It’s Time for Change, Do You Know Where Your Infrastructure Is?
I recently attended a meeting of local and state business and government leaders. They are all sincere individuals who meet on a regular basis seeking ways to benefit their region of the state. The area is blessed to have such dedicated persons sharing their time, efforts and expertise for the entire community.
Topics of discussion that day included healthcare, economic development, education, transportation, and tax reform. As the all-inclusive discussions passed from one important subject to the next, the word infrastructure routinely found its way into consideration. Infrastructure is defined as the basic framework of a system or organization.
One must assume from that definition that it would be difficult, if not impossible, to create a system or organization lacking an infrastructure. Most, if not all, of those subjects identify a system presumed to have an infrastructure. “Presumed to have” because it is difficult to discuss any of those subjects in detail without some eventual reference to that subject’s framework.
The problem arises when the question is raised, how many of those highly-educated, sincere individuals would be able to describe, in detail, the infrastructure of even one of the systems or organizations discussed?
The specific focus of this blog is the current rush to healthcare change in America. Monumental change in any large social system shares certain fundamentals, and a clearly recognizable depiction of a system’s infrastructure surely is one of those necessary fundamentals.
To plan for monumental system change in healthcare, or any other equally important system, without a detailed understanding of that system’s infrastructure, or organizational configuration, is precisely how we came to the healthcare chaos of today.
Massive, direct governmental involvement at both federal and state level regarding regulation, cost and access are fairly recent events as far as the history of healthcare in America is concerned.
Most states began their initial acts of the regulation of hospitals and their medical staffs about the time Congress was creating Medicare and Medicaid in 1965. One will find no evidence of consideration or concern for their existing infrastructure of either healthcare in general or Organized Medicine in particular by Congress or any state legislature during that period of monumental healthcare change.
That fundamental failure is rapidly being re-enacted.