A Logical Health Care Debate - And Polite Discussion:  Part 1

Michael Round

August 28, 2009

House Bill 3200, also known as "America's Affordable Health Choices Act of 2009)", has drawn the scorn of many Americans as no other issue for some time. 

Why this issue?  Why now?

The House Bill, spanning a whopping 1,017 pages, seems to redefine the nature of the health-care delivery system as we know it.

Though the bill is online, there is a debate as to what it actually says.

There should be a further debate about how the bill came into being in the first place.  Where does a 1,017 document come from?  From what general principles?  Where is the document listing the ills of the system, the cures, and the relationship between the cure and the ill?

How significant are the various prescriptions to cure the "ailing" system?  For example, the idea of the "public option", once understood from a financial and logical perspective, was attacked.  President Obama retreated quickly from this. 

Was this a significant retraction, or a minor deletion from the Act?  We don't know.  When one posits multiple solutions and retreats from one, an inference might be the solutions are all of equal importance, the relationships between the solutions insignificant.

Is this true?

"Problem solving" of this nature is common in government and industry.  One sees many problems, and proposes many solutions.  Customer service is slow in telephone response time?  Add more phone reps.  There - problem fixed.

Materials costs are too high?  Put it out to bid, and go with the lower cost firm.  Problem fixed.

Many problems.  Many solutions.

Did I neglect to say the materials were of low quality, and the new material periodically broke under pressure?  When it broke, the customers - naturally - called customer service!

Two separate perspectives on solving problems to improve the system.  We could describe them as "System A" and "System B".  One sees a complex system, assumes the solutions must be complex, and attacks the various subsystems.  System A thinking.  On the other hand, one sees a complex system, seeks to understand the relationship between the components, the interdependencies between the problems, and seeks the few issues giving rise to the system problems.  Inherent Simplicity.  System B thinking.

Clearly, Health Bill 3200 is an example of System A thinking.

Let's suppose we were to address the health-care / health insurance issues.  Where would we start?  Fortunately, the two methods of thinking have something in common - the problems.  What are the problems in the system?

But let's start from our OWN perspectives, and not merely repeat things overheard in the media.  What personally are health care / health insurance problems you've perceived?

e-mail me privately at round@rationalsys.com

And we'll move on to Part 2 in the near future!