Wednesday, January 7, 2009

Kaizen in Medical Care

Tom Daschle is now the Health Care czar. His ideas are laid out in his book "What we can do about the Health Care Crisis". A key aspect of this his approach is a "Federal Health Advisory Board", an innocuous sounding idea that is effectively a governing board of allowable medical procedures. It looks like a cost-savings approach to increasing health care costs. In truth, it is a powerful approach that will effectively stop payments to physicians for any procedure that is not approved by the Board.

This is not Health-Care Rationing. It is significantly worse than that. This is anti-Kaizen for healthcare. This is "no improvement" for health care, locking down treatment and limiting future health care developments. Sound unbelievable? Let me prove it to you with a little thought experiment, which I will call "It’s a Wonderful Life”: Picture the year 1950, just after the end of WWII. If we had a Daschle-esque plan implemented, with allowable care guidelines listed, creative people (physicians, University professors, pharmaceuticals and affiliated hospitals and the businesses that fund them) would have stopped innovating as their products and procedures would not be "allowed" to be purchased.

With medical care frozen in 1950, we would have polio with us today. Anyone who can remember this knows what a scourge it was, and how it ruined many good people. 

  • Jonas Salk would have invented the vaccine in 1952, but he never got the funding to continue his research.
  • CT scanners were not invented by Hounsfield and Comack and they did not win a Nobel Prize in Medicine in 1979.
  • The MRI was not developed in the 1970s. 
  • The birth control pill was not invented in 1952.
  • Artery stents were never invented. 
  • Cholesterol reducering drugs do not exist. 
  • Genentech did not develop synthetic insulin in 1980 to help diabetics.

Fast forward to today, in 2009, we do not have thousands of drugs, life savings procedures and knowledge. The list would be all the innovations of the last 50 years. Scary?
Well, with 1950s Daschle-care, we will never see some of the innovations that are being discussed, as funding for new ventures will dry up. If anyone thinks government can invent these items, they deserve the future they are going to get. His plan should be called "No more Health Care improvements. We have all the medical procedures we need".

So you see, even though the current health care system needs a lot of Kaizen to keep improving it, the wrong answer is to freeze it in the name of controlling costs. The right answer is to find ways to allow life saving innovation to continue, so we don't end up with 2009 healthcare in the year 2050.