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HL20: Clayton Christensen—The Innovator's Frustration

Edward Prewitt, for HealthLeaders Media, December 13, 2011

The national healthcare debate is anything but a model, he says. "I'm frustrated … it's the politicians—it's not that they are inert or that they don't want to do it, but they don't have time to sit down and wrap their arms around the problem or the solution, and their mindset is so fleeting that they want a simple answer." Debate has not yielded to deliberation, in Christensen's view. "Everybody convenes in Washington with self-serving data and self-serving arguments. It's kind of like the people in Washington are sitting around the base of the Tower of Babel, and they can't talk to each other, let alone come up with any answers," he says.

A big part of the political babble, he says, is the false choice between single-payer and multi-payer healthcare systems. "It turns out, as we've studied it subsequent to the writing of [The Innovator's Prescription], that categorizing the world as private multi-payer vs. government single-payer systems is the wrong categorization scheme. At their core, the publicly paid systems in Canada and the Netherlands and Germany are organized very much like most of America, in that the providers are in silos and their inability to stake a systemic view is just the same as in America."

But the integrated health systems that do exist in America "are organized in the same way that Sweden and Finland are organized. Those nations in Europe are way out ahead of those who are organized by silos, in terms of the efficacy and the cost of healthcare, in the same way that the systemic companies in America are way ahead."

To Christensen, who bases his books on research and who speaks in measured, carefully chosen sentences, proper terminology is the key to reforming healthcare. "What I had not realized is how critical a common language and a common way to frame the problem is in trying to make any significant progress in solving the healthcare problems," he says. "It's just really important that we frame the categorization in the right way. When you do that, it becomes clear that the systemic view is critical at this point. I understand that problem more than I did before."


This article appears in the December 2011 issue of HealthLeaders magazine.


Edward Prewitt is the Editorial Director of HealthLeaders Media.
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1 comments on "HL20: Clayton Christensen—The Innovator's Frustration"


John J Flavin (12/14/2011 at 8:36 PM)
Mr. Christensen is correct in his posit that the HC institutions and HC system have resisted change. The fundamental driver(s) of this resistance is either a deep rooted belief that HC providers were not to operate from a profit & loss model (e.g. manufacturing company with products) due to the human aspect of their client base or to maintain an intellectual/academic distance separating them from lowly profit and loss considerations. However, the consequences of a failure to intimately understand the sources of profit and cost within a healthcare provider institution nor system has resulted in the runaway costs which the entire industry and nation now try to contain. The lack of financial discipline and competitive forces found in the free market have enabled costs to rise sky high. Analytics are now providing insights to financial leadership within some institutions which serve to substantiate gut feelings or in a worse case illuminate financial realities to the surprise of doctors and administrators. When the "real financial picture" comes to light, the integration of centers of excellence (and the shuttering of those which cannot operate profitably) driven by the correct focus of providing the best care for a given condition will become the needed if not natural order of healthcare provision.