The U.S. Health Care Consortium:
An Evolution In Health Care

The U.S. health care system is not suffering from a lack of financial support. There is enough money in the current system to provide comprehensive, high quality coverage to every American. The U.S. health care system suffers primarily from fragmentation, misaligned incentives, and an inability to differentiate between effective and ineffective care. These problems increase the cost of care dramatically (and unnecessarily), and greatly reduce the quality of care that patients receive.

The goal of any comprehensive reform effort should be to ensure that the trillions of dollars that flow into the health care system are directed to pay for services that actually improve patient outcomes. The current system does not adequately track the results of the care that is provided and therefore cannot confirm which dollars have been well spent.

This proposal advocates the use of advanced information technology to track medical inputs and patient outcomes in order to assess the impact of specific health care interventions. From the perspective of patients and providers, this system would be as easy to administer as credit card transactions between consumers and merchants. Provider payments would occur instantaneously at the point of service. The data that is collected would enter into an automated feedback loop that incorporates sophisticated computer modeling systems based on applications from the field of complexity science. This system would provide a direct mechanism for determining which care is effective and which is actually counterproductive.

In order to facilitate the very complex (and controversial) data work that would be involved, a U.S. Health Care Consortium would be established that would include representatives from each of the major stakeholders in the health care system. The Consortium would manage data collection and storage and would facilitate the scientific and political process of assessing which medical and patient inputs are responsible for the observed outcomes. The Consortium would establish the rules of data analysis, but would remain completely neutral regarding specific medical interventions. The observed patient outcomes would become the arbiter of quality.

Under this system, providers and patients would be free to pursue any care path they chose, but would be required subject their data to rigorous evaluation. Payment amounts would fluctuate based on observed experience. With outcomes being tracked, the disturbing variations in practice patterns currently observed would actually become a positive force for exploring new, and possibly more effective, treatment regimens. In the same way that biological diversity fosters evolutionary advances, treatment diversity would facilitate medical advances.

Once financial incentives for providers and plans were aligned with improving measured patient outcomes, innovations in care delivery would rapidly spread throughout the delivery system. This would facilitate not only an improvement in care quality, but also a significant reduction in health care expenditures that would make health care more affordable for all Americans.

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