A Problem Well Stated

“A problem well stated is a problem half-solved.”
Charles Kettering

Clearly health care presents both significant challenges, as well as opportunities for employers as health care purchasers.  With wide, wild, and apparently unwarranted variations in both provider pricing and quality (the two components of “value”), the opportunity to improve the value proposition of health care is simply enormous.

To solve a problem, however, we must begin with stating it properly.  As such, calling US health care today as a “broken system” – as it is typically referred to – points us in the entirely wrong direction.  It does so for two reasons.  US health care is only euphemistically a “system.”  A better term –  applied by Dartmouth Atlas founder Dr. John Wennberg nearly 50 years ago – would be “hodge-podge.”  And it is not broken in the least.  In fact, as founder of the internationally respected Institute for Healthcare Improvement  and former head of CMS Dr. Don Berwick puts it, “Every system is perfectly designed to achieve exactly the results it gets.”

If we’re serious about improving health care’s efficiency (keeping in mind that Bloomberg Business rates us as 50th of 55 countries in efficiency) and effectiveness (recognizing that medical errors are the third leading cause of US deaths), we must address the cause:  a dysfunctional market – by which I mean a market that currently brings disproportionate value to the various sellers than to its employer and government buyers and is therefore neither reciprocal nor sustainable.


The focus of CBGH in 2018 will be exactly this: to collaborate with any willing organization so as to change the dynamics of today’s health care market by promoting and sponsoring the requisites of value-based purchasing: pricing transparency, reference-based pricing and contracting, quality transparency, alternative and aligned payment methods, adoption of common performance measures, and, benefit designs that incentivize consumer engagement.  To the extent that purchasers employ these tactics, they will fundamentally change health care by changing the marketplace.


Join us.  It should prove to be an interesting year.