How does a COVID-19 United States Healthcare System Rebuild?
Thank you for the great responses to and continued support of Parts 1 and 2 of this series. We are pleased by the support of our post-COVID framing of the issues within healthcare.
Our last couple of blogs have been a little depressing; however, maybe that is what healthcare really needs. As I walk throughout my neighborhood in a community called a “forest” (mainly because of it’s amazing number and variety of trees), I’ve noticed that my community is not producing many new trees. The area was nearly all-natural forest 40 years ago before this community was built. I am told that without planting new trees to replace those lost to disease or a fire, many of the beautiful trees in this former natural forest will eventually die and not replace themselves. Eventually, this once majestic forest will be replaced by much more native trees, one of the many variations of palm trees in Florida. I literally know nothing about plants or botany, so I could be wrong however, go with me on this for now.
I told this story because the metaphor I want to create with this relates to healthcare. It appears as though we have just had a natural fire and many of our formerly majestic trees – providers that have contributed their lives and careers (some more than 50 years) to the practice of community-based health – have succumbed to the conflagration that has swept through the healthcare delivery system. Unfortunately, it is in fact, still sweeping away as more and more PCPs are folding each week. I know for certain that new solutions (new replacement trees) are being planted and they are already emerging, like the regeneration of my beloved forest.
As noted in our last blog “Renaissance for Healthcare,” we mentioned a global “Gray Rhino” event that eventually led to a “Black Swan” event for healthcare, and if we are even slightly correct, it will change healthcare in a measurable way in the United States – and possibly for many developed countries forever!
I am reminded by history lessons about the Black Death in the mid-14th century. That pandemic devastated the people of Europe and Asia, and it was an unprecedented human catastrophe. Some academics have noted that Italian society was transformed or perhaps better stated “reformed” following the bubonic plague. Cities like Naples (my original family roots) were devastated and the population of Florence was cut by 50%. The consequences or aftereffect on commerce and even the control of the Catholic Church was enormous. People began to question authority and there were even material cultural changes that continues to impact societies today. Scholars believe that the word “quarantine” was derived from the era by the Venetian term “trentino” or the 30-day isolation period for merchant ships that was imposed during the plague.
Why is this important to our view?
What happened after the plague in Florence, Italy, was remarkable and by many scholars it led to what became known as the Italian Renaissance. The cultural impact that resulted in an explosion of arts and innovation eventually became the Renaissance Humanism.
See this quote by Daily History:
“The Black Death devastated Italian society in the middle of the 14th century. It led to great socio-economic, cultural and religious changes. After the initial horrors of the plague, Italian society, staged a spectacular recovery. Italy became richer than before. The impact of the plague reduced the influence of the Catholic Church as diminished, and the culture became more secular. The new social mobility meant that individualism came to be respected. The Black Death unleashed the forces in Italian society that made the Renaissance possible.”
The bubonic plague was mostly attributed to the transmission from rodents, lice and fleas. That got me to thinking that the rat we now know was the principle vector in transmitting the Black Death and resulted in Europe emerging from the “Dark Ages.” So, there was a proverbial silver lining in the catastrophe, like a fire refreshes the forest. This connection led me to see that beyond the “Gray Rhino” and “Black Swan” we could have a “Golden Rat” event where a catastrophe leads to a dramatic and unforeseen positive societal change.
Early on, the COVID-19 virus was referred to as the Wuhan Virus referencing the city in China where the virus originated and forced the cancellation of the Chinese New Year celebration on January 25, 2020, in the Wuhan region. Coincidentally, and somewhat surprisingly, the year 2020 is also known as the Year of the Rat in the Chinese calendar. So, perhaps out of this event, we will witness a “Golden Rat” – a revival, rebirth or a “Renaissance in Healthcare.”
This new era must dramatically change healthcare and in the way care is given, who gives it, how it is given, and where it is given. In this new era, technology is going to play an unprecedented role in maintaining wellness. The role of the hospital will change, the way we involve specialists in our care will be different, and the value of our primary care providers will increase. Think about this one fact; primary care providers collect less than 10% of all healthcare expenditures, yet account for nearly 50% of all patient-provider encounters.
More next time.
-Noel J. Guillama, President
As we have done before in this series, we share a small collection of NEW headlines over the past few days, beyond the articles we have shared in the last two blogs:
29 hospital bankruptcies in 2020
Health system financial results for Q1
Ill-Timed Health-Care Buyouts Bruise KKR and Blackstone
Hospitals could struggle — and more will go bankrupt — until they get patients back in the door