Nancy Napier: Let’s rethink health care from top to bottom

No one disputes that health care, insurance and its regulation are complicated. Even President Trump agrees. So how can we grapple with the complexity of such a messy problem?

I don’t have solutions but I’ve been looking around for people who wrestle with problems that are big, complex, and appear unsolvable.

Leyla Acaroglu’s approach intrigues me. Could we use it to retool the whole idea of how we do health care?

Acaroglu is an award winning designer, sociologist, entrepreneur, sustainability provocateur and noted TED speaker. With a Ph.D. in change-centric disruptive design from RMIT University in Melbourn, she developed the Disruptive Design Method that looks at the how something is used to determine how it can be better designed — especially from an environmental impact standpoint. As a result she is a 2016 Champion of the Earth for her sustainability innovations by the United Nation’s Environmental Program.

She argues that when we look at complex problems, we need to understand that many systems are connected, especially three big ones: social (rules to help humans live in harmony), manufactured (the ways the material world works), and ecosystems (the natural “services” like clean air, water, food, and other resources, that support the social and manufactured systems). She calls it “life-cycle thinking.”

My brain hurts when I try to hold all of those ideas together, especially when I thought about how the social system so heavily influences the others.

Then Acaroglu made my brain ache even more.

She suggests that systems thinking 101 should consider several rules. Two struck me especially hard.

The first is “Today’s problems are often the result of yesterday’s solutions.” That’s part of what we have with health insurance — solutions that worked in previous times but may not now. Do we know which those are? Is the reason for their existence still valid?

A second 101 rule is that “Easy solutions can lead to negative impacts elsewhere.” I have this image of a Alexander Calder mobile—we solve or pull on one part and that forces another part of the mobile to move, often in unexpected ways.

This leads me to wonder who are systems thinkers we can draw on for help going forward in health care? What examples can we examine from elsewhere (other countries) that have sorted some of the challenges? What if we took Acaroglu’s advice and rethink the problem of from its origin.

“If we want to overcome the systemic issues behind today’s problems, then we need to change the thinking that led to them to begin with,” she writes in her Disruptive Design blog.

Maybe I should put some good student thinking on this one.


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