Healthcare: Solving The Problem By Specialization.

There are three basic ways to take care of your car:

1. Baby it – give it the best oil and best fuel, wash it weekly, have regular checkups, take it in any time it even pings and park it in the heated garage.

We all know this option is the best for your car. If more people would do this cars would last longer, perform more efficiently and run cleaner. Perhaps, the biggest reason for people to do it would be to reduce their problems and anxiety. If you knew that before you left on your long road trip your oil was changed, your gas tank was filled up with premium fuel and your car had had a full tune up think how much more relaxed you would be. Also, imagine how much your peace of mind would increase if this is how you had treated your car since you drove it new off the lot.

Realistically, this is not how most people treat their cars. Instead, they opt for one of two other alternatives:

2. Enough – change the oil, fill it up with regular gas, wash it when it’s dirty and when it breaks down fix it up.

3. Into the ground – never change the oil, put fuel in it when it runs out and when it breaks get a new one.

You probably know as well as I do the results of these two options. With option two the car works well enough until it breaks down, at which point you fix it up. With option three, like the name implies, you drive it until it won’t drive anymore; and then you buy a new one and do it again. The abundance and relatively cheap cost of cars allows this to be an option. You probably also know why most of us choose options two and three: option one is just too much work.

Now consider something that may make you change which option you would choose. What if the first car you ever bought would be the only car you could ever drive for the rest of your life? Which option would you choose then? Obviously the first. In today’s society a car is so essential that if you were only allowed one for roughly 60 years of driving you would do everything you could to make sure it would last and that it would continue to perform as well as possible.

Yes. One car for 60 plus years would indeed be a challenge. In fact, many people, myself included, would not be content with just regular checkups. Cars, as we all know, are just too temperamental. Besides that, it would be such a hassle to spend so much time worrying about maintaining our vehicles. We would want not just option number one, but option "number one plus!” We would want to put our vehicle and its future squarely in the hands of the most qualified mechanic we could find. In additions to oil changes and tune-ups we would want the mechanic, not ourselves, to regularly perform complete diagnostic assessments and install new equipment that would ensure longevity. As brilliant as we are we wouldn’t trust something as important as our one and only car to our clumsy supervision.

Thankfully, this is not the case. But this imaginary situation does evidence a tendency that humans, and especially Americans have. When something is vitally important to us and immensely complicated we wisely abdicate its supervision to specialists more qualified than ourselves (this is commonly known as specialization). Think about it. How many Americans do their own taxes? Most people hand it over to highly trained and specialized accountants. They figure it is far easier to pay a professional a healthy fee than it is to spend hours puzzling over forms themselves. What about plumbing? When the water heater breaks do you get out the wrenches and instruction manuals or do you call the guy with the crack? Or, how about on a national scale: when foreign nations threaten your safety and security do you personally pick up your rifle and head off to war? Probably not. You pay taxes to fund and train a professional army of soldiers. Learning how to be an accountant, plumber, and soldier, while all worthwhile goals seems to be too much for the average individual. Instead, we choose to specialize in one discipline and make enough money doing that to pay other people to meet our needs by specializing in their disciplines.

So what does all this have to do with healthcare? Simply this: for far too long Americans have been content to trust something immensely complicated and tremendously important to their own supervision: that is, their own health. We know that the average American can’t do taxes, can’t fix a leaky kitchen sink, and certainly can’t defend themselves against terrorists; yet we somehow think that they can optimally manage the maintenance of something as complicated as the human body. Well, here’s a revelation for you: we can’t. Although the life expectancy of the average American is much longer than ever before it is ridiculously low considering how much knowledge and expertise is available. The current debate over health care in America recognizes this. What it fails to recognize is that the solution to the American health care problem is the same as the solution to the American accounting, plumbing and defense problems: when they are managed by people ignorant of their intricacies you will only get poor results. It is far past time that we turn the maintenance of our bodies, the only vehicle we have not just for 60 years, but possibly 100 plus, to the most qualified professionals we can.

“But wait a second!” you may be saying. “We already do! We have regular check ups with our doctors and head right to the ER in times of big trouble.” What we don’t realize, however, is that this is hardly option number two, and not even close to option number one, let alone option “number one plus!” Regular check ups with the doctor are comparable to badly needed oil changes and ER visits are more like calling a tow truck for a wrecked vehicle than anything else.

What then, would a health care option, “number one plus!” consist of? Quite simply this: a qualified professional would regulate all aspects of your health and be paid handsomely for their services.

“Great!” you say. “And impossible too.” It is, however, easier to be achieved than you think. What will make the difference is how completely Americans follow the principles of specialization they follow in other areas. For instance, how many people upon hearing what their plumbing problem is and how their plumber intends to fix it say, “great, lets do that; but I want to pick out the parts myself.” Nobody does that! It would be ridiculous. If you can’t even correctly diagnose the problem or figure out how to fix it how likely is it that you’ll be able to pick out the necessary repair parts? Yet how many people, upon hearing their doctor say, “you need to take better care of yourself!” implement their own “custom” workout program or start the first random diet they stumble across?

