by Thomas Dahlborg

Sometimes what is not heard is even more important than what is heard. This is especially true in the case of reforming healthcare, from the most basic of levels all the way to a national overhaul.

For example, a short time ago, while waiting in line to listen to President Obama discuss health reform, I overheard someone talking about the nation's broken healthcare system.

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"It does more harm than good," I overheard the person say. "I go outside the system to seek my own healthcare." The person went on to conclude that the key to fixing our current system was ensuring access for even more people.

To those points, I have several questions:

* What specifically is broken?
* How do we know and what are the antecedents and triggers?
* What is the root cause of our broken system?
* How can we fix the broken system to ensure it is set to do "no harm"?
* Why is our goal to provide more access to a broken system if in fact the statement that the current system does more harm than good is true?
* What specifically is being received from outside the system that is not being provided from within the system? Or even how can we provide more access outside the system if in fact that is where better care is being provided? [NOTE: Perhaps an example of disruptive innovation?]

A short time later, in the same line, I overheard another individual declare that "more access" to healthcare, and not improvements to "lifestyle, nutrition, stress...and exercise habits," was the key to keeping people healthy.

But what I don't understand is, how can we truly position both individuals and communities for true healing when we do not address the well-known drivers of optimal health? Clearly, this person was not interested in truly understanding the ROI of prevention and wellness compared to the ROI of our current healthcare model.

President Kennedy once said: "Our problems are man made, therefore they may be solved by man." To solve our problems, I believe we need to be asking the right questions, rather than looking for quick-fix solutions. Rather than just simply accepting the first solution to come along for reforming healthcare as gospel, maybe we should be digging deeper to try to achieve true reform.

Thomas H. Dahlborg, M.S.M., is executive director of the physician practice True North Health Center, where he focuses on improving growth while ensuring access for the uninsured and the elderly. He has 21 years of experience creating competitive advantages, analyzing customer expectations, and developing and implementing focused and aligned strategic deployment plans. Formerly he served as the chief business strategy officer at Network Health, a comprehensive Medicaid health plan based in Cambridge, Mass.; and was COO of the U.S. Family Health Plan at Martin's Point Health Care in Portland, Maine.