It's no secret that health care delivery is convoluted, expensive, and ofte
n deeply dissatisfying to consumers. But what is less obvious is that a way
out of this crisis exists.
Simpler alternatives to expensive care are already here-everything from Ss
eyeglasses that people can use to correct their own vision to angioplasty i
nstead of open-heart surgery. Just as the PC replaced the mainframe and the
telephone replaced the telegraph operator, disruptive innovations are chan
ging the landscape of health care. Nurse practitioners, general practitione
rs, and even patients can do things in less-expensive, decentralized settin
gs that could once be performed only by expensive specialists in centralize
d, inconvenient locations.
But established institutions-teaching hospitals, medical schools, insurance
companies, and managed care facilities-are fighting these innovations toot
h and nail. Instead of embracing change, they're turning the thumbscrews on
their old processes - laying off workers, delaying payments, merging, and
adding layers of overhead workers. Not only is this at the root of consumer
dissatisfaction with the present system, it sows the seeds of its own dest
ruction.
The history of disruptive innovations tells us that incumbent institutions
will be replaced with ones whose business models are appropriate to the new
technologies and markets. Instead of working to preserve the existing syst
ems, regulators, physicians, and pharmaceutical companies need to ask how t
hey can enable more disruptive innovations to emerge. If the natural proces
s of disruption is allowed to proceed, the result will be higher quality, l
ower cost, more convenient health care for everyone.