Abstract
After decades of retooling and resets of the healthcare system in the United States, patients are left wondering if they were ever at the center of the decisions and choices driving the evolutionary journey. After half a century of several iterations of good and bad ideas, there are signs that some aspects of the patients’ experience are better and some are worse. Some of the policies seem arbitrary and poorly conceived, while others died in the vineyard of execution. And still, many more seem misaligned with the goals they were intended to achieve. Because the healthcare industry has so many stakeholders with different needs, wants, and expectations, it is always a challenge trying to balance the needs of the stakeholders with the constraints of the industry. Rather than give up in the face of the mountains of challenges facing the healthcare industry, I decided to write this book in an attempt to refocus the bright lights on the patient and his/her interpretation of value. Although the healthcare value creation process largely occurs on a person-to-person basis and often within the confines of an organization, a facility, an office, or clinic, it is still subject to a whimsical pattern of laws and public policies. An awareness of the macro-level factors will deepen our understanding of the challenges facing the industry, while the micro-level factors will help us focus on the daily encounters. Any attempts to understand the healthcare value creating process must be informed by the national and even global perspectives.