1. The anonymous patient.
Despite all the efforts to create medical records that are portable and shareable, there is still no single repository of a patient’s data. As patients move from provider to provider and insurer to insurer, continuity of care suffers as their health history is hidden in myriad siloed systems. Existing systems don’t work because no single entity is managing all of a patient’s data during a lifetime.
2. Higher costs do not equal better outcomes.
Numerous studies have shown there is no correlation between the cost of health care and its outcomes. Try to come up with any other commercial transaction where you can’t weigh costs against outcomes, and you’ll come up blank. It just doesn’t exist, because we would never tolerate it anywhere else.
3. The episodic care conundrum.
The disconnected nature of health care makes predictive diagnostics and interventions nearly impossible. As a result, we are constantly stuck treating individual symptoms and not the underlying issues.
4. The complexity crisis.
A typical primary care doctor has 1,200-1,900 patients. However, according to an article in The New York Times, only 27 percent of doctors’ time is spent with patients, whereas nearly 50 percent is spent on paperwork. Attempting to coordinate care for that many patients with an ever-increasing paperwork burden is next to impossible.
5. The missing link.
No single provider or insurer has all the data needed to coordinate your health care. Neither do you. Having the government step in through Medicare For All or a single-payer model isn’t the solution. We need independent trusted entities that manage all of a patient’s data and coordinate its use. This may be the greatest opportunity for new business-model innovation.
6. Drifting from the core.
Health care providers are spending too much time on the administrative aspects of care, such as documentation, coding, and billing procedures, which distracts them from their core task of caring for the patient.
7. The tragedy of the commons.
Everyone involved in the delivery of health care is forced to game the system in order to optimize their own success metrics, rather than the patient’s.
8. Defensive medicine.
According to Gallup, 25 percent of all health care costs are due to physicians protecting themselves from the potential of malpractice. A 2017 survey of 2,106 physicians reported that 20.6 percent of overall medical care was unnecessary.
9. The primary care crisis.
According to the Association of American Medical Colleges, the U.S. will see a shortage of up to 120,000 physicians by 2030. Primary care physicians are the single most important factor in determining quality health care and patient longevity. This undermines the long-term effectiveness of any health care model.
10. The aging of America.
As noted before, an aging demographic will exacerbate the problems of the above culprits dramatically over the next two decades, making today’s health care models economically unsustainable.