The real failure to meet the health care problems, however, lies not with individuals but with the private industry. They have, almost unanimously, failed to apply the principles of specialization found in other industries to health care. Besides ridiculously expensive and short-term health spas there are no health care facilities that purport to completely meet all the needs of clients. For example there are lots of gyms, but most gyms just turn you loose and let you do your own thing, regardless of weather its good for you or not. Some gyms offer personal training, ensuring that the exercises you’ll be doing will indeed be beneficial, but offer no advice on nutrition. Other gyms do offer personal training and nutritional counseling but fail to proscribe a realistic long term way to implement the two. It is like our car example earlier: how many people really would have the dedication to do everything necessary to keep their car running for 60 years in optimal condition? Just a few; the rest would want to pay a specialized mechanic to do it for them while they concentrated on other things. There are no gyms or health clubs that do this. They’ll train you and council you on what you should eat but then they’ll leave it up to you to come to your training appointments and leave it up to you to implement their nutritional council.

So what should they do? Should the government require you to go to the gym every morning and get your meals in the cafeteria after? Absolutely not. The key to achieving success is doing what the other specialized industries have done. Make your product so superior, so affordable, and so easy that to not buy it and do it yourself would seem as ridiculous as a business owner doing his own taxes. And here, in a few steps, is how you do that:

1. Find out what people’s real needs are.

2. Take over in meeting those needs.

3. By doing steps one and two free people up to specialize in the areas they’re good at.

These steps merit a bit more discussion.

Step one: find out what people’s real needs are. In this step the health care facility or business would do extensive work to find out what really needed to happen to help people get in and stay in optimal health. This would include evaluating the current health status and eating habits of the individual. It would also include a detailed physical examination and evaluation of past, current, and likely future health conditions.

Step two: take over in meeting those needs. This would happen in three main ways. First, based on the results of step one the health care facility’s personal trainers would post each day an exercise plan for their clients to complete. They would also provide the necessary instruction and facilities to complete the plan. Second, the facility would not just provide nutritional information for their clients but would provide the actual meals. Only in this way could they ensure that their clients were indeed getting the right food and right amount of food for their particular situation. This would also serve as an additional motivating factor to come to the gym. A person would know that if they skipped out on their workout for the day they would also be skipping out on the three meals that they had bought and paid for. Then they would have to go to the added hassle of picking something up at McDonalds or going to the grocery store. Within a little while going shopping for groceries would become completely unnecessary. Your gym would be your grocery store. Lastly, for step two, the health care facilities would need to provide on site physicians and schedule regular appointments based on the clients needs. For example, a fifty-five year old man wouldn’t keep on putting off scheduling his colonoscopy but would find out in a friendly phone call that next week at three p.m. he had an appointment with his doctor in room five of the club.

Step three: by doing steps one and two free people up to specialize in the areas they’re good at. It must be remembered that the two preceding steps should be done in order to free people up to specialize in things they’re better at. And they would. Imagine how much more time you would have if you didn’t ever have to go shopping for food, plan another meal or build another “custom” workout. Imagine how healthy you would be if you followed such a regimen? With meals guaranteed to provide you with all the essential vitamins, minerals, proteins, amino acids, etc. you wouldn’t get sick near as often. Also, within in a short time you would be in good shape, reducing your risk of heart disease, cancer, diabetes, etc, plus have the added energy that comes from being healthy. Not only would you be able to earn more money with your increased physical and accompanying mental capacity but your insurance company would probably be more than happy to pick up some of your gym bill for you as well. After all, it’s no big deal to insure someone in perfect health, especially if that person is doing everything possible to maintain that health.

Finally, I should also address the two biggest arguments against this.

First: it would be way too expensive for both the facility and its patrons. Well, actually, I don’t think it would be. It is important to note that I don’t envision something like this happening overnight. I know of few venture capitalists that would be willing to fork out the dough necessary to start such a facility from scratch. Profitable existing clubs, however, could start the trend. They could begin by offering daily-personalized workouts. Next they could add a kitchen offering one, then two, and finally three meals a day. Lastly would come the in-house physicians. As for the clients they would indeed be handing over a sizeable chunk of change each month; but they would also be saving a lot of money. As mentioned before, they wouldn’t be spending any more money shopping for groceries. This also means they wouldn’t be spending any more time shopping for groceries. And, again, as healthier people they would be more productive and could expect their insurance to help cover some of the bill.

As for the second argument I can hear it already: “You’re sick! How can you advocate handing over your freedom and responsibility like that to someone else?! That’s as bad as supporting government health care!” To this simple-minded objection I offer the following rejoinder. You are not giving up freedom or responsibility if you maintain the right to take back that freedom and responsibility any time you want. That would be like saying the person that hires a plumber is no longer free to do their own plumbing. If you don’t like the gym you can quit. If you don’t like the meals you don’t have to eat them. If you think your club’s physicians are quacks you can go to a private doctor. As long as the government doesn’t take over and make it mandatory for you to frequent a federally ran health facility you will maintain the right to walk away whenever you want or never join one in the first place. And in fact, this is what many people would do. Not everybody needs an accountant and some people can do their own plumbing. Not everybody is incapable of maintaining an optimally healthy lifestyle. For all the millions Americans that can’t, however, there exists or should exist specialized individuals willing to do their accounting, plumbing and health maintenance for them. This is the American way: solving problems by specialization.