Newtown, CT – May 25, 2012
On May 11th 1944, a few weeks before the allies land in Normandy, my grandfather (and namesake) dies in a concentration camp in Austria, of aggravated pneumonia, in an environment in which there was little to no value given to a human life. One of the enduring and endearing features of the US healthcare system is that it has, so far, refused to put a value on a human life. As we all fire up barbecues this weekend, and celebrate the beginning of summer as much as the memory of all those who died defending freedom, we should remember the stark contrast between the value given to a human life by the oppressors of freedom with that given by its defenders. Yet if we are to keep that value intact – and we must – we have to individually and collectively find the courage to radically change what we do and don't do. In a NEJM Perspective this week, Gregg Bloche argues that we must move to forms of rationing if we are to avoid fiscal ruin. We would argue that, instead, we must inject into US healthcare the same forces that have transformed every other industry – transparency in price and quality, activation of consumers as smart shoppers, and value-based purchasing. Recent research points clearly to the quantity of wasted resources, as well as the effects of pricing opacity and lack of consumer engagement. It also shows the hope and promise held in the better management of patients. These data tell us unambiguously that eliminating waste, improving quality and changing market dynamics can help us win this battle.
What this means to you – The US spends twice as much per capita in health care costs than the next country, yet does not achieve measurably better outcomes. So there should be no doubt in anyone's mind that we could freeze spending at current levels for way over a decade simply by reducing waste and improving quality. We could also reduce the overall weight of spending by transforming market dynamics. And we can and should achieve these goals without ever imputing a value on a life. To achieve these courageous and noble goals, we must, every day, look at ourselves honestly in the mirror and ask a simple question: "Am I doing all that I can to make the system better, or am I simply going along to get along?" How far are we willing to sacrifice the comforts of a job for the principles we should hold true? Seventy years ago, a generation went to war to defend freedom, to sacrifice the comforts of daily living for the principles they held true. My grandfather and countless others lost their lives fighting for these sacred principles against those that simply chose to go along in order to get along. As we look at ourselves in the mirror, it's not just our reflection looking back. It's theirs as well. We should strive to make them proud, to make their sacrifice count, and embrace the truth that every life counts, and is truly priceless.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.