The Berlin Wall of Healthcare
Over the past few weeks, we’ve seen several corporate announcements that, by themselves, feel like nothing more than market hype. Yet, when I look at them as a group, I see cracks beginning to form in the foundation of the wall surrounding healthcare. This wall is admittedly more metaphorical than certain historic walls, but I can’t help but be drawn into comparisons.
Unlike the tragic wall that divided Berlin for 28 years, we can’t blame any one person or group for leaving healthcare so divided from the rest of industry in the US.
True, we can probably lay a lot of the blame on regulation and the inherent complexities of healthcare as an industry. But the fact remains that, for whatever reason, healthcare has felt like an island unto itself for decades.
The effects of living trapped within the communist block were felt by millions who used Berlin to escape to the west. The wall of healthcare breeds a different kind of exodus. With physician burnout rates as high as 60% and the nationwide physician shortage, healthcare is facing its own mass migration.
The similarities between Berlin and healthcare appear when you look at health IT in particular. While the West German economy began to recover during the post-World War II period, East Germany fell behind.
Without making light of a decades-long international struggle, I can’t help but hear similar feelings of entrapment creep into providers’ voices when I talk with them about their frustrations with healthcare tech. They feel trapped behind a wall, not of ideology, but of old technology, mismanaged regulations and unsupportive executive structures.
They watch via live streaming SpaceX launching a roadster into space; the sounds of Musk’s well-chosen David Bowie soundtrack flow through their iPhones only to be interrupted by pagers or incoming faxes. Unfortunately, life behind the wall of healthcare tech looks bleak and grey in comparison to the digital world just beyond the hospital doors.
But is the wall really coming down? My inner optimist says yes.
Here's why:
- Apple just announced their iOS integrated PHR app and their intention to become their own worksite health services vendor.
- CVS and Aetna have announced their intentions to merge.
- Amazon, JP Morgan, and Berkshire Hathaway have joined forces to sort out healthcare for their employees.
- Intermountain Healthcare has plans to manufacture their own pharmaceuticals.
There are dozens of similar examples of companies chasing “healthcare disruption.” These cross-industry plays, coupled with inner-industry conferences and gatherings such as UPMC’s Top of Mind summit leave me seeing the wall’s foundation beginning to crumble. For everything seemingly going wrong in healthcare, it doesn't take much digging to find brilliant, motivated individuals working to solve those problems.
It’s hard to imagine what a “post-wall” healthcare world will look like. Margaret Thatcher infamously expressed concern that the removal of the Berlin wall (and subsequent reunification of Germany) would lead to another disastrous war. I’ve seen (and felt) a lot of similar skepticism of these moves to free healthcare from behind the wall.
It helps to remember that Kennedy delivered his “Ich Bin ein Berliner” speech in 1963, Reagan demanded Gorbachev tear down the wall in 1986, and the wall didn’t officially come down until the end of 1989.
Monumental changes don’t happen overnight, and occasionally, the gap between the flashy speech that captures our attention and the desired result may be longer than expected. Hopefully, with things like The Arch Collaborative, #hcldr, and the pink socks movement, we’ll at least start to see the healthcare wall come tumbling down.