Friday, December 13, 2013

Healthcare "Fail" Has a Silver Lining

How so? Every time I see one of those reports how the U.S. is near the bottom in terms of efficiency for healthcare spending in developed countries, I immediately think of the bright side: healthcare "fail" gives us a chance to seek out more inclusive free markets in knowledge use. What's more, open and voluntary healthcare markets can also serve as community templates, for further possibilities in other service and knowledge use areas. To be sure, it's not something that can happen overnight, but the lack of long term solutions for our present system, may eventually mean the demise of today's extreme limitations in healthcare practice.

Discrepancies have become vast, between what we would like to experience in service based terms, versus what people actually end up with. Insofar as markets for knowledge use are slowly evolving, the painfully dysfunctional healthcare marketplace of the U.S. is ripe for transformation. Just because a product is a services product, doesn't have to mean that more dynamic production and consumption patterns are impossibilities. Nor is any of this as simple as Baumol's disease costs, because methods of organization, ongoing coordination patterns, and potential healthcare strategies are also at stake.

Consider the recent "good" (?) news of growth containment in healthcare budgets. There is probably a world of pain behind those apparently "improved" numbers of slowing inflation, especially for anyone not close enough to retirement and Medicare. That is, many individuals and companies are likely delaying a lot of the healthcare consumption they would otherwise be taking on.

Delayed visits to the doctor are also a likely reality, since individuals are already transitioning out of private healthcare plans for the botched government rollout. Will it even be possible to determine the degree of activity which was lost in 2013, let alone continued delays in 2014? What's being missed in all this is the fact that balanced budgets and missed appointments are not a good indicator for imagined efficiency gains. While there are certainly problems in the system re some users "overusing" while others hardly use it at all, it seems fair to guess that few are really consuming to the degree that feels most appropriate to their circumstance, at the moment.

Not all doctors are comfortable with the participatory limits, which the AMA in particular has imposed over the years: wealth "shape shifting" limits on both production and consumption of healthcare in the U.S. While healthcare here has led to innovations which have spread around the world, at the same time its institutions have quietly subdued alternative strategies and healing methods. One aspect in this regard is that organized healthcare sometimes "takes out" preventative maintenance strategies, which can keep individuals from needing some surgeries in the first place.

How might one approach a better healthcare marketplace? Again this would not be a knowledge use market to replace current institutions, but to go where they can't go, and also provide what they often can't provide. Perhaps there was a time and place for the limitations they imposed so long as healthcare was available to wide swathes of the public, but that time is past. With government's permission, some doctors would be able to provide informal training in vital areas of medicine. This is especially needed for promising individuals in isolated areas who - by going the traditional training route - would have been priced out of the spending capacities of their own communities. Doubtless some would oppose this route, but it's not hard to see the writing on the wall otherwise as to a growing population with little healthcare access over time.

There is a significant degree of literature for alternative healing methods in the U.S. as well. While some of this is being accessed, one not only needs traditional medical education to provide it for patients, but the time available for alternative methods is quite limited. What's more, such options are more likely to be found in the cities, than in rural areas where they could do the most good for those with limited financial means. One of the benefits of voluntary coordination for healthcare is that people can also provide this in private settings which do not face the same regulatory problems and burdens of traditional healthcare environments.  Private environments can be beneficial as well, to prevent the spread of disease and antibiotic resistant infections.

Lots of healthcare problem solving can be met without resorting to surgeries and extensive prescription drug use. Plus, some of us just don't have metabolisms that tolerate prescription drugs easily. Some healthcare needs are really about bringing what's available in urban areas back to rural areas as well. There are so many unique facets and aspects of healthcare that could be represented by many individuals, in communities both large and small. While some of us aren't well suited for providing more basic aspects of healthcare, all of us can still contribute something of real value, because so much about our lives is directly related to overall health.

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