How Do We Move Beyond Regression to the Mean?: Improving Health and Health Care
So given we agree there is a normal distribution for a given treatment and there are often many confounders for which we must adjust, how might we think about moving that normal bell-shaped curve, to the right, wherein society as a whole improves its health and health care? There are likely many ways to achieve such an audacious goal. All require, a structure and governance, a focused strategy, tactics and resources, financial and non-financial, to make the necessary changes needed. The ultimate success requires dedicated leadership, with a clear vision, the courage to lead towards a better place for all and patience, as it will take time, a variable we cannot always control for, decades in this case, to achieve.
This goes way beyond payment and insurance reform. Just as some believe, lowering the “corporate tax rate” will improve the lives of many, corporations investing in new jobs and innovative solutions for the future, I believe, addressing the “social determinants of health,” will narrow the coefficient of variation and inequities. By so doing we will have moved the mean of the whole country to the right. This, in and of itself is not enough but will provide a much needed win and impetus to do more. Tax reform is likely part of the solution. Regressive taxes often impact those who can least afford them, this too must be addressed.
As a nation, we continuously struggle to make meaningful change necessary to create a more sustainable health system. The federal deficit in the United States is approaching $20 trillion, much of which is related to our health care cost of nearly $4 trillion. Notice, I did not say Health Care system. There are no real mysteries here. As a society we have not adequately addressed many of the variables needed to actually move the curve to the right, to alter our current regression to the mean.
At this time in our history, let's not lay fault or blame, let us, together move the ball down the field moving the normal distribution to the right. Each of us has to do our part and we all need to take some responsibility. After all health care cannot and will not improve many of the problems responsible for our nations’ health.