It’s tough looking at things objectively because it just doesn’t evoke the passion, the rhetoric or the sweat that seems to quench our daily thirst for opinion. One of the reasons I like 
Facebook is that it’s a great platform for people to let us know how they feel (non objectively) about things and ensures us a great reservoir of that passion, rhetoric and sweat. I very much enjoy diverse views, something that tends to drive my wife crazy, the opinionated person that she is. “My dear,” I told her, “because I have varied views does not imply I lack strong opinions or convictions. If I’m going to jump on a soap box, I better understand all sides.” It should be no surprise, then, that the healthcare debate is proving to be one of those defining moments, one that has generated a flood of opinion all the way from Facebook to my home.
Over the past several months, I spent time reviewing the proposed healthcare legislation, read editorial pieces on both sides of the issue, spoke with doctors and providers, and exchanged ideas with colleagues having diverse opinions. Have I formulated an opinion on healthcare reform? No – and that’s really starting to bother me. Why? Because I’ve invested so much time trying to figure out this societal predicament. Do I think healthcare is broken? Absolutely. The issue, though, is not whether we have to fix it, but rather the approach we take to doing so.
This is where I have an issue with both sides (are there really just two?) in the debate. Why? Because we have no way to measure spending or gauge the current performance of our healthcare system. We have neither quantified healthcare nor have we put together actionable data. Some people will jump up and down over this assertion, but there is no common baseline or framework sufficient for quantitative analysis. Some will argue that looking at things this way – objectively – will risk lives and depersonalize care. Time for a strong opinion:
Being able to sufficiently quantify healthcare will allow us to make informed decisions, to allocate resources much more efficiently and, ultimately, to provide better care and save lives.
One of my friends challenged my views on this concept, claiming “Healthcare is too complicated to fix and it won’t fit into one of your mathematical equations, Rob.” That’s the problem. How can we possibly fix a system we can’t measure? We won’t know if it’s fixed or where it’s broken!
Our efforts in healthcare should be directed at getting the numbers in place and baselines established – and doing this fast. In the meantime, the debate train moves on. From yesterday’s Wall Street Journal on Olympia Snowe, the senior United States Senator from Maine:
Mrs. Snowe began by noting that this year’s health debate is “one of the most complex and intricate undertakings the Congress has ever confronted,” and that she, too, has devoted much of her three-decade political career to promoting cheaper, better quality insurance. “But it must be done in an effective, common-sense and bipartisan way,” she cautioned.
Real numbers will help simplify the decision, promote bipartisanship, and get public support. Make all the numbers public. There’s a valuable lesson from the open source world in technology: when all the information is publicly accessible, more people will look at it, analyze it and make it actionable. Let’s give the numbers to a couple hundred million people and we’ll get some great results. Remember Color by Numbers? It was – for me at least – a lot easier to work from than a blank canvas.
Rob Ciampa
Rob,
I agree that measuring results is the first step to addressing the issue. However, I would add that the debate over what we measure is just as complex as the debate over how to fix it. The “experts” that will provide the data, analysis, and commentary will be lead by powerful groups who are interested in maintaining the existing system or tweaking any new system to suit their own purposes. Drug Companies, Insurance Companies, Trial Lawyers, Universities, and the media all have interests that are not in sync with the public.
To paraphrase Adam Smith
“The interest of the dealers… is always in some respects different from and even opposite to that of the public… The proposal of any new law or regulation of commerce which comes from this order ought always be listened to with great precaution, and never be adopted till after having been long and carefully examined, not only with scrupulus, but with the most suspicious attention.”
All of the “Dealers” mentioned above and many more than I can not even think of will have their hands in this soup. Publicizing the numbers will only be helpful if they are analyzed with scrutiny and suspician by the public. This takes time, and open debate. I fear our impatience, fueled by the media and the rhetoric of both political parties will result in the birth of a colossal bureaucracy that affords little improvement to the public and new windfalls for the dealers.
Hey Mike,
The call-out to Adam Smith is warranted, but the deficiencies in quantification by “experts” shouldn’t impede our pursuit. I agree with your concerns, but that we need to figure out “how to count.” Until we do that, we’ll continue to burn money and jeopardize lives.
Rob
I don’t know, Rob. There are plenty of numbers already. Do we really need more? I think you’re pursuing an illusion of certainty (“let’s just quantify this”) that does not, and can not exist. Simply put, there will never by a way of achieving pure “objectivity”; whatever numbers emerge, will be, by the nature of the way they’re gathered and used, colored by some degree of subjectivity.
At some point, we need to drive a stake in the ground and take action, even if it’s imperfect. After years of delay, now’s the time.
Jonathan, that’s the problem: there are lots of numbers, but weak (if any) correlation. Perhaps the optimist in me feels that quantification would give us solid ground for a rational, national debate. I think even chaos theory would struggle with this. Until we have that ground, we’ll all continue screaming at one another.
-Rob