A valuable question

Glorfindel's talking about this piece on Michael Porter in the Boston Globe. The gist of both authors is: Porter is has a lot of credentials, so his assessment of US healthcare could cause real change.

Porter and Teisberg have a deceptively simple diagnosis: Healthcare competition today works on the wrong level. The players -- health plans, payers, providers, and doctors -- engage in what the authors call ''zero-sum competition," dividing value rather than creating it. They seek to transfer costs onto one another, limit access to care, hoard information, and stifle innovation, all to the detriment of patients.

The right kind of competition should occur at the level of preventing, identifying, and treating patients' conditions and diseases, Porter and Teisberg assert.

Oh! Ok. I agree; it's deceptively simple. So deceptive, and so simple, that it really doesn't answer anything. I haven't read Porter's HBR paper, though neither of the reviewers above seem to have, either (it costs $495 to download the pdf -- how's that for runaway costs?). Otherwise, they'd have discussed just how Porter's idea for encouraging competition to treat diseases will create savings in excess of, say, excluding the uninsured, the old, the sick. There's value in treating this people, yes, in very human terms. But monetary savings?

I remember Bill Clinton asking, ten years ago, why market forces do such a good job generating value in many industries, but fail so thoroughly in healthcare and education. He called it the most pressing question facing America. I don't think Porter has come up with the answer.