Responding to the New Yorker piece by Atul Gawande:
“Delivering healthcare to a large population of people in totally new ways paid for by totally different methods is uber complex, much harder than selling books online. Large scale pilot projects in healthcare have traditionally been much shorter than seven years. Why? Multiple reasons but mostly because pilot projects to rethink healthcare have been half-baked and small grant funded. Also, the amount of money people are potentially losing through experimentation is too large to risk a seven year investment and there’s little incentive to buck the system and create new ways of paying for or delivering healthcare.[…]
”[…]Healthcare experiments and pilot projects need to be rethought. We need the government to foster new platforms that markedly reduce communication overhead, much like Hello Health and the NHIN are doing.“ Jay Parkinson
Parkinson suggests a venture capitalist funding model – adopted from the technology sector, wherein the government would sponsor new and innovative methods for healthcare delivery. In other words, perhaps this is a mirror of the NIH funding model that powers biomedical research.
Of course, what emerges from these pilot projects may not be a single, unified model that works for every community. Rather, we might find that some communities (e.g with a unique socioeconomic structure, disease prevalence, age distribution, or pattern of genetic variation) will require specialized delivery models. As such, I hope that the government can provide not only funding, but also a critical review system that encourages well-designed, properly-controlled studies of healthcare delivery.