Tuesday, November 4, 2014

Uncertain Health in an Insecure World - 6

"We’re From the Government and We’re Here to Help"

Paraphrasing Ronald Reagan’s nine “most terrifying words in the English language”, health care has become a raison d’être for most jurisdictional governments. Even the most hardened trickle-down health care funders now acknowledge that the connection between socioeconomic supply factors and medical care services demand is neither nuanced nor opaque.

The International Social Survey Programme (ISSP) of public attitudes in 33 countries shows that the economy (25%), health care (22.2%) and education (15.6%) were the top ranking concerns among people around the world between 1993 and 2013.

Not surprisingly, modern political parties repeatedly run on one of two policy planks – economic growth or better health care. The interplay between the public’s desire for better health and the mounting cost of health care as a percentage of GDP is undeniable.

The average political election cycle length of between just 2-4 years does not help matters. Inevitable political transitions spawn endless acronym-laden health care policy and process reforms.
Beyond serving up easy fodder for health care watchdogs and the press, continuous governmental cycles of re-invention, re-organization, re-purposing and re-positioning often culminate in vote pandering and organizational change fatigue. 

Here's what we know to be true...

The common thread of publicly-financed health care system breakdowns is a lack of courageous governmental health policy. The private sector profitably manages the related collateral damage.
The unifying threat is massive health care system bureaucracies parsing banal governmental policies. Entrenched bureaucrats quickly conclude that they can hunker down and survive most changes.

The antithesis of real progress – institutionalized risk aversion – renders situational hopeless-helplessness the new norm. People sick of hearing alarm bells simply turn them off.

Unlike in Reagan Country, your government has not likely “signed legislation outlawing the Soviet Union. The bombing begins in five minutes”. (1985 President Reagan mike-check quip)

But like in Reagan Country, your government is probably at the heart of the problems with your public health care system.

Welcome back to The Square!

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