In reply to a discussion thread on the potential benefits of applying business process management (BPM) to “fix” healthcare, I wrote:

Applying BPM or any process improvement to “healthcare” is still just rearranging deck chairs on the Titanic. Until the hard questions – which no politician or healthcare entity is willing to ask at this time – are answered, the “fixes” are only symptomatic relief for pervasive disease.

What are those hard questions? Tops among them is, “How much responsibility does this society/country/population expect its individual constituents to take for their own health?” Will we continue to treat the effects of personal health abuse (drugs, alcohol, obesity, smoking, etc.) as medical conditions under the terms of contributory or public-funded health plans? Will we continue to reinforce poor health behavior by “fixing” it symptomatically, while those engaged in healthy behaviors (while personally happier and healthier) are penalized through exorbitant taxes/premiums?

A totally market-driven solution will not address the moral and social implications of decisions around this question – providers will continue to “treat” what they are paid to treat, and insurers will continue to try to eliminate as many unhealthy prospects from their insured pool as possible, to keep costs down and profits up. No Process modification will alter this balance until this market/economic tension is addressed and resolved; which is highly unlikely in an election year and remains unlikely thereafter.

Are there processes that can be improved in the existing system that will improve patient care, reduce cost, and contribute to the overall well-being of society? Of course. But don’t expect a comprehensive, long-term “fix” until the really big issues are wrestled to resolution.

Comments?