We tend to forget that healthcare, whether you want to adhere to the concept or not, is a business. This massive business is never going to flourish, be successful, or survive if in the design and implementation, the basic concept of a working business model isn't in the mix. Without a business model and you have the same model as many other failed systems around the world where you have a huge engine fueled by government and taxes. Sustainability is the single most important design element, yet its not even discussed.
What brings sustainability? Here's a list. Beware though, you won't find these in the majority of the health reform models.
Innovation. Huge costs running a system dependent on surviving by receiving approximately 50% of what you actually bill, yet outsiders continually telling everybody what is wrong. A messed up, mess, loaded with uninformed people making uninformed decisions. Innovation can fix stupid problems. It works in almost every area of business and it can work in healthcare. The problem is how do you get government and yesterdays leaders out of the way to let innovation make its move?
Entrepreneurship. This is the Mojo behind design, implementation, and wild success. Entrepreneurs can build a new tomorrow and there are a ton of them wanting to get going but once again entrepreneurs don't do well with certain things like control, regulation, roadblocks and ridiculous processes. Actually we like the typical government leadership and their decisions because therein usually lies the opportunity. If you have government running anything than you get the full monte of opportunity of improvement if you can get them out of the way. Government run healthcare is not the design that entrepreneurs want to jump into.
Competition. Give me one way to cut costs, increase efficiency, increase customer satisfaction and maximize quality it's free enterprise. Unencumbered competition. Let people build a better mousetrap, reward the effort and they will. Without the government red tape, bureaucratic oversight, mindless reporting and idiotic controls and today's $1500 MRI would easily cost much less. People love to improve, maximize, take on the big players and show us their innovative selves. Problem is you actually have to let them do it! You will never induce competitive market costs in a system that has a thousand federal and state employees running the shop behind the scenes. Never.
Private investors. No one with a savvy eye for business opportunities would look at a typical hospital operation as an investment in the United States. The biggest reason is they are all owned by the federal government. Not literally, but literally. Really. One of the largest venture capitalist groups in the Northwest recently decided to invest $100 million in healthcare. A potentially innovative industry with mind blowing possibilities, but of course, not here in the U.S. They invested in India where they are building 10 new hospitals. Each one is expected to break even financially in 18 months and be profitable in 2 years. Secret is they are all private and all free market. Just incidentally India is emerging as one of the premier medical development countries in the world. And, one with higher quality than the U.S. And, one with astonishing lower prices. Go figure. More entrepreneurs, investors, and innovation than you could dream of.
Leadership. The one thing that can change healthcare more rapidly than any other operational change to build solid sustainability is leadership. Not necessarily the tenured experience this-is-how-we-always-did-it-kind. But innovative, entrepreneurial, get it done, don't-sit-back-and-wait kind. Excited, motivated I-don't-care-how-you-did-it-for-the-last-10-years kind. You can't take a sinking ship and build a rocket boat out of it unless the guy or gal in the drivers seat knows how to floor that baby and her rip. Get people lined up behind wanting to be a part of it. Don't get me wrong as there are many people wanting to get into healthcare. I meet them everyday. Problem is they want in as they see it as a relatively secure job, at relatively great pay. Counter that with an opportunity to join a hospital start-up with low pay, no security, and a huge risk. But, if it has an incredible, motivated leader, entrepreneurial in spirit and a passion to take on the competition head on then the game changes. It's true you won't get as many wanting to jump in. The difference is I want the ones who do want in. That's the team that will not only win but have fun doing it.
Finally one more key item. Probably the most important and sometimes the hardest to find.
Everyday hospital leadership, government officials and key folks in management scramble about trying to make it work. The difference in those that can and will transform healthcare as we know it must have this one ability, or trait. I don't mean put-it-on genuine, I mean the real deal. You can't fake it, learn, it, copy or borrow it from your mentor. Either you are a genuine person in your intention, your motivation, your passions and your dreams or you're not. Genuine means trust. Genuine means keeping your word, or more importantly not just keeping your word, but when you give it people know you always mean it. No proving it. You got it and we feel it. You care about others and what you do. You'll never let one staff member down in support of a political decision for a strategic one. I know a genuine person from the time we meet. They are rare. But when this one trait is in the hearts of leaders, the beginnings of new ideas, concepts, and innovation can actually freely take place. Innovation, entrepreneurship, free enterprise, private investors, leadership and genuineness. Awesome buzzwords that scream of success and fun, and excitement, and motivation. Even in the messed up world of what we call healthcare reform.