Wednesday, October 4, 2017

The price of healthcare

Health, a recently identified luxury for humans, has been poorly understood. It was not a concern in a regime where humans ended their lives in violent encounters with wild animals but most recently, we have less of those. It has now become a complex question, something that policymakers are ill-equipped to influence, let alone understand. Health is not a property of the individual but of society and it remains to be the most valuable real asset available. Those who can understand and make better policies around it will be leaders of tomorrow and from the looks of it, the US is falling far behind.

Health is fundamentally about prevention and not treatment. The latter is driven by technology and the former, largely by information. As emerging technologies, albeit fancifully christened "Artificial Intelligence," by the millennials, ride high, we may have a small opening to leapfrog ideas around how to improve "population health." The concept is apt but the practice of it sorely lacking as the idea has attracted technologists in droves as they have been waiting to jump off the last technology cliff and hop on to the next. Population and societal health could certainly be improved but it will require thoughtful designs and not a sledgehammer approach to technology preferred by the behemoths, who are trying to unload their silicon clusters in the cloud and elsewhere. And, consultants are always lurking to "implement," the latest wares with little concern for outcomes and productivity.

More strategically, far from the fog of Washington, there may be thinking brains who could understand that societal health is a good with very high positive network externalities but the academics, who are able to push this idea effectively could never be accused of action, except perhaps to win their own tenures. This is why we have a divided society where those in the know hide behind the smoke screen and those who have no clue, scream (or tweet) in front of it. Both are equally guilty, as all one could measure are outcomes and not the fanciness of speeches, promises, and academic papers.

An advanced society will prioritize health and education as the most important common good - but the chance of us moving into the next stage of development, appears slim.