1 Centimeter & Healthcare’s Dilemma


Blog by Joe Babaian

Greetings #HCLDR community far and wide! We are into the last weeks of the year — both Colin and I feel energized about the past 12 months of valuable conversations and anticipate an even better 2018. Who do we thank? All of YOU in the #hcldr community from long-time friends to the folks newly joining each week. The sustained brilliant contributions, thoughts, action plans, and desire to improve healthcare show exactly why I am so excited to see how we can move the needle further in 2018!


Rasu Shrestha


Poonam Khanna

In the last few weeks of 2017 alone, we have covered topics like Empathy, Connecting for Health w/guest host Poonam Khanna, Healthcare Communication, #AI (w/guest host Rasu Shrestha, Healthcare’s Productivity Paradox w/guest host Mitchell Josephson from KLAS, and the promise (or risk) of Digital Health. What do YOU want to talk about in 2018? Keep the ideas coming – let us know!

This week I want to share a personal story that reflects the some of the zeitgeist of healthcare right now in America. These themes are international and we want to hear from everyone based on their experience and understanding.

Healthcare costs and insurance. No, this isn’t about what’s right, what’s best, or even how to fix what so many agree needs fixing. This is about healthcare at the N of 1 and how we must stay engaged and active to create the future we all desire and deserve.

1 centimeter. 4/10ths of an inch. Not much is it? Of course, we all know that a centimeter in the human body is a lot when we walk around with such a delicate and wonderful gift. But it helps to be reminded when we least expect it.

I won’t bore you with too many details, so here’s what we have — my 12-year-old son was ice skating the day after Thanksgiving, Black Friday if you will. He slipt and fell as kids do, but this time another skater was whooshing by and in a flash a razor sharp blade sliced by his finger. No pain, just a strange feeling, and a run to find me rink-side. Take a look at the diagnostic image up top, you’ll see a very typical right hand for a 12-year-old. Look closer at the pinkie and you might see the slightest missing bit – not much mind you and certainly nothing catastrophic. Right?

1 centimeter.

1 centimeter one direction, and my son would have stood up, brushed off the ice, and laughed his way around the rink again. 1 centimeter the other direction, he would have lost an entire distal phalanx. As it happens, he lost just a bit of his finger while the blade only shaved the bone less than 1mm. For those holding their breath, he is OK, in good hands, and the repair is in process. In six months he’ll be good as new.

Almost everyone reading this will know that in the US, repairs like this will be well into the five digits – we’ll leave it at that. That’s not the point here. The point is does the healthcare system and our laws have the ability to understand and distribute care given the chaos of cause and effect? Good question.

Recently, during the heated healthcare coverage debate over the fate of Obamacare and the current administration’s suggested changes, Representative Mo Brooks of Alabama talked about the plan to allow insurers to charge people more when they have preexisting conditions. As quoted in New York Magazine:

It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives. They’re healthy; they’ve done the things to keep their bodies healthy. And right now, those are the people who have done things the right way that are seeing their costs skyrocketing.

Mr. Brooks conceded that many people with pre-existing health conditions have them “through no fault of their own” and therefore deserved help.

Brooks shared a common belief when it comes to distributing the healthcare load. Days ago, Mo Brooks announced he has been diagnosed with “high-risk” prostate cancer. Brooks lost a primary election this year to Roy Moore and this lead him to a realization as shared with The Hill:

Had I won, I would not have had time for my physical and PSA test. I would not have had a prostate biopsy. I would not now know about my high-risk prostate cancer that requires immediate surgery. In retrospect, and paradoxically, losing the Senate race may have saved my life. Yes, God does work in mysterious ways,

Representative Brooks further has shared that prostate cancer runs in his family – impacting both his father and grandfather.

No time for schadenfreude, a cancer diagnosis is always horrible. Period.

This brings us back to my point. Can a system parse through the chaos that often leads to a diagnosis? Even someone like Mo Brooks, sure in his beliefs and convictions was not immune to the vagaries of what preexisting really means and what that means for distributing care (and costs).

1 centimeter. An injured hand just avoiding disfigurement but still costing more than many could ever afford. An accident. Careless or chaos?

A prostate-cancer-cell oncogenesis at the microscopic level. Bad living, environment, genetics, or chaos? You see, I’ll argue there is no way to slice and dice this to determine the answer.

Let’s join the collective #hcldr community to examine healthcare’s dilemma.

Please join us Tuesday, December 19, 2017, at 8:30 pm ET (for your local time click here) as we discuss the following topics:

  • T1: How should limited healthcare resources be distributed and paid for?
  • T2: Where is the line between controllable factors and “chaos” when it comes to diagnosis/accidents? Is there a line?
  • T3  How might advances in healthcare technology make prevention the cure vs. fixing the damage later?
  • T4: In healthcare, how can empathy and the social contract track with fiscal responsibility?

Photo Credit: Joe Babaian





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