Living in uncertain times
Some simple lessons from our nation’s farmers and healthcare providers
What’s holding back the economy? What’s troubling Wall Street? What’s really ailing America’s healthcare system? It’s quite simple: There’s just too much uncertainty. All we need is a little more confidence about what the future might hold and everything should start to improve significantly. Or so we’re told.
We hear it constantly. If only small businesses could be more certain about their regulatory burden or their effective tax rates, they might be more willing to start creating more jobs. After all, they are the job creators. So we’re told.
The U.S. Supreme Court’s ruling on the Patient Protection and Affordable Care Act was finally going to bring about more clarity and certainty regarding the law’s farreaching effects on employers, payers, patients and providers. So we were told.
The eurozone’s public-debt pandemic has spread from Greece to Spain to Italy and beyond. Back home, Taxmageddon lurks. The fiscal cliff looms. And a competitive presidential race is nearing the home stretch.
Oh for even a small dose of that elusive certainty to soothe our angst. Unfortunately, that medicine would be snake oil. Blaming a lack of certainty for our dysfunctional decisionmaking is more properly labeled excuse-making, because with very few exceptions, certainty is not of the real world.
Kudos to the leaders, innovators and laborers, no matter the industry, who move forward in their work weighing risk and reward but almost always taking a leap of faith to some degree.
Consider the nation’s farmers, especially in this summer of recordbreaking heat. Their efforts are almost the exact opposite of betting on a sure thing. Everyone knows how fickle nature can be, but how many of us would have guessed that during this season nearly 80% of the country would experience some level of drought? However dismal the final harvest, farmers will be back next year, we can be sure of that.
Also deserving recognition are the healthcare players, notably hospitals, physicians and payers, that continue to take a chance on the grand experiment of accountable care. The concept, driven by provisions of the health reform law, promotes improved care at lower cost through a coordinated approach emphasizing wellness and prevention. And the players get to share in savings achieved.
As Modern Healthcare reporter Melanie Evans writes in our second annual Accountable Care Organizations Survey report (See pullout section opposite this page), many ACO partners were willing to take a chance on the sustainability of the concept even before the Supreme Court ruled on the legality of the ACA. Striking down the law would have put Medicare’s support of the program in peril.
As Evans writes of one health system investing in an ACO, “Officials believed that preparation for Medicare accountable care would not go to waste despite the uncertainty ahead of the (Supreme Court) decision. If the court threw out the ACA—and with it, Medicare accountable care—fledgling commercial efforts would nonetheless continue.”
Lastly, we would like to pay tribute to another person who never let big-time uncertainty get in the way of a pioneering role in our nation’s history. This person is Sally Ride, who became America’s first woman in space with her trail-blazing flight aboard the space shuttle Challenger in 1983. Ride died last week at age 61 after a battle with pancreatic cancer. Her vocation and passion, in addition to her risky work at NASA, inspired children, especially young girls, to learn to love the subjects of math, science and engineering, just as she did.
She will be missed, but her legacy is indeed certain.