Handbook of Healthcare Analytics

2 Access to Healthcare

Donald R. Fischer

Highmark Inc.

2.1 Introduction

Health has become a national obsession. The mainstream media presents a nearly continuous focus on health‐related topics, covering anything from extremely fit individuals who focus on nutrition and exercise for chronic disease prevention to those who are already chronically ill and clamor for appropriate healthcare and insurance coverage. Yet, the current healthcare “system” often fails to deliver value to its customers. Whether we're ultra‐fit and determined to live forever or we're living a lifestyle that invites chronic disease, we all eventually need healthcare in some fashion. Ideally, we will all be insured against catastrophic financial losses from the costs of such healthcare. However, despite the universal need for healthcare, we buy it directly or indirectly with little objective guidance on quality, and Americans spend more than any other country per capita on the service. The national conversation about the percentage of uninsured individuals has been politically charged and is front and center once again in the coming years as a new administration controls Washington.

Although the United States generally enjoys the availability of the newest, most advanced, and innovative medical procedures and health technology, there is no question that variation in quality of care across regions and populations is large, and that the value derived from new discoveries is not being fully captured. The ...