Reflections on change.gov and the health care ecosystem

So, its here. Obama Barack has been elected as the next US President. At change.gov they have outlined the agenda for "health care for all". Their approach is consistent with the approach during their campaign i.e departing from the traditional either-or mindset. It's an approach that looks at problems and opportunities in the context of thinking about the correct things to do by asking simple questions. (simple is not the same as easy). This approach is in contrast to the approach of viewing things as being leftist, rightist, or centrist -- that's what politicians think, ordinary people seldom do. (see this Web 2.0 panel that put me on that track).

Why? Well, the idea of the National Health Insurance Exchange on Change.gov appears seems to be heading in the direction of national insurance schemes like I know in Norway or in Sweden. Providing health care services as a basic right to its citizens. By the way, in Norway, where I live, the philosophy behind the insurance scheme is about ensuring that people have the means to take care of themselves - inntektssikring - and is broader in scope than just health care and covers even unemployment. The welfare state is a different and larger discussion for a different forum.

What is interesting to read on Change.gov was the approach of "making insurance work for people and businesses -- and not just (securing profitability) for insurance and pharmaceutical companies". I would prefer to include medical professionals and institutions to draw a holistic picture of the "provider <-> customer" relationship. In such a context, the insurance and pharmaceutical companies are very much part of this health care ecosystem. I believe that it is government's role to secure transparency in the procurement, provisioning (delivery) and payment of services that occur in this ecosystem.

Transparency will provide me as a "consumerzen" (a term I use to describe the consumer-citizen) insight into what services I am entitled to and what services I can augment by purchasing these on the open market. The government must provide this transparency. One way to ensure such transparency is the provision of a societal digital infrastructure that includes standards to secure organisational and technical interoperability, technology can provide tools to support the enforcement. Beyond ensuring transparency, such standards will help players of this ecosystem to innovate and create services that consumerzens can chose from. Building such an SDI requires an investment, but then at every stage of our history, infrastructural investments have driven innovation and generated prosperity.

I guess the trick is in educating consumerzens on the realities of the service economy and creating conditions that will help newcomers to the ecosystem to thrive (which means we need newer ways of educating people ... see this. The system will be able to generate funding once there is sufficient awareness, involvement and opportunities to generate prosperity.