The US 4SOS

Before hitting the Scott Bridge in Baltimore, the ship's captain sent an SOS distress signal. The container ship Dali appeared to move sluggishly before striking the Francis Scott Key Bridge in Baltimore on Tuesday. Yet it delivered a force so large that one reasonable comparison is to a rocket launch.

How could something traveling slower than a casual bike rider cause such a devastating impact? The answer lies in its mass: roughly a third to a half of the Empire State Building.

The "healthcare' ecosystem has been sending distress signals to Americans for over 100 years, describing it as sustainably "unsustainable" as long as politicians are willing to add to the $35T national debt to pay for it.

America does not have a "healthcare system". Instead, we have a sick, siloed, sick care system of systems (4SOS).

Sick: Characterized by poor outcomes, prohibitive cost, poor experience, and inequitable access

Siloed: Little of no data interoperability or data sharing and a painful patient and doctor experience exchanging and accessing medical information

Sick care: We have a sick care system masquerading as a healthcare system. Over 95% of the $4.5T is spent taking care of sick people.

System of systems: There is no one system, but rather a patchwork of systems, insurance companies, payers, hospitals, and healthcare professionals

Transforming the 4SOS to healthcare will take a BIG FIX.

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In the current era of digital disruption, the pace of change has dramatically accelerated, leaving traditional risk management wisdom lacking. Across a variety of industries, technology-enabled disruptors have changed the rules. Many brands that moved cautiously have dramatically increased their risk of irrelevance or set themselves on a path to extinction. This author thus argues that playing it safe is in fact the riskiest choice. He illustrates this with the example of traditional brick-and-mortar retail companies that chose a “timid transformation” — as well as those that effectively pivoted and avoided that fate. Moving faster doesn’t mean being reckless or endless moonshots, but cultivating a culture of experimentation and finding ways to “shrink the change” so that companies can better deliver value to customers.

If the past is prologue, the Baltimore harbor will be open much sooner than real healthcare and politicians will continue to ignore the distress signals. Then we the taxpayers will have to clean up the mess when the whole thing collapses.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack