If you had to remake the health system from scratch, what would you do? Turn the system on its head, making the hospital the place of last resort and beginning with what keeps people healthy
Last week, I suggested we need to radically re-think Canada’s “health care system” – actually, 13 separate, mainly publicly funded, often privately operated non-systems for illness care, with federal cost-sharing.
Now obviously we can’t blow up the system, so I did a thought experiment, inspired by Albert Einstein’s approach to physics: What if the health-care system disappeared overnight and we had to rebuild it from scratch? What would we build, knowing what we know today? What I propose instead is a true health system, one that is designed to first create good health. So the first thing to do is keep people healthy, because clearly, the best way to deal with an over-burdened illness care system is to stop over-burdening it.
Thus, in my thought experiment, I turned the system on its head, making the hospital the place of last resort and beginning with what keeps people healthy. The model I created — first published in 1993 — is an upside-down triangle, with each layer in the model involving fewer people needing services. The better the layers higher up in the model do their work, the fewer people the lower levels need to care for.
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