Healthcare Infrastructure
The Random House Unabridged Dictionary defines infrastructure as the basic, underlying framework or features of a system or organization. If you were to Google “healthcare infrastructure” you’d find a great number of entries dealing simply with Information Technology (IT).
Information technology is a vital aspect of quality healthcare, but it is NOT part of the infrastructure of our present healthcare system. When well-meaning individuals adapt the use of a fundamental concept for their own purpose they distort its original meaning.
Healthcare infrastructure should only apply to the organizational structure of our healthcare system. NO ONE in America has ever accurately displayed, in detail, how our healthcare system is “organized.”
Think about this:
1. The Department of Defense (DOD) and our healthcare system are comparable in size and scope, yet the organizational structure of the DOD can be demonstrated from the Secretary of Defense down to the newest recruit in all of the armed services. Such organizational detail has never been accomplished for healthcare.
2. The sudden, disastrous collapse of the Minneapolis Bridge was due to infrastructure defects known to exist, but their extent was unrecognized.
The Minneapolis bridge disaster should be a wake-up call for every healthcare expert offering strategies for improvement. “Bridge experts” were repairing visual defects when the infrastructure, with its recognized flaws, collapsed. The very same scenario is being played out in the stampede to change healthcare now.
Cost, access, and information technology are among the very important “visual defects” of our current healthcare system. Yet no one is talking about the true infrastructure of our healthcare system. With very few exceptions, every form of healthcare begins when one doctor sees one patient. But no effort has been made to describe the larger composition of Organized Medicine.
How did that system evolve into its present form and who regulates what portions of that system? Who should society look to for that greatly needed and much anticipated healthcare change?
Doctors and hospitals are primarily regulated by individual states. Congress, except for the DOD, the Veterans Administration, and Public Health had no real participation in our healthcare system until Medicare’s inception in 1965 and Medicaid’s in 1972, Now everyone seems to think the incoming president and Congress will solve the problem, when in fact, neither they or anyone else truly understands where such change should begin.
People are demanding change in a very large, complex system no one can clearly explain. Hopefully, some will find that realization frightening. Only fools would attempt to substantially change something they don’t really understand. But, such thinking has rarely stopped Congress before.
The private practice of medicine is the least regulated economic activity in America.