Has anything in health care improved for the better for us patients… for anyone?
Over 10 years ago as we approached the new millennium I was finishing an intensive Health Policy Fellowship. As a synthesis of all I had seen and learned from an insider’s perspective, I penned a vision of what I thought healthcare should look like in the next century. It was more a statement of some twenty principles and directions rather than specifics. We are now a full decade into the 21st century so it seemed a good time to take a look at my old roadmap. Perhaps it is a measure of my current pessimistic state of mind, but I am not immediately able to declare progress towards any of the goals I envisioned. In fact, it seemed at first blush that despite all the money and best efforts of public and private interests, that most of the items on my wish list were getting worse.
What do you think? Please prove me wrong. Help me indentify something good that has happened to us as collective patients. Is anyone better off? If so, who? Convince me that we are not irreversibly lost in a status quo of decreasing access to healthcare of uncontrollable cost, and of unknowable quality.