A recent post by Joe Flower on The Health Care Blog titled “Health Care as a Complex Adaptive System” applies the idea of game theory to the debate about healthcare reform with some very interesting results.
Flower notes that all dynamic systems continually adapt, but that over time the healthcare system has become optimized to benefit those with the greatest resources. The challenge is that while all systems are also to a degree self-correcting, healthcare has not righted itself and is swamping the economy. In the process, patients are paying the price, both literally and in terms of compromised care, including healthcare translation.
In game-theory terms, we have, according to Flower, reached a “Nash equilibrium,” which is a kind of systemic paralysis in which no one part can benefit from a unilateral change in strategy. In fact, such moves are usually punished. A doctor who decides to spend more time with each patient, for example, may pay the price economically and maybe even professionally.
What’s clear is that a change is necessary. Hopefully the current administration’s commitment to finding a solution and the vote of confidence expressed last week by a number of healthcare industry trade groups will help us build a system that serves ― and communicates with ― all patients.