Don’t be satisfied with stories, how things
have gone with others. Unfold
your own myth, without complicated explanation,
so everyone will understand the passage
We have opened you.
then comes a moment of feeling the wings you’ve grown, lifting.
– Rumi, “Unfold Your Own Myth”
I love this poem! I read it when I feel lost. I read it when I feel inspired. It speaks to the strength of the individual…how we can each overcome the social forces buffeting us as we make our way through the world. Rumi captures the journey of “Me” in a sea of “We.” I can’t think of a better reflection of the inspiration behind my company, InSun, a practice designed to narrow the gap between the aspirations of technology and the realities of healthcare. We do this by placing humans first in everything we do.
Why humans first? My career has been a journey of connecting people and ideas to improve health. The challenge is to do this within a system designed for institutions, not humans. A disjointed and siloed system in which the needs of individual patients (the “Me”) are drowned out by the cacophony of insurers, hospitals and pharmaceutical companies’ (the “We”) clamoring for attention to their own competing interests.
I’ve personally witnessed the “Me-We” play out in emergency departments where I delivered care, in corporate meeting rooms where the cost of care took center stage and within start-ups passionate about disrupting our “broken healthcare system.” It’s painful to watch and incredibly frustrating to see human-centered solutions withheld from those who need them because the “We” fail, and sometimes refuse to align. Today, US healthcare spending accounts for nearly 18% of GDP, higher than in any other developed nation, while many US health outcomes are only on par with those of developing nations. In effect, the “We” are failing to deliver value and robbing healthcare consumers of a dignified human experience.
Why InSun? I grew up, professionally speaking, in the trenches of Chicago’s ERs where the courage and resilience of my patients left an indelible imprint on my soul. Every day was a reminder of our collective mortality and a confirmation that individual fates are largely determined by chance: by the zip code where someone happens to be born and the economic conditions that come with it. Seeing this play out in the ER, I came to realize that the social determinants of health are not an academic concept but a concrete reality. Yes, we saved lives and responded to tragedies of every size and scale, but more often than not, we were bandaging a slew of social ills and helping humans navigate a system designed for institutions.
Nowhere was this disconnect more painfully palpable than when hardworking men and women, unable to look me in the eye, would softly whisper that paying for the medication I had prescribed meant going without groceries, electricity or heat. These were dignified, honest and kind people who could easily have been my parents or grandparents. Despite having health insurance, my patients often found it necessary to forgo treatments that would prevent heart attacks, ease breathing, manage blood sugar or treat infection. Healthcare was their greatest vulnerability.
How was it that one of the world’s most technologically and scientifically advanced healthcare systems was failing to deliver a dignified human experience? Curious about this question and inspired by my patients’ stories, I set out to understand the economics of healthcare in America.
For the next decade, I navigated the board rooms and work spaces of corporate America, where I saw, quite starkly, that the engine driving any institution to fund research, develop life-saving treatments or provide access to healthcare is profit. I wasn’t surprised though I will admit that the vast sums under discussion and the unyielding focus on bottom lines took my breath away.
Healthcare is so expensive that the nation’s largest and most storied employers have to tie the price of their products and services to the impact of each healthcare dollar spent. CFOs and HR professionals, supported by an army of consultants, analyze the cost of each airplane delivered, car manufactured or food item produced in terms of the “per member per month” cost of healthcare for each employee and his or her dependents. Smaller companies with fewer resources struggle to balance the costs of life-saving medicines for one employee with the need to make payroll for all employees.
The purpose of health insurance, it turns out, is to give humans access to “discounted” healthcare while containing the costs of the services they consume. Dedicated people, in a sea of cubicles and open workspaces, administer a system of oversight tasked with reducing the rise of healthcare costs.Yet very few of those administrators know the real cost of anything, which means C-suite executives are compelled to hire waves of high-priced consultants to try to make sense of it all.
In corporate America, just like in hospitals, clinicians are employed to help the “Me” navigate the world of “We.” On occasion this leads to dystopian conversations between CFOs, who are beholden to shareholders, and clinicians, who are sworn to “Do no harm.” Those clinicians find themselves having to explain to laypeople the nuances of human disease, the pharmacology of drugs and the limited availability of assistance programs to cover medical expenses. Frequently these doctors prevail, convincing employers to pay for medically necessary services, treatments and transportation despite the high costs associated with them. But not always. Observing all this, I came to see that healthcare is everyone’s greatest vulnerability.
Today American healthcare is in the midst of transformation — an excited, energetic flurry of technology-based innovation fueled by billions of dollars of investment. And digital health is the Viagra stimulating every healthcare C-suite initiative. Executives, entrepreneurs, technologists and investors (the “We”) are defining healthcare’s future for the “Me.” With promises of simplicity, personalization and precision, technologists and big tech companies are telling consumers that they have what it takes to make things better. And yet, just like in hospitals and corporations, the “Me” are not present in any of these discussions and decisions.
I’ll be honest. I have a soft spot for healthcare entrepreneurs. I’ve worked with well over 100 companies across the globe, each of which demonstrate the same qualities and motives that inspired me as an emergency physician. Like ER docs, healthcare entrepreneurs are driven to create, problem solve, inspire, help and do good. They’ve chosen to forgo the promises of fame and the “immediate” riches of coupon platforms and rideshare apps to work on solutions that improve health. They’re playing a longer game with more incremental gains and higher risks. Through an array of apps, interconnected devices, bots and algorithms, the new “We” promise the “Me” a more human-centered and dignified healthcare experience.
InSun, which means “human,” is as much an advisory as it is a call to action. We believe that patients are best served when the “We” works with the “Me” to co-create solutions to healthcare’s challenges. We intend to use our real-world expertise to foster a movement based on our values. We’re excited for the journey and hope you will join in this endeavor to create a dignified healthcare experience for each of us, for our families and for the generations to come. Until next month…