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Healthcare Issues [2]
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by Ken Rawlings, DHSA 13 the future of Healthcare

A contribution to the Summit for the Future on Risk

Somewhere, there must be a designed action plan for that pet dog on a key chain using a common language and a common framework. A mind map of actionable SMART objectivity (specific, measurable, assignable, reasonable and time relative) and associative measure. But, how do we measure? Is their “this”, the same as my “this”? Is their “to” the same as my “to”?

How do we leverage and measure efficiency, equity, growth and stability; the examination formula of economic fortitude or failure?

How much does that little doggie on the key chain cost? Do we know how much output we should produce? Do we know the best practice to produce that output? What should each evidenced input be to each demand?

Demand for services will increasingly exceed ones destiny to control costs by controlling supply. How do we balance supply/demand with economic fortitude as a form of force and function, anticipation and reaction? How do we balance ethical fortitude as a form of things or works?

Can we find common sectoral (common and uncommon ownerships) provision of economic contribution continually identifying ratio of cost and weighted benefit and justify opportunity cost to the tribes? The end might look like economic accountability and ethical integrity of mirrored imagery.

Can we identify key opportunities (win/win) of low cost evidence based practice, and have it delivered efficiently and flexibly?

Can we identify key threats (lose/lose) and avoid the loss? That might look like “lack of purpose”, too much short term profit near sightedness, excessive operational costs of technical facilities (energy generation) and mans input (costly benefits), lack of quality process (patient safety), bad alignment of information systems around data collection, information interpretation and organizational applications.

Should we dance the tune of monopoly, defined as a persistent market situation where there is only one provider of a kind of product or service? Monopolies are characterized by a lack of economic competition for the good or service that they provide and a lack of viable substitute goods. Due in part that it is only profitable for a monopoly to increase output when marginal revenues is higher than marginal cost. MR=MC. Monopoly tends to turn out an inefficient mix of output and thus restrict output and charge more, seeking economical profit.

Should we dance the tune of a monopsonist? A monopsonist has market power. They can affect the market price of the purchased good by varying the quantity bought. Due in part because a monopsonist faces a supply curve with a finite positive price elasticity or oligopoly.

Or might it be collusion? Whereas a health imperialism team works together limiting competition, produces a single product of no substitute (evidence based health ends) and whereas joint profit is gained. Is it produced by flexible tripartite ownership with only three societal entrance barriers? Might tripartite ownership of flat organizational characteristic look like; prevention/remedy, disease/remedy and healthcare/remedy? Can we be tripartite in culture and decrease cost with output? Can we transcend monopsonist comprehension to the tribe, so they become knowledged that their general life long health impacts mutual market powers?

As integration and cross culture is a click away. Are we connecting with the global experts? There is much information, some of it is good informed knowledge and some of it is not. Many lessons learned are a click away. The web is a global tool “to be magnetized” of informed “formations”. When minds of polarity attract, mental magnates are created. Can we marry today’s science with yesterday’s machines? Are we living beyond our means?

Any “small wins” learned via information convergence that may be applicable to the tribe could help build future tribal stabilities by manner of decreasing costs from lessons already learned. If costs can be decreased, perhaps, output and mix may be increased.

However, increasing output also requires increasing labor. One may cut wages or court with employee buy outs and free capital for more labor resources. But as that option runs out .The second option is to intensify the work of the laborer. But it too has drawbacks in the form of employee absenteeism, lost productivity and diminishing quality. The final option is to optimize via re-organizing organizational structure and improving the instruments of production.

Part and parcel to instruments of production is their reproduction enabling more efficient process to an end and reflective of adaptive challenge. The instrument production pouch, similar to that of a carpenter has two pockets. One might call them technical and labor. The technical pocket holds, “machinery of production”, the necessary infrastructural supports. There might be a new more efficient machine of diagnostic potency. It might be the electrical power grid. It might be air transport. It might be communication. Again, each tribe with its own circumstance. The second pocket holds labor. Labor wages being equated by supply and demand produce labor power value of surplus consideration in the equation of revenue. The worker having labored over many process of commodity building owns not the commodity. With repetition of worker process to commodity the investor will consume the original technical investment courting profit and the ability to reproduce instruments of production. Indeed, there is surplus value generated by labor. It is all about man and machine. With these two pockets of instrument production, that is labor and technical, reproductions deliver the commodity. Where are we now? The act of meeting quota was yesterdays standard. What might the production possibility frontier look like?

Maybe, it is the tripartite team who seizes, leverages low costing “workable” solutions and increases mixed output have identified an economic adaptive challenge. At the end of the day, the commodity and its consumption might be of surplus value comparative to the production cost of the commodity. This allows capital accumulation.

As there is an air of adaptive challenges: how does one find that starting point? What are/is the core priorities? Should we change the way we operate and deliver upon commodity to leverage the priority? Should we seek to increase revenues to leverage the priority by seeking system wide efficiencies, streamlining duplications? Is it man or is it machine, or maybe both. Should we sustain resources for the short term or in the long run in an effort to buy time? Do we as a tripartite diversity make the best use of our resources?

You can find more about Summit for the Future on Risk in the Books, Articles and Links section.

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