Saturday, September 17, 2011

White House 1





On Tuesday morning about 20 health organizations, mostly large hospitals like Methodist Healthcare, will meet at The White House for a day of opportunity solving. We will not be coming to complain that we are facing harder challenges than any generation since humans figured out how to walk on two feet. It is a group of grown-ups trying to do what grown-ups are supposed to do--work together in the interest of those that depend on us to do the right thing.

These are tough times in more ways than can be listed in a blog. Government and health organizations facing radical changes driven by technology and global interconnectedness that has bound us together in ways we don't even know how to manage. We are swimming--almost drowning--in more information that we we can make any sense of. That's the new normal. But this is not entirely new, which is why I began with the picture of one of the bronze carvings on the front door of Grace Cathedral in San Francisco.

It is also still normal that adults try to make decisions to work with what we have to give hope a chance. When you fill up a room of 15 or 20 faith and community-based healthcare organizations and federal experts, you have a LOT to work with. Even one of the more modest systems--our own in Memphis--has 10,000 employees providing care to 64,000 inpatients and another quarter million outpatients every year. About 8% of our total revenue covers those who pay nothing, with another 2% only partly covered by the government and we still give another 2% to our University partners to train medical professionals. We absorb that $156 million and still have an A+ bond rating. It is quite a feat of skilled--faithful--management, but we and others like us do that. It is not a small point to note that these faith-based institutions accomplish this in very tight relationship to the federal, state, county and local governments beginning with the very large portion of our payments that come from Medicare or Medicaid, not mention the grace in not having to pay taxes. That's what we were designed by an earlier generation of grown ups to do and it works pretty well.

We are meeting at the White House because we think it could work even better.


Warren Buffet knows you make you most profitable investments when the market is paralyzed by fear. The most significant social investments are also made in times when things seem to be falling apart. You can make different connections and alignments precisely because the pieces are apart. When the ground shifts, new things are possible.

The picture is of the rock bent into gorgeous new shapes just north of San Francisco, which sits above the fault line. The earthquake shaking health organizations these days is the fundamental shift in science that has shaken our wall to the point they are almost irrelevant. The wall has collapsed between the old idea of public health (prevention, surveillance) and healthCARE (treatment, disease management). We all tend to live inconveniently and expensively long, precisely because of earlier success in both public health and the treatment organizations (hospitals).


Our common challenges are conditions we can live with over time, sometimes shockingly long periods of time even with AIDS, diabetes and many cancers that only recently were death sentences only demanding lament (hence the picture of the poignant AIDS Interfaith Chapel inside Grace Cathedral).

These high-capacity organizations built in one paradigm now have to re-organize ourselves around these new opportunities to extend the promise of 21st century science to our communities. That's really what is happening on Tuesday; not pleading, but planning how to be together in a new way so that all the assets are aligned to serve what is now possible.

That sounds so naive, doesn't it? But it is the cold truth that many billions of dollars of health assets will be in the room that are owned by and accountable to faith or community. Their adult leaders are paid pretty well to make sure those assets provide a maximum return on the investment measure in the health of the communities that have trusted them with such extraordinary possibilities.




From time to time it is still normal for adults to do the right thing. The United Nations was formed in the aftermath of the catastrophic events of World War Two, partly as a result of fervent prayers offered up and still remembered in Grace Cathedral (marked by this wall just inside the front door). Adults to that kind of thing. And they still can.

Tuesday's work is far less ambitious for we already have all the institutions we need. We just have see new ways to learn from each other and work with each other. We don't have to invent water, just rearrange the plumbing so that health--and maybe a bit of justice--can flow down as it is intended to do.

- Posted on the journey

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