Go Ahead, Just Say NO to Socialized Health Care!

But please don’t say YES to more of the same old capitalist health care!!

Instead, we ought to remove the dead weight encumbering the health care market and figure out how to improve its efficiency. Transaction costs are by far the most important costs in a market, and transactions are defined, by and large, by the quality of the information available to the parties in the exchange.  We have the means in hand for making vast improvements in health care information quality. Advanced measurement technologies integrate mass customization with meaningful, universally uniform, and ubiquitously available reference standard metrics and common product definitions.

We desperately need investment in a new infrastructure of metrological standards for every important metric in health care (health, chronic disease, and functional status; quality of life and care; employee and organizational performance, etc.). Such standards could function as a fungible common currency for the exchange of individual and organizational health capital.

If we don’t create these measurement systems, it really doesn’t matter whether the government runs a single-payor health care system or if we stick with the current dysfunctional system. Consumers and payors need to be able to compare products’ value-per-dollar just like we do in grocery stores. Quality improvement specialists and researchers need to be able to compare outcomes across treatments in common metrics. And perhaps most importantly, front-line clinicians need to be able to evaluate a patient’s condition on the spot, at the point of care, in the terms of the same measure that will be used for accountability and quality improvement.

Our long history of successes in science, engineering, and market economics illustrate the astounding benefits that accrue from thinking together in common languages, and from acting together harmoniously, in coordinated ways that do not require choosing between uninformed decisions and negotiating every detail. Our challenge is to figure out how to extend those successes into new domains. The question is how to configure representations of human, social, and natural capital so that their markets work the same way that manufactured, liquid, and property capital work.

Answering this question, and successfully addressing this challenge, are not beyond us. Improved measurement will play a vital role in reducing transaction costs and in taking the health care market to a whole new level of efficiency. Without improved measurement, it really doesn’t matter if health care is socialized or not.

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