I’m often asked why my life’s work has become helping build a new health ecosystem that restores humanity to patients and clinicians while achieving the Quadruple Aim. I give my most personal explanation why in the Preface to my book that publishes tomorrow. Every day, I’m inspired by those who break free from the tyranny of low expectations that healthcare isn’t fixable or have lost hope. Sadly, that feeling of despair is pervasive. That’s particularly striking given the passion and smarts of health professionals, not to mention the massive sum we spend. Many of us are seeing something entirely different that is quietly rippling throughout our healthcare system that gives me great hope. This compels me to share how communities are transforming by getting smart about how we approach our healthcare system. The dividend for overall health and well-being is enormous. This is why the front cover description of The Opioid Crisis Wake-up Call says the following:
A Citizen Leader’s Guide to Restoring the American Dream: Rebuilding Hope, Health & Well-being in our Communities.
Every hour, nearly 10 people die just from opioid overdoses. As you’ll read, this is entirely avoidable which is why I’m making a free download available of the entire book. Too many of us have been impacted by losing friends and family members to the scourge of the opioid epidemic and the rising benzos epidemic. You can help stop this.
Before I was 40, I had lost ten close friends who were my age or younger. It’s a gut punch to be reminded how short our time here is, but one loss hit me harder than any other: a friend died of cancer, and the system failed her in every way. She was a talented tech executive and worked her way to the top levels of Silicon Valley. She should have had access to great health care, but got a harmful treatment plan which led her to be financially, physically, and emotionally ruined leaving her 10 year old daughter behind. It was devastating to witness.
Her death struck me particularly deeply because I realized I was part of the system. I was raised to know that if you see a wrong and don’t do anything about it, you are complicit. I had started my career consulting with faith-based and children’s hospitals as a revenue cycle consultant—a fancy term for generating as big a bill as possible, getting it out as fast as possible, and getting it paid as quickly as possible. At one time, this was simply to ensure that a hospital didn’t forget to bill for something, but it became the root of a scheme that is arbitrary, abusive, and has absolutely devastated the working and middle class in America. Like my friend before her death, hundreds of thousands of victims of our corrupt health care system file for bankruptcy every year—even though 70% of them have insurance. I saw the fear in my friend’s eyes thinking about her daughter’s future, knowing that even after working hard and being extremely successful, she wasn’t going to be able to leave her with much, if anything.
Not long before my friend’s passing, I had been leading the most successful technology platform in health care. I was excited about how patients and doctors could finally realize value from easy-to-use software after decades of mainframe computers. But despite breakthrough technologies that could improve patient outcomes, that’s not what hospitals wanted to buy. All they wanted were systems tuned to game every reimbursement opportunity the industry had to offer. Despite being at the top of my game in health care, I couldn’t be party to that and vowed I wasn’t going to work on technology that I knew was going to do more harm than good. I was frustrated that I didn’t have the solution, so I left health care for over a decade.
Around the time I was returning to health care, a high school kid asked me to buy a candy bar for her school fundraiser. Great, I said, were they raising money for a band trip? No. It turned out they were raising money for science lab supplies. What?! Taxes paid for that stuff when I was a kid.
Turns out this often isn’t the case anymore, primarily because of health care. Bill Gates devoted an entire TED talk to how health care has been devastating education: larger class sizes, laid off teachers, fewer music and arts classes, and increased college tuition for state universities and community colleges. He also outlined how devastated education budgets would impact the future by preventing bold experiments and limiting opportunities for excellence. When Gates gave his talk, California alone owed more than $60 billion in health benefits costs that it couldn’t pay. I started my K-12 education in California at a time when the state was generally considered to have the best education system in the country; today it has the lowest high school graduation rates in the entire country–and the highest student to teacher ratio.
The scale of the medical and financial devastation that health care has wrought on America is something most people can’t imagine. The opioid crisis, the largest U.S. public health crisis in 100 years, is entirely a self-inflicted wound, driven almost entirely by a dysfunctional health care system. More than two decades of wage stagnation and decline are overwhelmingly driven by health care’s hyperinflation. Today, 60 percent of the workforce makes $20/hour or less, while health insurance premiums for a family of four are over $20,000 per year. With over half of the workforce having a deductible greater than $1,000, most Americans are a bad stubbed toe away from financial ruin. And these are the people who have insurance!Despite this gloom, I’ve found real hope in the solutions I’ve discovered. Every structural solution to prevent what happened to my friend and countless others has already been invented and proven, and is working someplace in this country. A small hotel company has the best benefits package of any employer I’ve ever seen—and they spend 55 percent less than employers of similar size. In addition to providing quality, affordable health care to employees and their families, they’ve invested a small fraction of what they saved into the local community and school system, which are seeing stunning results: crime has gone down by 67 percent and high school graduation rates have doubled to essentially 100 percent. It sounds unbelievable, but it’s true, and it’s happening in Orlando right now.
The most amazing discovery I’ve made in studying successful innovations is that the best way to slash costs is to improve health benefits and outcomes. How could I not share this great news?
The excitement from health care professionals, elected officials, employers, and other civic-minded Americans is contagious. If you’ve picked up this book, you are part of the solution. No matter who or where you are, you can join this effort to catalyze change and restore both hope and health to the community where you live and work.
There’s no time to lose. As bad as the opioid crisis is, in its shadow are lurking other potential crises that could grow as big. While in Boston recently, not far from “Methadone Mile,” I saw two things that we now know are profoundly connected— gleaming billion-dollar medical towers and students “on strike” because of school under-funding. The antidotes to both of these issues already exist. For example, we can go a long way to stopping the opioid crisis in its tracks while fixing education under- funding and preventing other potential crises through access to great value-based primary care, a critical foundation for a fair, rational, affordable, and effective health care system.
There are many things you can do to foster such a system. For example, work to ensure that your company, union, or community has access to great primary care. Implement the 12 antidotes to the opioid crisis in this book. Join the Health Rosetta community to share your successes and learn from those of others. If you are a city leader who makes health care-related decisions, lead by example with city employees and use your bully pulpit to reinvent health care in your community. If you are a union leader, follow the example of dozens of school districts around the Pittsburgh area, where labor and management leaders put aside old differences to work together for benefits that boost the health—and bottom line—of all parties.
Write down every organization you have influence over and share with them that the best way to slash health care costs is to improve health benefits. Share this book with them—we’ve made a free download available of it and my last book (CEO’s Guide to Restoring the American Dream) at www.healthrosetta.org/friends. We care more about spreading success than losing a few book sales. Whatever your role, start with one organization and one tactic. For too long, we’ve let health care crush the American Dream. We can’t take another 20 years of economic depression for the working and middle class. Whether we knew it or not, we all contributed to this mess. Now, it’s on us to fix it. When change happens community by community, it’s impossible to stop. Yes, health care stole the American Dream. But it’s absolutely possible to take it back. Join us to make it happen in your community.
Read/download the rest of The Opioid Crisis Wake-up Call here.
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