CPB and Ricky: We Have a Sick-Care System

Treating disease instead of preventing it

Chris Brandlin argues that American medicine is built as a sick-care system rather than a health-care one — organized around treating disease after it appears instead of preventing it from appearing.

The distinction he draws is structural. Capacity, training, reimbursement, and measurement are all oriented toward intervention, so the system performs well at acute care and poorly at the slow metabolic conditions that generate most of the long-run cost. His contention is that this is a design outcome, not a failure of effort by the people working inside it.

What a health-care system would look like instead is the harder half of the conversation, and the one with actual legislative content: what gets measured, what gets paid for, and what a state can change on its own.

Related: prevention over prescription, eating real food, and why health reform stalls.

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Nothing here is medical advice.