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Getting Better But Feeling Worse: Why Health Systems Innovation Begins with the Patient as Consumer

Joseph F. Coughlin, Ph.D., Senior Lecturer, Engineering Systems Division, Director, MIT AgeLab

Already under siege, the current health system is poised to face its greatest demographic challenge. The nearly 80 million baby boomers -- the largest generation ever of older Americans -- are now in chronic disease prime time. The boomers are not just ‘more old people’: they are America’s consumer generation. Since birth they have been catered to, taught to expect better, faster, cheaper and personal -- now that healthcare is about them and not just their parents, what will they demand?

Current healthcare discussions focus on improving ‘the system.’ Squeezing for efficiencies here. Improving outcomes there. Providing better access. While these may be both noble and necessary, they are incomplete. All levels of government, insurers, employers, retailers and providers must think beyond systems improvement and address systems change. A new generation of older consumers (and voters) assesses improvements from where they experience the system, not from improvements in the system as a whole. Will current solutions and strategies under consideration improve the system’s performance, but leave the public feeling worse?

MIT System Design and Management Site