What do you think is the most current important issue about healthcare in your country? Why?
The most important current healthcare issue in the U.S. is dissemination and comprehension of accurate information by the end users. Directly or indirectly, national healthcare decisions are based on the input of America’s 320 million people. The single most important lesson learned so far from the 2010 Affordable Care Act (ACA) is that far too many Americans have no understanding of the basics of how health care is provided and paid for. However, although educating all Americans about healthcare is necessary, it is also a very difficult prospect given the staggering complexity of the many healthcare plans that exist in the U.S. at this time.
Are there any measures you are taking notice of in other countries that might help your country?
The existence of a so-called “single-payer system” in every developed society in the world– except for the U.S. – can hardly be a coincidence. My guess is that eventually cost containment pressures will compel the U.S. to also adapt some form of single-payer mechanism.
How can business schools support governments or other coordinating bodies to improve their healthcare systems?
B-schools provide a unique source of information to decision makers because the information they can generate is high quality, interdisciplinary, and non-partisan (independent from political considerations). Furthermore, B-schools can generate data internally, via faculty research, studies by students, or partnerships with governments, corporations, or other schools. They can also generate data by acting as coordinator or facilitator, as is the case with the current Council on Business & Society Forum.
Which topic should be the highlight of the forum? What are the insights you hope to get?
There is a famous phrase that comes in handy in many situations: “Follow the money.” Although issues of technology, public policy, ethics, the role of private companies, and others are all fascinating, at the end of the day if the money isn’t there, nothing is going to happen. For example, as much as I deeply admire and respect Japan’s health care system, like many others I have serious questions about its sustainability given Japan’s rapidly aging population. I will be extremely interested to see how experts view the economic viability of different healthcare systems.
What is the corporation’s role in employee health? Do you believe corporations should be concerned about and involved in the health of their employees? Why?
A company has two reasons for having healthy employees. One is enlightened self-interest: healthy employees are more productive. The other is moral. Managers have an ethical obligation to ensure that their subordinates are healthy and work in a safe environment. Depending on where I look, I am disturbed when I see managers who are negligent in taking adequate care of their staff and heartened when I see companies that increasingly consider employee health in holistic terms that involve both physical as well as emotional health.
Do you see any global convergence in the role in corporations in employee health?
Whether we like it or not, globalization – empowered and spurred by the internet – is increasingly creating “global standards” that are supplementing or in some cases replacing local standards. Nowhere is this trend more pronounced than in global business. Increasingly, every country around the world is basically competing to see who can come up with the best system, and this has two interesting results. One, countries with excellent healthcare systems may find themselves under increasing pressure from visitors and immigrants seeking the benefits of that countries’ healthcare system possibly without having fully paid into the system in advance. Two, as global best practices develop, end users in other countries will increasingly demand that these best practices be adapted in their own countries.
How is information technology being used at the macro and micro level?
IT enhances healthcare in too many ways to count, but any list would have to include cost optimization and better diagnostics at or near the top. I would note, however, that privacy is and will continue to be a major concern, and ultimately global end users will resent and reject any system that infringes on their privacy regardless of how good the care may be in a medical sense. One other very interesting aspect of IT is simply in global consumer education and the creation of a “global marketplace” for healthcare. This results, for one thing, in the creation of “medical tourism,” a concept that barely existed a few years back and has the potential to be a market worth trillions of dollars a year – if it hasn’t already.
Each country has to answer the questions of who pays for healthcare and how it is supplied. How should a country adjust its answers to these questions given demographic changes?
Healthcare has a unique business model in that it has two special qualities and three core aspects. The two special qualities are 1) healthcare is recognized as a basic human right, and 2) healthcare is and must be managed as a business; that is, it involves the management of resources for a purpose. Healthcare’s three core aspects are : Cost, Quality, and Access. It can be quickly seen that Cost, Quality, and Access all involve trade offs; it is logically impossible to have the lowest cost, highest quality, and highest (universal) access. The challenge that will always face health care managers is how to balance the three aspects while always respecting healthcare’s two fundamental qualities. This means that there is and never will be such a thing as “perfect” system. The best we can hope for, and the objective that everyone must strive for, is to have a “really good” system that provides the optimum balance of Cost, Quality, and Access – based on the values and resources of every society at every point in time.