A Health Care Renaissance?

The stage is set for a complete rebirth of our healthcare system.

The COVID-19 pandemic, a new wave of technological advances, and a renewed awareness of the historical deficiencies in healthcare have all led to a monumental inflection point.

A new chance to solve old healthcare problems.

I had just stumbled in late to a Zoom meeting when I heard Stan Dunlap, SVP of Total Rewards at Salesforce and panelist at ReWork Health, proclaim “We were in the midst of a healthcare renaissance.”

Surprised to enter the conversation on that note, my mind quickly began racing to find the points of intersection between 15th-century Italy and 21st-century America.

Then it clicked. The rebirth of Europe, a time that left behind the fixed ideas of the Middle Ages and created the beginnings of the modern world as we know it, may be the perfect prism for understanding the period we are entering for U.S. healthcare.

Just as the 14th-century Black Death pandemic led to fundamental shifts in all aspects of life in the Middle Ages, the COVID-19 pandemic has catalyzed wide-reaching reform today. The invention of the printing press democratized knowledge and led people to challenge institutions, while today’s increased access to personal health information empowers people to drive their own healthcare decisions. We even have something akin to a modern patronage system, with the likes of Tiger Global backing healthcare entrepreneurs with the same vigor that the Medici family supported Italian artists, scientists, and writers.

Health care in this country is undergoing an exciting revolution, even as those on the front lines of COVID-19 continue to fight their toughest battles yet. The same way da Vinci first incorporated scientific principles into drawings and Brunelleschi advanced mathematics to design immense buildings and expansive domes, we are making extraordinary advances in biotech, gene sequencing, mRNA, CRISPR, and precision medicine. But even as our scientists and practitioners develop new innovations at a previously unimaginable rate, we must consider: Can our healthcare infrastructure support them in these era-defining advances?

In his famous and profound Atlantic article, How American Health Care Killed My Father, David Goldhill captured the “terrible and perverse results” of our healthcare system’s misaligned incentives. While the system still suffers from the same ills he decries—complexity, hidden costs, and a bias for treatment over prevention—I believe we are better positioned today than ever before to finally solve these problems.

So, why now?

We have in place all the ingredients—dedicated clinicians, entrepreneurs, healthcare leaders, and innovators—to make the next decade a transformational one for healthcare. But to truly capitalize on all this potential and emerging good, we need to be intentional. We must systematically rid ourselves of what has held us back from what we are all here to accomplish: better experiences, better outcomes, and lower costs. The masters of the Renaissance had access to emergent tools and conditions that allowed them to flourish. What is it about our time that makes it equally rich with potential? Here are some of the key components:

• There is a rise in dissatisfied healthcare consumers—and trends to empower them. High deductibles, co-insurance, out of pocket increases, and opaque pricing. There is no greater force than a dissatisfied consumer to drive change and much-needed market convergence. The burden has been placed on consumers, and they are ready to start fighting back.
• Technology is making its much-anticipated debut in the world of consumer healthcare. We now have apps with useful tools, programs to scale accessibility, and information available at the fingertips of both patient and physician. Virtual care and digital therapeutics are ushering in a brand-new standard of care impossible before the smartphone. Consumer healthcare has long felt like the last frontier for technological transformation. It feels like it is finally being discovered.
• Specialization is broadening the realm of possibilities. It used to be that your PCP guided you on your healthcare journey. Today, there are hundreds of companies in categories like women’s health, diabetes, adolescent behavioral health, and beyond. While this has generally been helpful for consumers, it has also complicated and added noise to the landscape, so much so that we need apps to help us choose which specialty health apps to use. While the expansion of choice is good, we need companies to align on one common goal—helping patients access resources they need when they want at a reasonable cost.
• Tools for the rich are being democratized and made accessible to all. Concierge medicine through One Medical, healthcare navigation through Rightway, and family planning through Progyny. These types of services used to be reserved only for those with privilege. Raising the standard of care is important, but it’s only meaningful when it’s raised for all, which is facilitated by technological advancements.
• Talent is flooding the healthcare and digital health space the same way it did in the finance industry a generation ago. Health care now offers a similar financial upside with a much greater opportunity to have a positive social impact. There is an emerging crop of talent that is hungry, diverse, and ready to disrupt in a way that healthcare has not experienced before.
• Money is flowing into emerging businesses. Health care was not an easy choice for investors for too long. Regulatory hurdles, reimbursement, value-based care, binary risk—healthcare has many of the risks that tend to make investors shy away. So they stayed on the sidelines, wary but fascinated with an industry that produces 20% of our GDP. While all the risks prevail, there are mitigants and approaches that now make investing in healthcare hot. Recurring-revenue businesses, risk and dollars shifted from the government to private companies, and technology overlays to complex conditions have all changed the investing narrative. Outcomes like Livongo, One Medical, and Doximity are all certainly helping the case.
• Employers are finally saying, “Enough is enough” to rising costs.” For a lot of companies, healthcare has become their second largest line item on the PnL and they know they need to get it under control or face significant consequences. This is a conversation that has been elevated to the C-suite, with the focus on trend and impact as pronounced as ever. With more attention, expertise, and buy-in, the conversation and strategy around the true economic stakeholders are as strong as they have ever been, and they are not going to keep perpetuating the status quo.
• The COVID-19 pandemic cannot be ignored, both for what it did to raise awareness around some of the inadequacies and inequities of healthcare and for the way it has started to tear down some of the bureaucracy that stymies innovation. In 18 months, we witnessed 30 years of progress in consumer behavior, telemedicine, and digital transformation. And there’s no turning back.

So, now what?

With an unprecedented set of conditions aligned to support a renaissance in healthcare, what are the necessary next steps? Technology needs to move faster, consumers need to be smarter, employers need to be more discerning, and insurers need to be more aligned. The list is long, but it doesn’t require extreme (and likely unactionable) moves like going to a single-payer system or ending insurance companies’ profits.

Find out the seven foundational action items for the healthcare system—doable today—that will lay the groundwork for the healthcare renaissance.