Healthcare is broken. A popular refrain that echoes all too often through the hallways of American healthcare institutions. There is truth in the statement, driven by a lack of cohesive data that affects everything within the industry, from logistics and supply chains to the patient’s inability to secure life-saving treatments. It isn’t however simply a data issue. There are other, far more malignant gremlins entrenched in the machinery that drives modern-day healthcare.
All the usual suspects
To identify the root causes, and there are many, we need to examine the engines that power the industry, the healthcare behemoths. The corporate giants that have clawed their way to dominance, many amassing levels of wealth and influence on that journey that place them beyond the reach of even governments. They have become a law unto themselves, and they are without a doubt, what ails healthcare at its heart.
The extent of the wealth acquired by these corporations, their reach, and their influence has been brought home by the pandemic. What has become even more apparent is that the harmonious balance required for an effective relationship between the patient (the customer) and the company (in whatever form) has all but vanished. That relationship, so key to both the health of the industry and the patient, relies on two key elements to function — trust and ethics.
Both of which are absent in modern healthcare in 2022. The blame for the erosion of these elements can be laid squarely at the door of the behemoths. Patients are, for the most part, now viewed by industry as cash cows, rounded up for fattening and subsequent slow exsanguination over the course of their lives. Any loud complaints from the herd and the ranchers simply move the ranch house further from the pens.
It’s a terrible picture to paint, isn’t it, and one many healthcare experts would deride as being a ridiculous representation of the industry. Nothing could be further from the truth.
In an article by NPR which hit the headlines in the last week, a baby powder produced by one of these companies contained carcinogenic asbestos, which, had unfortunately found its way into their powder during the production process. Sadly, by the time the product has been removed from shelves, consumers had been diagnosed with cancers. A class-action was brought against the company by the affected customers, seeking some form of redress or compensation. Faced with a choice of paying settlements, the company elected to pursue a legal loophole.
In a shuffle, known in legal circles as the Texas Two-Step, they registered a new company in Texas, shifted all onus for the product claims to the new division, and then filed for its bankruptcy, effectively killing off the hopes of any potential payments to their affected customers and ending the class action. As appalling as this is, it is an acceptable legal loophole which many companies use, in itself an indictment of the American legal system. The existence of the loophole, however, does not excuse the ethics of the companies prepared to engage it.
Profits are protected at any expense, with trust and ethics forgotten, and therein lies the problem. These companies aren’t selling us cars or cellphones. They are, in many instances selling us products that can cure our ills, extend our lives or potentially kill us, and in medicine, where that product ends up on that scale can often be a fine line.
So trust matters, hugely so. Breach it and you better have a damn good reason, supported by an ethical and transparent response to any harm you’ve caused. The fact that lawyers make a living off class actions aimed at these companies speaks volumes to the behemoth’s disregard for the customer and their wellbeing. Engage in legal shenanigans to avoid that responsibility and then offer me your Covid vaccine with the assurance it’s safe.
The Power of the People
If we then assume that much of what ails healthcare can be resolved by addressing and regulating the business practices of these corporate giants, that leads us to the title of this piece. Can these companies be “saved” or are they too far gone, despotic dictators obsessed with their own self-inflated worth who’ve lost the ear of their people? I tend to believe the latter.
The public is rediscovering their voice in terms of their health, determining outcomes, and engaging in the processes that surround their treatment. I use the term public and patient interchangeably, as any member of the public is, was, or will be a patient at some stage in their lives. We all require healthcare, no matter our status, race, or sex.
This patient-centric movement sweeping through healthcare is long overdue and has been birthed as a direct response to much of what I have described above. Taking that as a given, logic dictates that a popular movement that arises in response to a dictatorship will not endeavor to change the minds and hearts of its despotic rulers. Complete regime change is called for, and almost always results. You cannot fix something that is fundamentally broken and no longer fit for purpose. The behemoths have served their purpose and must be retired. For the sake of the patient and healthcare globally, we need to start afresh.
If we look to oust the current regime, how do we then harness this new force sweeping through the industry? How best do we use the momentum of the patient voice to engage lasting solutions?
At the risk of buying into trending catch phrases, decentralization of the industry is key. Redistributing the power amassed by the few among the many. Smaller, more focused companies that address specific needs, specialists in their chosen fields, offering tailored solutions to the real issues affecting the development and delivery of equitable and accessible health care. In short, a new model of care and delivery, built from the ground up with patients actively engaged as masons. And yes, ethical businesses that place their customers’ interests first and foremost can be profitable.
It isn’t simply the patients that stand to benefit from this change. Make no mistake, the egregious travesties visited on healthcare by these large corporations extend beyond the patient and has ensnared providers, who are in many ways, products and prisoners of the environment they are forced to function within. Patients looking around their lifeboat will find themselves surrounded by white coats.
I’d like to end this with a few probing questions, directed to the industry in its entirety. What happens when the next pandemic strikes, an event that is inescapable? How, at that point do we convince the global population that any potential treatment we’ve developed is in fact fit for purpose? How, when we currently engage in deceitful and dishonorable practices and place the acquisition of wealth before the interests of the very population we’re sworn to protect, do we reclaim our credibility? How do we rebuild and regain trust?
Now is the time to build afresh from the ground up, as many promising new start-ups are doing. We have the technology, the intellectual capital, and the desire. Time will show if we possess the will.