While lifesaving measures are the most common exception, many patients and doctors haven't been pleased with the healthcare marketplace for some time. If doctors and patients didn't have problems enough: automation which is now "compelled" to replace labor where possible, also eats away at the logic of arduous educational strategies. Why commit decades of time and resources to medical education, if robots can perform similar skill sets?
What if present day healthcare was monetized? While direct producer to consumer relationships would be restored, they would only exist for limited numbers. Oddly, GDP would also be lost from organizations which profit from mass confusion. (or, some complexity is better than others...) Many organizations are simply trying to compensate for what amounts to initial losses in time equity. And yet, they are only able to proxy that equity, to the extent resources become available to substitute for time aggregates.
Unlike the product chains that assist traditional manufacture, layering in the present day services model does not necessarily present a cohesive or collective logic. Not only does that make some of these organizations superfluous, it adds to problems in productivity measurement. Many organizations "assist" the consumer from external perspectives, which means they might not perform integral roles in services networks. In other words, their "product" often consists of "we can help you achieve your product access".
If healthcare were monetized overnight, some hospitals would continue to flourish, while rural access would in many instances disappear. Hence removing fiscal components - without changing the nature of limited knowledge use rights - would diminish the healthcare marketplace quicker than the "slow goodbye" presently playing out.
In a sense, one could argue that governments had little choice but to turn themselves inside out with fiscal measures, once knowledge use rights limited the extent and geographic dispersion of the healthcare marketplace. Just the same, the present services pattern for healthcare will no longer suffice for populations as a whole. Here's Timothy Taylor:
The growth in healthcare spending has been putting pressure on government budgets all over the world, and in the U.S. it puts pressure on household budgets as well. However the rise in U.S. healthcare costs has slowed in the last few years, which has led to a dispute. Is the slowdown in healthcare spending mainly a reflection of the Great Recession and the sluggish economic growth that has followed? Or does it represent the start of a potentially long slowdown in rising healthcare costs?When it comes to causation for healthcare issues, the Great Recession was another - albeit unnecessary - bump in the road. What's more the recent slowdown in spending is likely temporary, in part because of a demographic lull. Many baby boomers are waiting for retirement, in order to access any kind of healthcare that requires office visits and the inevitable follow up costs they generate. For this group, healthcare needs have been lumped into the same group of discretionary spending which has not yet recovered since the Great Recession.
Just the same, plenty of institutional reorganization is already occurring, given a lack of resource capacity to meet a growing level of societal expectation. In other words, one could liken the present situation to the "calm before the storm". In these circumstance, the primary way to address growing budget issues (much as for other public concerns and private industry) is to automate and utilize as little labor as possible.
At the same time, this means healthcare - in aggregate - is further removed from the marketplace, both in production and consumption terms. Worse, human aspects of healing have little choice but to become home remedies with occasional assistance from knowledgeable authors. Even though direct (provider to patient) labor costs continue to be trimmed in aggregate, additional costs remain in the myriad of overlapping institutions which attempt to remedy the situation. Hence costs still rise, even as marketplace availability declines.
So long as healthcare is defined on fiscal terms with limited rights to heal, a form of "permanent" austerity (in this regard) could ensue. In order to balance budgets, automation would become the default consumer option for most income levels and procedures. Doubtless, some would still retain access to the actual time of other individuals. Oddly, however, personal care involving individual time and attention, either becomes a Veblen good or that of poorly compensated aides, instead of a normal and human part of life. The actual wide variety of skills sets between these two extremes would largely disappear.
Why should this dismal path be the only choice? There are ways to just say no to healthcare austerity, and begin the process of restoring sanity. To be sure, automation works well for some procedures. Even so, personal attention is part and parcel of any actual healing process. Personal time value needs to be directly coordinated in voluntary settings, so that its contribution to services production and measurement capacity can be understood. Skills arbitrage could not only restore time value to its rightful place in economic activity; knowledge use systems would also remove healthcare from the clutches of austerity.
If readers wonder about the logic of "setting knowledge free", imagine a more inclusive, complete healthcare marketplace through monetarily compensated time arbitrage. In this setting, time value would become product in its own right. Local communities would eventually be able to compensate matched time for a full array of healthcare options - some which do not even exist in many areas now. In turn, local citizens would invest in the healthcare innovations which are utilized - and created - at local levels.
How to determine whether a community becomes capable of providing adequate healthcare skills? Multiple options would be tapped for a flexible knowledge use base, in part from local educational/practicing services entrepreneurs and the digital realm. All of this would be tied in to local educational efforts. Those who work with patients would still have a reasonable amount of time left to teach others. The goal would be to make certain enough providers reside locally, that it would not be difficult for them to coordinate their time with others who could benefit from their own.
Of course, these are generalities. However, this provides a sketch re what could be achieved with a new outlook for services production reform. Presently, what is most important is to move away from the prospect of healthcare on a decline trajectory. That also means restoring healthcare to its rightful position as a component of long term growth - albeit in time centered terms.
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