The Two Sides of the Health Care Coin

Having spent more than a few years of my personal and professional life engaged in discussions related to the delivery, consumption and financing of health care, there's obviously a crisis at hand. But do we, in fact, have a ...

Health Care crisis involving the quality of the science, technology, and treatment being offered by the medical community? Or is it a Health Plan crisis involving the level of benefits being offered? Or is the issue the ...

Quality of Care in terms of patient safety and outcomes or the Cost of Care? Or if Cost is the problem, is it the ...

Premium Cost or the Out-of-Pocket Treatment Costs (in the form of Copays, Deductibles, Coinsurance and Plan Exclusions) that need to be addressed?

Beginning to see the problem with painting any issue with a single broad-brush? Along similar lines:

• Have we built a Health Care System or a Sick Care System?
• Have we adequately addressed the care and treatment of Physical Health along with the other side of the coin - Mental Health?
• Should we reimburse providers based on traditional Fee-for-Service Payments or in the form of Value-Based Payments that reward performance and outcomes?
• Does the industry support the movement toward Value-Based Care with a complementary approach - Value-Based Insurance Design (VBID)?

The bottom line is that it's often easier to reduce complex problems to a single issue with an all-encompassing description that is typically inaccurate - or at the very least, insufficient. And if you can't accurately identify and name the problem itself, how do you go about solving it?

While the two-sided coin metaphor is certainly appropriate, keep in mind the fact that each side of the coin may point to a variety of challenges and potential solutions which means that choices are not binary - we're not playing a zero-sum game and the objective of stakeholders can't be "heads I win and tails you lose." Not to mention the fact that as is evident above, there are multiple coins involved in the game itself.

We need to begin by RE-IMAGINING the entire Health Care system, taking an integrative approach that addresses the challenges, needs and opportunities involving Health Care's three primary stakeholders - Health Care Providers, Health Plan Payers and Health Care Consumers. The ultimate objective needs to be the elimination of silo-thinking in order to find common ground that prudently supports their mutual interests while appropriately addressing obstacles to the benefit of individuals, families, employers and the system itself.