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A Four-Step Plan to Unbreak Healthcare

by Jonathan Bush, President & CEO

Ask anyone about the health of our healthcare system, and chances are good he or she will tell you it’s sick.  America’s health outcomes lag behind other parts of the developed world, despite a shocking investment of nearly $3 trillion dollars a year. Patients are unhappy, and providers are burnt out. The Affordable Care Act is struggling to address healthcare access and bring new coverage options to the health care marketplace.  John Oliver recently addressed another issue--Americans’ crippling medical debt--in a spectacular move where he purchased $14.9 million dollars of discounted medical debt, then forgave it, providing relief to nearly 9,000 Americans.

It was a bold move that captured the attention of many.  But John, what about the administrative technocracy which inflates the cost of health care and drive all that debt in the first place?  



Addressing medical debt is a great first move, but there are so many other aspects of health care that are broken and that we need to unbreak.  If we limit the national discussion on healthcare to simply debt or access, we will fail to come to terms with how fundamentally broken healthcare really is, and what it will take to fix it.

I recently shared some thoughts in Forbes on the manifold ways in which health care is broken, and the gauntlet athenahealth has thrown down in our “Unbreak” campaign to fix them:

Healthcare has been broken for some time. It’s been broken by misaligned incentives, by endemic inefficiencies and redundancies, by thousands of well-intentioned regulations and guidelines that have stifled market dynamics, and by our complacency with the status quo. It’s time for a reckoning. It’s time to unbreak healthcare.

How did we get to this state? The familiar mechanisms that exist for lowering cost, improving quality and increasing customer satisfaction don’t exist in healthcare—things like price transparency, competition between new entrants and incumbents and an appetite for rapid innovation. There are many innovators trying to break through, but not nearly enough. A system that feeds on a lack of connectedness and transparency boxes out disruption.

So why hasn’t healthcare overcome its disconnect and among other things embraced transparency and information sharing? It comes down to an abundance of government regulation and misaligned financial incentives. But thanks to a combination of financial pressures, shifts in incentives and payment models, increasing consumer engagement, and physician outcry, change is imminent.

Healthcare—if we do things right—could be at its (un)breaking point.

Follow the rest of my commentary in Forbes for my four-step plan to unbreak healthcare


Jonathan Bush is the President and CEO of athenahealth.

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