Healthcare reform
In this Bill Moyers interview, U.S. health industry insider Wendell Potter makes transparent some of the powerful forces that are and will be blocking healthcare reform in that country.
Potter's wake-up call came when he stumbled into a rural exhibition-like treatment bazaar for the uninsured near his hometown. After a crisis of conscience he left his very influential industry PR position and began to speak out on behalf of the uninsured.
Among US reformers, Canada's healthcare system is often held up as an example of a more humane and effective system, but many fear that our system is also being driven to the breaking point by systemic forces and managed illusions.
What could our two countries learn from one another? What would that learning look like? Where are the levers for influence? What is the right level of scale at which to be working? Where are the bright spots of innovation and how could they be connected to one another?
Potter's wake-up call came when he stumbled into a rural exhibition-like treatment bazaar for the uninsured near his hometown. After a crisis of conscience he left his very influential industry PR position and began to speak out on behalf of the uninsured.
Among US reformers, Canada's healthcare system is often held up as an example of a more humane and effective system, but many fear that our system is also being driven to the breaking point by systemic forces and managed illusions.
What could our two countries learn from one another? What would that learning look like? Where are the levers for influence? What is the right level of scale at which to be working? Where are the bright spots of innovation and how could they be connected to one another?
Tags: Moyers, health, healthcare, system
Views: 1
Replies to This Discussion
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Permalink Reply by Glenda Eoyang on
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Interesting and difficult questions, of course. I think one thing we can learn from the CA and US health systems comparison is that capitalism (though a tremendous problem in US) is not the only problem with current systems.
You ask lots of really juicy questions. The one that seems seminal to me is, "What is the right level os fcale at which to be working?" Of course, across the system, work needs to be done at all scales either directly as the focus of intervention or indirectly as patterns above and below shift as a consequence to change at a level of action. For example, as a nurse, I may choose to focus and take direct action on the scale of my team and its patients. Over time, that may have consequences for my institution and for the individuals who constitute and/or engage with my team.
So, the short answer is . . . I begin at the scale that I can influence. I am a citizen--I focus on my own health and the health of my family. I am a doctor--I focus on the health of my patients and of my practice. I am a public health practitioner--I focus on the facet of public health I am accountable to influence. I am a legislator--I focus on public policy and financing. The challenge is to be sure that, from each of our perches, we are singing the same song, so that as the change at each level ripples into and accross others, the emergent picture is both coherent and healthy.
We talk about a variety of ways to move toward such complex coherence--simple rules, dialogue, measurement, regulation, community engagement, professionalism (more or less), electronic medical records, and . . . . Which of these strategies is most robust? reasonable? easy? likely to avoid negative unintented consequences? within our individual powers to influence?
Susan, thanks for starting this discussion. I will include friends and colleagues who have much more experience with health care system than I and look forward to everyone's perspectives. -
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Permalink Reply by Pamela Schreiner on
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Glenda, To continue your "I am... -I focus...." list:
I am a consultant who attends ALIA conferences-I focus on hosting conversations about health with those from far-flung reaches of the system.
And I'm working with 15 other consultants here in Ottawa.
I love the possibility of shifting the patterns.............. -
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