What Would Happen If It All Went Away? With Brian Pfingstl

March 5, 2012

Imagine this scenario: The faltering safety net of Medicare and Medicaid is significantly reduced and is only available to the most impoverished of our citizens. Many severely disabled Americans are without care that had existed for decades and are confused about their options. Health care industries that had been largely dependent on public funding are asking “what do we do?” There is an understandable fear of change, especially at times of transition like local and national elections. Bellicose politicians encourage anxiety and many wonder if we will return to the pre-FDR days and nearly Neolithic times. Really?

We are in the midst of one of the most challenging and opportunity-filled times in our history. The cases of Medicaid and Medicare well illustrate the point for healthcare and other marketplaces. For over 40 years these services grew inexhorably to the point where it became clear it was unsustainable. And we kept going (the “why” is grist for a future article).

What is ignored is that basic needs for independence, respect, inclusion, and accessibility exist regardless of large-scale public funding. These needs are a positive Pandora’s box – for example, you can’t successfully argue for decreasing individual independence. What you can advocate for is a careful look at big waves and the courage to innovate. You can also consider the following: The systems we create to address a real need can lose their principles and become an enemy to independence and good quality care.

Some principles to consider as the safety net is transformed with fewer dollars:

  • Thrifty innovation is personal – One of our readers, Jake Carls, a healthcare entrepreneur from Oregon, writes that “cookie cutter services are expensive” and “they will transition to less expensive and more personalized services.” Why? Because at the same time customers were being impacted economically they were also increasingly insistent on making their own healthcare choices. If you don’t believe it check out the evolution of health insurance marketing the past five years.
  • The more we pay, the more independent we see ourselves – The issues of time and value rise to the top as we spend what we believe is our own financial resources. As Alex Goldfayn noted in our last issue, executives often try to “guess from a conference room” without engaging customers in direct dialogue about their preferences. If you ask you will hear the truth of the marketplace.
  • Resilience trumps adversity – If public resources decline it does not mean that the quality of life necessarily descends. In fact, it may lead to a new need for cooperation that our younger generations are better able to achieve than Baby Boomers and older generations. We are a nation bred on the cultural DNA of hope and moxie.

We do not suggest that significant reductions in public healthcare funding are good. Quite the contrary. But if you look clearly, you will see the threat can also awaken innovation and improve quality that we believe has been accelerated by recent economic trauma.