A New Synthesis

Document Type : Editorial

Author

Institute for Health and Social Policy, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

Abstract

We are on the eve of a revolution in health policy that will forever change our way of thinking about health and healthcare. A few years from now, our vision of the organization and the administration of healthcare services will be transformed.
 
This is not a revolution born out of crisis, albeit the financial pressure on public and private funders of healthcare is clearly at play. It has not been induced by technological change, even if new means of acquiring and analyzing large amount of data—and consequently, unforeseen possibilities of testing hypotheses and answering puzzling questions—are among the most evident determinants of innovation. It is not a revolution driven by a clique or a conspiracy, although I will mention a few (intellectually) leading figures without whom the movement might have been less decisive.
 
It will be the third time in my lifetime that I have witnessed such an upheaval. The first revolution took place in the 1970s, a decade or more before I began my training in health administration. During those years, the field that we now know as “health administration” or “health policy”, distinct from medical care or hospital management, emerged as the result of an intellectual breakthrough. It happened when leaders in our discipline realized that instead of just trying to adjust supply to an ever-growing demand, our most important task was to align health services with the population’s health “needs”.

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  1.  

    1. Donabedian A. Aspects of Medical Care Administration: Specifying Requirements for Health Care. Cambridge (MA): Harvard University Press; 1973.
    2. Forest PG. The comparative study of disciplinary strategies in health administration [in French]. Sainte-Foy (QC), LEPA: Laval University; 1990.
    3. Kohn LT, Corrigan JM, Donaldson MS. To Err Is Human: Building a Safer Health System. Washington D.C.: National Academies Press; 2002.
    4. Frenk J, Donabedian A. State Intervention in Medical Care: Types, Trends and Variables. Health Policy Plan 1987; 2: 17–31. doi: 10.1093/heapol/2.1.17
    5. Berwick D. The Moral Test [internet]. 2011. Available from: http:// www.healthcarechaplaincy.org/userimages/IHI-FINAL-Forum- 2011-Berwick-Plenary.pdf
    6. Pescosolido BA, Perry BL, Long JS, Martin JK, Nurnberger JI Jr, Hesselbrock V. Under the influence of genetics: how transdisciplinarity leads us to rethink social pathways to illness. Am J Sociol 2008; 114: 171–201.
    7. Diez Roux AV. Integrating social and biologic factors in health research: a systems view. Ann Epidemiol 2007; 17: 569–74. doi:10.1016/j.annepidem.2007.03.001
    8. Krieger N. Embodiment: a conceptual glossary for epidemiology. J Epidemiol Community Health 2005; 59: 350–5. doi:10.1136/jech.2004.024562
    9. Ubel PA. Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. New York: HarperOne; 2012. doi: 10.1007/s11017-013-9255-3
    10. Oliver A . From Nudging to Budging: Using Behavioural Economics to Inform Public Sector Policy. J Soc Policy 2013; 42: 685–700. doi: 10.1017/S0047279413000299
    11. Forest PG. A Tale of Two Perspectives. Healthc Pap 2012; 12: 58–62. doi:10.12927/hcpap.2013.23226
    12. Gawande A. The Cost Conundrum: What a Texas Town Can Teach Us About Health Care. The New Yorker [serial on the internet]. 2009 June 1. Available from: http://www.newyorker.com/ reporting/2009/06/01/090601fa_fact_gawande
    13. Wennberg JE. Tracking Medicine: A Researcher’s Quest to Understand Health Care. New York: Oxford University Press; 2010.
    14. Hood CC. The Tools of Government. London (UK): Macmillan; 1983.
    15. Salamon LM. The Tools of Government: A Guide to the New Governance. Oxford: Oxford University Press; 2002.
    16. Harding M, Lovenheim M. The Effect of Prices on Nutrition: Comparing the Impact of Product and Nutrient Specific Taxes. Working Paper No. 19781 [internet]. 2014. Available from: http:// www.nber.org/papers/w19781 doi: 10.3386/w19781