About six weeks ago, Jason posted “Vista, Office, and Outlook 2007 are a Nightmare”* over on Spend Matters [WayBackMachine]. Since that time, one hundred comments have materialized in response to this post, and thirty three of those comments, or one-third, have been with respect to Dell machines – and similar problems. Furthermore, the first Flaming Laptop, if I recall correctly, was a Dell.

In my view, a good supplier is one that delivers a good product of good quality at a good price in a good time frame. It seems that Dell is only hitting three of these four metrics: quick delivery, competitive price, and comparable hardware power – quality, it seems, has slipped through the cracks. Quality assurance requires you test everything you use in the construction and delivery of your product and service – not just what you manufacture in-house. Dell seems to have forgotten that. It doesn’t matter what you are buying, who you are buying it from, or what their reputation is. Any supplier can make a mistake. And if you’re the one delivering the product to the end customer – it’s your responsibility to make sure all mistakes are caught before a product is shipped. At this point, all I can say is I’m glad they’re not making pet food, otherwise, with the recent fiasco, I do not think that a single pet in North America would be safe!

* All posts prior to 2012 were removed in the Spend Matters site refresh in June, 2023.

Although not a common topic for this blog (as my only post focussed on the topic to-date discussed The Dismal State of US Health Care), it is an important one, and a favorite of vendors like VendorMate (acquired by GHX, acquired by Thoma Bravo) and CombineNet (acquired by Jaggaer). I don’t know of a single country where health care is not as good as it could be, and should be.

The reason for this post is a recent article by The McKinsey Quarterly which discussed some “Universal Principles for Health Care Reform”. According to the article, a health care system’s fundamental problems can be addressed if the decision makers recognize the interlocking nature of its elements.

A premise of the article is that, in health-care, regulators struggle to reconcile three competing objectives: equitable access, high quality, and low cost. Furthermore, increased supply creates additional demand for care and often fails to generate commensurately better outcomes and higher spending does not necessarily correlate with higher-quality health care. And without a comprehensive perspective, a remedy for one aspect of the health care system might generate unintended – and potentially negative and costly – implications for another part.

The authors contend that the development of a comprehensive perspective requires a framework to help guide decision making. To this end, they identified the primary elements of supply and demand and derived six principles that apply to a broad spectrum of health care systems. Furthermore, they derived a seventh principle, concerning the organizational and operational framework necessary to implement the concepts.

The principles they derived are the following:

1. Prevent illness, injury.
2. Ensure value-conscious consumption of services, treatments.
3. Promote efficient creation of capacity for labor, infrastructure, innovation.
4. Safeguard the delivery of quality by providers.
5. Promote cost competitiveness.
6. Promote sustainable financing mechanisms to collect and distribute funds.
7. Build and organize capabilities of intermediaries to enable them to effectively manage the system.

With respect to each of these principles, they then define levers, or implementations, that can be used to achieve the principles. Furthermore, they also outline three main approaches to shape demand and supply: awareness, incentives, and mandates; under the pretext that local differences in health care systems need not preclude a structured, systematic approach to reform based on enduring, universal principles.

What I do not understand is why it needs to be so hard. For instance, why would not the following four principles cut it:

• Insure that treatment services are available to anyone who needs them. (Emergency and Life-Threatening services.)
• After insuring patients get the critical care they need, the next priority should be to prevent illness and injury in the first place.
• Be fiscally responsible in the delivery of health care services.
• Allow for a private, or semi-private, system in addition to a public system for alternate service provision, including provision of non-essential services.

For example, my point (3) would subsume (2), (3), (5), and (6); my point (2) would subsume point (1); my point (4) would subsume point (7); and my point (1) would seem to be the most critical of all – service is there when you need.

Now I know that it is difficult to define need, since each of us could define it differently, but I do not see why it is so difficult to bring healthcare into the twenty-first century. But then again, I do not understand how your average political system and politician can be so useless either. I guess I’m still too much of a mathematician at heart.

It’s a common known fact that american network TV steals, or at least allegedly steals, ideas for TV shows on a regular basis. (One of the more recent fights ws chronicled on Corante in “Your Million Dollar Idea is My Million Dollar Idea”.) And it’s also a known fact that most of the reality shows take all of your rights away just for the privilege to appear on them. (Take American Inventor for example.) And if they couldn’t steal jokes, some TV shows would have nothing left. (Without borrowed content, Family Guy would be nothing but dead air.)

However, some of us were kind of hoping the good old Canadian Broadcasting Corporation held itself to higher ideals. But that might not be the case. Check out this post over on BongWaterMusic on “Big and Mighty CBC Steals Little Guys Ideas”, March, 2007). Is the CBC trying to hone in on the action and steal a great idea from a little guy who’s been pouring his heart and soul into it for two years? I don’t know … but I will be following this story.