need to be tried in shorter time periods.  And not all strategies can be condensed in time.  Complicated, eh?

The rules are simple – selection by consequences.  The outcomes and context is complicated. (just consider your personal state of your health and your health-care.)

Transparency – expanding our knowledge of the consequences – improves our ability to try more strategies faster.

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