Potent Medicine
The Collaborative Cure for Healthcare
By John Toussaint, MD
It would be safe to say that we have a healthcare crisis in this country and that The Affordable Health Care Act will not be the final answer regarding how to solve it. The crisis is the result of a disturbing trifecta: rising costs, not enough accountability and transparency, and lousy results. We as a country spend more on healthcare than any other industrialized nation and yet we have data that shows that tens of thousands of people die every year in hospitals because of preventable medical errors. We rank 39th in the world for infant mortality and 36th for life expectancy. Wisconsin MD and ThedaCare CEO John Toussaint set out to solve the problems a few years ago and after brave efforts to build agreement and collaboration in his state, he has made remarkable progress that can be replicated. His new book, POTENT MEDICINE: The Collaborative Cure for Health Care, lays out in detail a template that with very few adjustments could work anywhere. Borrowed from the Toyota Production System model (also a completely replicable model that launched Toyota into its most profitable and productive period) it describes a competitive, choice-driven system that focuses on three key elements:
Transparency of treatment quality and cost
Paying providers for outcomes
Care designed around the patient instead of the provider
Potent medicine challenges many if not all of the long-held notions about healthcare. It describes the issues and the failures of a system where the doctor is “King” and The System impenetrable and arcane. It also explains that, much like politics, all healthcare is local, and the crucial and real-time performance and outcome measures should also be in the hands of local
providers and be easily accessible to anyone. “If the government decides what every doctor and hospital in the United States should report, then collects it and then is solely responsible for publishing the data,” says Dr. Toussaint, “we will be stuck with information’s lowest common denominator.”
Getting the powers that be in Wisconsin to come to agreement on these issues has been a gargantuan task, fraught with danger and filled with the angst and hand-wringing that all real change efforts bring. Potent Medicine pulls no punches in describing the shouting matches and the legal wrangling that were and are part of the process of bringing about a real overhaul of the Wisconsin healthcare system. Beginning with a shoestring budget, John and several other forward thinking healthcare organizations, consumer groups, and large employers formed the Wisconsin Collaborative for Healthcare Quality.
The results of their efforts speak for themselves. From 2003 to 2007, average medical costs for patients in the U.S. aggregate group rose from $8,000 annually to about $9500. Patients in the Collaborative started at less than $7,000 annual costs and then rose more slowly than other groups, ending at about $8,000 a year in 2007. And, more importantly, the numbers that describe the overall health of the members improved during that time as well.
In the end, the good people of Wisconsin are the benefactors of Dr. Toussaint’s efforts. Hopefully the rest of the nation can benefit as well. POTENT MEDICINE tells us how.