One of the best-designed systems in the country gets better


For the fifth straight year, the US highway system set a record low number of traffic fatalities. Through the ultimate combination of built environment, carefully-calibrated enforcement levels and incentives, and extensive buy-in from auto manufacturers, a large number of moving pieces with different agendas have come together to keep people safe in ways that most drivers don’t even think about.

This is the model health care should follow. Stakeholders are allowed far too much leeway to run rampant in pursuit of their own interests because there are so few people at the top who understand how everything works and can articulate a cohesive system with any kind of authority.

This, of course, is excellent news.

But if roads, like sickness, were privately held cash cows owned by 900,000 independent businesspeople, I guarantee the people at the top would be just as powerless. Medical treatment happens privately, behind closed doors, with very, very little proven standards– regulating 300 million people’s treatment and diagnosis is much more difficult than installing roadside barriers to prevent collisions with streetlights. Even those at the top have no idea, nor any precedent, about how to make profit-driven sickcare affordable and safe.

If auto-manufacturers didn’t get on board a few years ago with the fact that families don’t want to die in 65mph steel death traps anymore, cars would be much, much less safe (thank you Nader). 

Contact with the American Healthcare System is about three times as deadly as our highway system. I wish doctors and hospitals would actually start caring about their safety record and then marketing to their customers bragging about how safe they are, just as Volvo did back in the 80’s, twenty years ahead of any of the other auto makers.

One of the best-designed systems in the country gets better