30 April 2008

Change the Rewards

In terms of patient care, here's a basic problem with the modern "medical" system: There's more money in treatment than curing. Therefore the system's rationale rewards long-term "control" of the patient's condition rather than outright elimination of the condition. Consequently there's no real incentive to cure, but there's a huge incentive to "manage".

Now I know there are some conditions, primarily congenital, that cannot be cured. But if there's something We've learned over the past century it's that what often slows down or impedes a "cure" is not based on facts, but on perceptions. And perceptions are highly-influenced by the rewards and penalties already in place.

Every system creates its own framework, establishing rewards and penalties as part of a value balance in order to provide support, management and control of its intended processes. So when the system is subverted--by accident, good intentions or malice--the problem isn't necessarily with the system itself, but with the value balance it provides. 

Using the pharma-medical system as an example, the value balance is obviously "Cure better than treatment and prevention better than cure." If the system's value balance were in direct accord with this basic truth, We would have a radically different health-care system and a much healthier population.

Of course, the factors impinging on the whole pharma-medical-health care system are widely diverse and a simple value balance adjustment is not going to fix the entire system in one fell swoop. But a system is composed of sub-systems and by dropping to the sub-system level and adjusting the value balance there you can eventually fix the entire system. Do the mental exercise and you will see that the only sub-system that needs adjusting and--guaranteed--will intrinsically fix the larger system is called "the individual." You. And Me.

At the individual level, adjusting My value balance away from "Treatment first" to focus "Prevention first" automatically adjusts the entire system to My benefit. What "prevention" the system provides is now a priority in My favor--as it should be--while whatever "prevention" is missing can be properly identified and tended to. Does this place a greater burden on you or Me than the current system? Not at all. It openly places the ultimate control of the system where it has always been: In Our hands.

Will the entire "medical" system collapse under the combined weight of "too many individuals?" No. Good health is not an individual (unique) set of conditions, but a commonality of conditions. Smoking is bad for everyone, exercise is good, low-fat foods are better for you, etc. Achieving a wider range of benefits with less effort means a system is more efficient. The current system is far from efficient; in fact, it is notably far from even being effective.

A system works better--for the common good--when its value balance is aligned with the actual benefits, the ideal benefits, and not the self-serving "benefits" of a mere handful.
That applies to the health care system. And to government as well, where the sub-system boils down to the same point: You. And Me.

The Jenius Has Spoken. 

1 comment:

Unknown said...

Nothing positive to add. Big pharma is a huge part of this problem. Medical School is sponsored, directly or indirectly by big pharma and big pharma research. Doctors graduate without a predisposition for holistic treatment. They treat individual symptoms.
Hell, I know more than one pharma executive exited about the prospect of a billion Chinese adopting more western ways (food etc) because it will mean a billion more diabetics and hearth patients.