Let's play health!

Today, we're experiencing what I consider a healthy debate on the business of Healthcare in America. With so many sides involved in the argument, the details tend to become unclear. There is a growing rift between the system of healthcare and the business of healthcare. Initial finger-pointing, the immediate response, has now given way to an intensely detailed discussion of the facts concerning the state of health in the US, or perhaps more appropriately, how healthy we are as a nation. However, with each side armed with suggestive reports and similar opinion-delivery-systems, it is easy to see how the average person could be led out or even exclude themselves from the debate.

The structural problems with healthcare in America reminds me of another business that has struggled it's way back to relevance after many errors in judgment. The game of baseball... or rather, the business of baseball. I'm sure correlations may exist to many other businesses, and some may be more closely related, but baseball serves as a clear litmus for the effort to improve relevance in businesses dealing with public dollars. Common people pay for the relevance of baseball and healthcare alike.

The owners of baseball vary from media conglomerates and corporations to individual franchise owners (did you know Nintendo owns the Seattle Mariners?). All have a stake in the well-being of the league, since they, as owners, seek the reward of all that comes with having the team they own be winners.

The owners of healthcare tend to be a much more varied list of doctors, practitioners, hospitals nurse-residential-and-social assistance providers, and insurance companies. The definition of the job description of these "owner" entities varies widely based on their section of the business. The difficulty in this area is that the "league" that is the healthcare sector in America doesn't seem to have a clear objective.

Business managers in baseball (GMs) manage the hierarchy of decisions and talents that produce the bottom line profits for the owners. Both the GM and the owner have a vested interest in the team's well-being as well as that of the league in general, so that profit may be maximized as fans show support for "their" team.

Business managers in healthcare (HMOs) manage the hierarchy of doctors and other care providers to produce bottom line profits for the owners also. This is where a breakdown occurs with the baseball metaphor, because the fans (or patients) are so far removed from the discussion, where team decisions are public knowledge.

Club managers in baseball are responsible for holding teams accountable for the fans. Managers must reconcile the business needs of the GM, as well as deciding on strategy and motivating the players to reach their goal. In this case, political influence, while present, doesn't hide the fact that there are good club managers and temporary club managers (as well as good and temp GMs).

Club managers in healthcare are the office administrators and various chiefs of staff that keep the balance of revenue and expenditure so that the providers can focus on the business of making the patients more healthy.

Baseball players are the talent by which the game is made more interesting, and therefore viable as a business. Players decide their level of commitment, also, and deal directly with the fans, and reporters to the fans - who judge their performance, as well as the performance of the club as a whole - thereby directly affecting the relevance of the league. In essence, the fans and players make the game... the business decides how it will be presented.

Healthcare players, or talent, are the people who apply the knowledge they seek or sought with great effort from systems of education designed (hopefully) to produce the best doctor, practitioner, nurse, etc... which makes the contribution of the patient more justified. After all, if Joe down the street could offer the same care, we'd be the healthiest nation in the world (which we are not). The healthcare providers are the show, and business decides how it will be presented (or accessed).

And finally we reach my level... the common person's level... the fan level. Fans are the people who support the industry through financial contributions in the form of tickets sales, merchandising and ad dollars, and local taxes for updated facilities, by which the team they support may succeed to the benefit of everyone involved in the venture. The "win, win" nature of fan support makes it the single biggest contributor of long term success for any team.

The common person's level when it comes to healthcare is that of the patient. Patients support the industry though payment of insurance premiums, co-pays and doctor, clinic or hospital fees. The primary means of support, though, comes from benefit packages offered by employers. Employers pay the lion's share of healthcare premiums, and represent the single biggest account for the industry. The reason people support the current industry is that they seldom see the money that's spent in their name, and they fear that something might go wrong with their bodies that would require a medical professional to "fix" them.

The another disconnect in the baseball/healthcare metaphor is that I know a helluva lot more people that would rather go to a ballgame that a doctor's office. The perpetuated stigma that clinics and hospitals are bad or sick places has brought to a head the argument over the importance between healthcare and the business of healthcare in America. The fan principle still applies though. The common person's level of involvement directly reflects the judgement of the resulting product. Before you take a side and argue one of the points of view available, ask yourself just how healthy do you want to be? Is medicine a "fix," or a "process?"

Baseball teams are forced to adjust constantly in many different areas in order to stay relevant to the fans. In a nation that ranks 45th in the world in life expectancy, how relevant is health?