I am sure you have all read or heard a version of Goldilock’s and the three bears. Goldilocks finds one of the bears’ beds too hard, one too soft and the final bed is just right, which allows her to lie down and fall asleep.
At the moment the United States is having an existential crisis about the cost and value of its healthcare system. A series of articles in the New England Journal of Medicine (NEJM) is asking whether or not the massive amount of money that the US spends on healthcare is delivering good value for money. It is quite clear that the US is an outlier when you look at a simple integrator of population health outcome (see figure below).
At the same time that the NEJM is reflecting on the poor value that the US healthcare system delivers there are fundamental changes happening to healthcare delivery, which are being rapidly adopted because of the impact of the coronavirus pandemic.
As a person with a chronic disease is your MS being under-managed, over-managed or managed just right? Maybe you don’t know how to answer this question, because you don’t know what an ideal MS management pathway looks like.
A related issue is a fundamental battle been two ideologies that is currently playing out across the globe; the socialist European model of healthcare versus the neoliberal or capitalist US model of healthcare. Should the management of MS at a population level be value-based, i.e. based upon the utilisation of limited resources that deliver value by improving the length of life and/or increasing the quality-of-life experienced by a population of people with MS? This implies that the focus is on the population and not the individual.
Are these a topic worth discussing on this blog?
Eric Schneider. Health Care as an Ongoing Policy Project. N Engl J Med 2020; 383:405-408.