Fwd: qotd: Is The Commonwealth Fund serious about searching for disruptive breakthroughs?

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-------- Original Message --------
Subject: qotd: Is The Commonwealth Fund serious about searching for
disruptive breakthroughs?
Date: Mon, 5 May 2014 12:03:41 -0700
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



The Commonwealth Fund
May 5, 2014
Searching for the Next Breakthrough in Health Care
By Anne-Marie J. Audet, M.D, M.Sc., S.M.

It is well documented that health care in the United States is not just
expensive; it's world-class expensive, and unsustainably so. And
although many would like to believe that all that spending buys us the
safest, most effective care to be found anywhere on the planet, it is
equally well documented that our health care system, on many levels,
doesn't measure up on a global scale. We're simply not getting what we
pay for.

Clearly, it's going to take more than minor tweaks or adjustments to
change our course. It's going to take a real breakthrough.

What do we mean by a breakthrough? Though incremental change is
valuable, and The Commonwealth Fund pursues this in many of its other
programs, that's not what we're looking for here. We mean an idea, a
paradigm, a strategy that positively and profoundly disrupts the status quo.

The Commonwealth Fund's new Breakthrough Health Care Opportunities
program aims to discover and vet transformative ideas that have the
potential to expand access to care, dramatically simplify the delivery
of care, decrease costs, and improve health outcomes.

We've set the bar high. Here are our working criteria for a breakthrough:

* How much does it disrupt the status quo? We're looking for major
disruption—a whole new approach that represents a break with what we do now.

* How big a difference will it make? Broad societal impact is the goal,
with large numbers of people benefiting nationwide. To gauge impact,
we're using a 20/20 rule for screening breakthroughs: the potential must
be at least a 20 percent improvement in health care quality and/or a 20
percent reduction in costs nationally.

* How quickly can it become a reality? The timeframe we envision is up
to 10 years to achieve impact.

Our work in exploring breakthrough opportunities is just beginning. We
will seek ideas from a broad network of colleagues, and communicating
what we find along the way. Please share your thoughts with us here or
Tweet them with the hashtag #hcbreakthrus.

http://www.commonwealthfund.org/Blog/2014/May/Searching-for-the-Next-Breakthrough-in-Health-Care.aspx

Breakthrough Health Care Opportunities
http://www.commonwealthfund.org/Program-Areas/Breakthrough-Health-Care-Opportunities.aspx

****


Comment by Don McCanne

The Commonwealth Fund's new Breakthrough Health Care Opportunities
program is looking for "major disruption - a whole new approach that
represents a break with what we do now." They aim to "discover and vet
transformative ideas that have the potential to expand access to care,
dramatically simplify the delivery of care, decrease costs, and improve
health outcomes."

Uh, there is a great idea already out there that would seem to be just
what they are looking for - a well designed single payer system. It is
highly unlikely that anyone will come up with any other idea that does
not yet exist which is a truly disruptive, transformative breakthrough
that will achieve their goals. It is much more likely that proposals
will be for incremental tweaks or adjustments which they say they are
not looking for.

But are they serious? As one example of "the scale and ambition we
believe are needed to achieve dramatic improvements in U.S. health care"
they suggest "the massive and widespread implementation of financial
risk-sharing arrangements to encourage more careful allocation of
resources and create incentives to keep patients healthy." Yikes! We
already have introduced that with accountable care organizations and
their predecessors, and the results to date indicate that improvements
are negligible or worse. A special form of risk sharing - requiring
patients to pay more of the costs of the care they obtain - might slow
spending very modestly but at a cost of increasing financial hardship
and impairing health care access.

Although single payer is not a new concept, it would certainly be a
beneficial, disruptive breakthrough for the United States. It will be
interesting to see if they are really serious about considering all
ideas, or if this will be yet another ABSP proposal. (ABSP - Anything
But Single Payer).