The Healthcare Discussion We're Not Having

Two narratives dominate 2020 — health and the economy. But they vie for our attention in very different ways.

There is the sensationalism of the pandemic: the number of positive cases and death count and rather grizzly tables of statistics that in some peculiar and dark way have replaced the stats of the sports tables for a couple of months; the politics and politicization of COVID-19 and in particular, the political symbolism of wearing a mask or not; the leading actors in this increasingly disturbing melodrama, and the real people stories — of death, survival, separation, and front line heroism.

In contrast, the more serious politico-economic analysis, though not as sensationalist, seems more substantive and thoughtful, in no small part, as it generally looks to place the pandemic in a broader and longer context.

Unsurprisingly, the big accounting firms and management consultancies — PWC, Accenture, McKinsey, etc. — have all published their versions of “The Effects of the Pandemic on the Economy.” And it’s not bad stuff.

They tell us about the shifts in consumer sentiment: the shift to value, the shock to loyalty, the flight to digital streaming, purchasing, socializing and gaming, and increased home activities; “The Great Acceleration” as McKinsey is labeling it — the gap that is ever-widening between the top corporate performers and the rest; and the effects of the pandemic on climate change, home leisure activities, and other not-quite-so-obvious areas, like the significant uptick in single-use plastic or the increase in waste.

We also have a good sense of the pandemic in the much broader politico-economic-historical context. For instance, an excellent New York Times article by Ruchir Sharma speaks to the continuation, and magnification, of the global implosion that started after the financial crisis of 2008. He points to populist leaders with autocratic tendencies more emboldened to “bash” foreigners, now with even greater leverage to control and close off societies as we emerge from the pandemic, and nations being increasingly less willing to expose themselves to world trade, global banks, and international migration.

This is just a smidgen. And while there is no lack of politico-economic commentary around the effects of COVID-19, it is this type of analysis that the health debate seems to lack.

Sure, we know about shifts in behavior like the explosion in telehealth: 46% of U.S. consumers using telehealth in 2020 compared to 11% in 2019. We also know about different behaviors related to COVID-19, such as 95% of people 65 and over say they are practicing social distancing, whereas only 58% of 18 to 24-year-olds say they are. And we know how people have been affected by the pandemic. Below is an example:

PwC Health Research Institute COVID-19 Consumer Survey, April 2-8,2020
 PwC Health Research Institute


But there doesn’t seem to be a bigger picture perspective. Health is the driving subject of the moment, and there is an opportunity for a more significant discussion. We believe the larger health systems at a national level, and smaller ones at a regional or local level, could do more to lead in convening, facilitating and contributing to this debate.

Arguably, they are better equipped than any other sector to raise issues about what COVID-19 means for healthcare provision in the U.S. and instigate debate about how we can address some of the long-term systemic issues that have surfaced. And now is a good time for them to embark on this adventure with goodwill in their sails and the light of attention on them.

How about a health-system-backed think tank whose mission is to start debating some of these future-forward issues? It’s not like there isn’t enough material! The first item on the agenda might be: “What we have learned from this pandemic that we might do differently next time?”

At ReviveHealth, we have been giving some thought to the future. We’ve been talking about the Post Health System Brand — a coherent philosophy of the future of health system that starts with, and responds to, people’s daily lives and their emotions around health provision as much as their medical needs. The pandemic has only strengthened our belief in this new way of thinking about health system’s role in the future.

We also have a weekly podcast, The No Normal Show, in which we invite guests, from healthcare and beyond, to discuss the big issues of the day and their impact on tomorrow. It’s a perfect forum for airing and debating views about the wider COVID-19 context and the implications for the future. There is no “normal” now. Instead, there is a once-in-a-lifetime opportunity to create a better future out of the current crisis.


August 7, 2020
Nothing beats a good old-fashioned conversation.
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