Chasing the Rabbit: Official Blog by Author Steven Spear

Bravo to Bob Herbert (”A Less Than Honest Policy,” NY Times, December 29, 2009) for outing this crazy Senate health care proposal.  It is exactly as he describes, an elaborate way to tax and spend–to transfer wealth and dependent on setting wage and price controls, both on health care professionals and also on those who need their services.

It will not advance quality, affordability, and access, despite its promises.

The are two real problems in healthcare right now.  One is the obvious one for which government is somewhat well suited to tackle.  Some people have too few means to meet their own needs.  Providing them with assistance is the charitable thing to do.  We do that with essentials already: Food, housing, eduction, and some medical.  No reason not to get that better.

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Synopsis: Health care reform is ostensibly aimed at improving quality, affordability, and access.  But why is healthcare such an outlier, when most other products and services are characterized by high and ever improving quality, low and ever decreasing per unit cost, and ever expanding volume-the stark opposite of the healthcare experience?  The problem is that the delivery of care is typically managed in fashions inadequate for achieving excellence, and markets for health care services are too primitive to encourage and reward improvement and innovation necessary to achieve excellence care delivery.

If Washington really wants to help, it should stop creating Rube Goldberg schemes that largely are about wealth redistribution.  Instead, it should focus on repairing health care markets, so health care markets can repair the delivery of care.

In the meantime, health care leaders can focus on improving the delivery of care.  Then they can advertise to patients and payers when they’ve made breakthroughs in complication-elimination, wait-time reductions, outcome-improvements, and the like, drawing more work to the best providers and denying it to the least capable.

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David Brooks is right (”The Hardest Call,” Dec. 17, NYTimes) and Paul Krugman is wrong (”Pass the Bill,” Dec. 17, NYTimes).

Health care reform is ostensibly aimed at improving quality, affordability, and access.  But why is healthcare such an outlier, when most other products and services are characterized by high and ever improving quality, low and ever decreasing per unit cost, and ever expanding volume—the stark opposite of the healthcare experience?

The problem is that the delivery of care is typically managed in fashions inadequate for achieving excellence, and markets for health care services are too primitive to encourage and reward the improvement and innovation necessary to achieve excellence.  This penalizes the providers most innovative in achieving excellence and rewards the laggards who don’t.

If Washington really wants to help, it should stop creating Rube Goldberg schemes that largely are about wealth redistribution.  Instead, it should focus on repairing health care markets to allow informed choice by patients and reward innovation in delivery by providers, so health care markets can repair the delivery of care.

Common across many competitive industries are superlative outliers, those firms able to generate far more value for customers, consuming far fewer resources, with less effort by employees.  Everyone benefits.

The commercial sector is not alone in having these standouts. I direct your attention to “Generation School,” which–through innovative scheduling of students and staff–provides more days per year and more hours per day without any additional staffing. (Did I mention this is a project of my brother, Jonathan?)

For more info, please follow this link.

Steve

Dear Friends and Colleagues,

Many are pressured to do the impossible: Increase quality, variety, and sales volume — all while controlling costs.

Some overcome these ‘tradeoffs’ superbly by improving and innovating relentlessly.  They see problems, solve them, and incorporate what they discover in ever better approaches.

Others try to do the same, but inadvertently sabotage themselves.  They overload in gathering data telling them where to look, but they terribly under equip themselves with information needed to make things better.

For avoiding this mistake and getting the information balance right, please see my new piece, “How to Get the Right Information to Improve Performance,” at HarvardBusiness.Org.

Best wishes,
Steve Spear

Author of Chasing the Rabbit: How Market Leaders
Outdistance the Competition (McGraw-Hill: October 2008)
• http://chasingtherabbitbook.com for preface, forward, and blog.

Other recent writing:

•  “Innovation and Workforce Engagement in a High-Velocity World,”
in  Quality Magazine.

• “Leadership and Innovation in a Commoditized World,”
e- piece on HarvardBusiness.Org