Healthy Changes

If you’re American, you probably already know this: There’s a good chance you’ll die sooner, and pay more to do it, than others around the world.

Indeed, the United States spends more on healthcare per capita than any nation, but its health outcomes are relatively poor. Now, an article by Rebecca OniePaul Farmer and Heidi Behforouz in the Stanford Social Innovation Review adds some new numbers: “Since 1960, the United States dropped from 12th to 46th in infant mortality rankings (below Cuba and Slovenia), and from 16th to 36th in life expectancy (below Cyprus and Chile).”

Luckily, say the authors, we could easily be doing things more cheaply and more effectively. This would involve two primary changes. The first is to start thinking less about doctors and more about health. “Models of healthcare delivery that improve patient outcomes while cutting costs are cropping up with increasing frequency,” they write. “One characteristic they share is a broader conception of healthcare.” The second change is that we should learn to do what we already know we ought to be doing. “Failure more often stems from ineptitude (not properly applying what we know works), rather than ignorance,” the authors explain.

Peter Drucker would have concurred on both fronts. He believed that a broader conception of healthcare was going to take hold among people. “Clearly, the most intelligent and most effective way to produce healthcare is the prevention of sickness, rather than its treatment and cure,” Drucker wrote in Toward the Next Economics. In fact, Drucker anticipated in Management Challenges for the 21st Century that healthcare would shift from “being defined as the fight against disease to being defined as the maintenance of physical and mental functioning,” with big consequences for existing institutions. “Neither of the traditional healthcare providers, the hospital and the general practice physician, may survive this change, and certainly not in their present form and function,” Drucker asserted.

That improving outcomes could be as straightforward as doing what we know how to do would likewise have resonated with Drucker. “There is an old American story of the farmer who turns down a proposal for a more productive farming method by saying, ‘I already know how to farm twice as well as I do,’” Drucker recalled in Post-Capitalist Society. “Most of us (perhaps all of us) know many times more than we put to use.

What’s the most important and obvious fix the United States can make to its current healthcare system?