Major federal programs to improve health and reduce costs have uniformly failed. They failed to show any significant changes in quality measures. This includes the Medicare Medical Home Project, Comprehensive Primary Care (CPC), CPC+, etc. The reason these projects failed is they don’t follow the evidence. I have shown you the
You sound like Semmelweis trying to get doctors to disinfect their hands before touching women giving birth. What you say is obvious and easy to implement. Trying is not key. Following the evidence is key. Getting the powers that be to listen is a hurdle. How best to get listening and implementing what works?
That is the problem in a nutshell. The path to better health at lower cost is clear. There is the barrier of new scientific paradigms as described by Thomas Kuhn and the barrier of perverse financial incentives. Every American is suffering because of our failure to follow the evidence.
The path is not quite what you see, in my assessment. I suggest you read Political Ponerology - or anyway the posts I've just done tis past week, starting with that. It is my sense that you are looking at a corner of the problem - like a local cancer, when there is a much larger systemic cancer below it. By the way, I'd be happy to talk with you about this. Note that you write of "our" our failure to follow the evidence. Who is this "our"? Important, including to track who is in the "our" cohort.
The huge white whale in the room is the lack of early detection and early warning systems to deliver information for primary prevention and lifestyle optimization. The evidence is overwhelming that metabolic dysfunctions are the cause of most of the chronic diseases. Ignoring this evidence is the root cause of the systematic failure.
You sound like Semmelweis trying to get doctors to disinfect their hands before touching women giving birth. What you say is obvious and easy to implement. Trying is not key. Following the evidence is key. Getting the powers that be to listen is a hurdle. How best to get listening and implementing what works?
That is the problem in a nutshell. The path to better health at lower cost is clear. There is the barrier of new scientific paradigms as described by Thomas Kuhn and the barrier of perverse financial incentives. Every American is suffering because of our failure to follow the evidence.
The path is not quite what you see, in my assessment. I suggest you read Political Ponerology - or anyway the posts I've just done tis past week, starting with that. It is my sense that you are looking at a corner of the problem - like a local cancer, when there is a much larger systemic cancer below it. By the way, I'd be happy to talk with you about this. Note that you write of "our" our failure to follow the evidence. Who is this "our"? Important, including to track who is in the "our" cohort.
The huge white whale in the room is the lack of early detection and early warning systems to deliver information for primary prevention and lifestyle optimization. The evidence is overwhelming that metabolic dysfunctions are the cause of most of the chronic diseases. Ignoring this evidence is the root cause of the systematic failure.