Seeking Change From Our “Crazy” Healthcare System

Last month, I attended the Simmons Women’s Leadership Conference in Dublin, Ireland. It was a wonderful experience and an opportunity to both renew old friendships and make new connections with interesting and accomplished women from around the world.

Two conversations in particular — both healthcare related — made a strong impression on me for their contrast with the state of healthcare here in the U.S.

The first was with Rachael, an Irish poet who shared the story of her “Ma,” who had developed Dementia. They had lived together for a long time, until her mother’s cognitive abilities declined to the point where she needed to transition to a long-term care facility.

I asked for more details about the experience and Rachael was incredibly complimentary about the care her mom received — before, during and after her transition. She said the transition was smooth, the care was fabulous, and the staff was very well trained. She described a sense of peace with the situation and never once mentioned cost.

The second conversation was with Joan, a colleague from Switzerland. She described how her father had transitioned to an “alternative living environment” following a severe illness and how issues related to access and quality of care were never a concern.

She went on to describe how in Switzerland, healthcare service is universal and is based upon the mandatory holding of health insurance by all citizens. When I told her about the average cost of healthcare for US citizens who do not have employer sponsored health insurance, she was aghast.

We need to acknowledge what’s working — and be honest about what isn’t

Upon my return home, I jumped right back into the deadlines that were looming for Medicare and Affordable Care Act Open Enrollment and reconnected with some clients who have incredibly complex healthcare situations. Soon after, I read this article about how life expectancy in the US is declining.

What a contrast with the simple and pleasant healthcare experiences of my new European friends!

It reminded me of a segment from a favorite HBO Series, Newsroom, in which the anchor, when pushed for an authentic moment, blurts out that the US is not the greatest country in the world. He goes on to back that up with data regarding life expectancy, infant mortality, and more.

This is not to say that we don’t live in a wonderful country! But if we ever hope to improve our healthcare system, we need to acknowledge what isn’t working, look to examples from around the world, and make changes to improve our circumstances.

Two Suggestions

Maureen Bisognano, from the Institute for Healthcare Improvement (IHI), states that part of the answer will be in overcoming the cognitive biases that slow the adoption of innovative practices. She said that one of the most effective ways to combat the common refrain of, “That sounds great, but it wouldn’t work in our context,” is to visit other places in person. Those experiences help open minds and nudge people into innovating.

Another solution may be to put design thinking at the heart of change. Don Berwick, president emeritus of the IHI, argues that the first step is to let go of previous assumptions. Things like, “If we just try harder, we’ll have success.” Instead, he believes we must be more curious, more accepting of uncertainty, and willing to emulate designers who pay attention to how people use and experience their surroundings.

Berwick believes that all health leaders should have training in design thinking in order to achieve a genuinely human-centered health system. This means seeking input from patients and providers for every innovation. Real co-design, he says, means using patient and staff expertise and passion to empower self-care, as opposed to simply getting users to comment on a preformed plan.

Final Thoughts

When it comes to making significant and lasting improvements to our healthcare system, it’s tempting to throw up our hands in frustration and assume that we are simply stuck with our current, imperfect model. I understand the urge as I guide my clients through the healthcare bureaucracy every day.

But I try not to think in those terms. If anything, my experience last month raised my hope that as innovative Americans, we can learn from others and make the kind of improvements necessary to give our citizens the consistent, affordable, top quality healthcare we all deserve.

As we embark on all the holiday festivities our family has planned, I find myself reflecting back on an incredible year, and also planning ahead for 2019. One thing I hope to do, is keep an open mind, overcome biases and continue to work to make our healthcare system better. Please join me in any way you can.