Think of proposed "solutions" like value-based care, alternative payment models, and the affordable care act as jobs in need of precise definitions, capabilities, and characteristics. If the goal is affordable accessible healthcare would you hire any of these for the task at hand?
Joseph Overton observed that in a given public policy area, ... only a relatively narrow range of potential policies will be considered politically acceptable. This "window" of politically acceptable options is primarily defined not by what politicians prefer, but rather by what they believe they can support and still win re-election. In general, then, the window shifts to include different policy options not when ideas change among politicians, but when ideas change in the society that elects them.--Mackinac Center for Public Policy
We are the society. Healthcare is the specific area needing new windows...are you going to hurl a brick or step back and imagine a better future--one that provides a vision of healthcare as a right for all citizens.
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In a world of "evidence-based" medicine I am a bigger fan of practice-based evidence.
Remember the quote by Upton Sinclair...
“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”