by Nick Jacobs

As a 40ish rookie in health care management, the common conversation around the board table in the late 80's was a chorus of woeful sobs directed toward the good ole days of cost based reimbursement. That was a time when hospital CEO's could pretty much count on getting checks equal to their costs to pay for services rendered. In fact, a book entitled, The Hospital That Ate Chicago, was a good example of how hospitals could actually make a profit from the government from building projects.

Ah, to have been an Executive Director or Superintendent in that era. If you didn't golf several days a week, you were not considered competent enough to be an administrator. One of my early mentors used to say, "Son, If you want to survive and thrive in this field, you are obligated to learn to golf and play a good game of bridge."

Needless to say, I sometimes drive over a bridge, on my way back from Washington D.C.this week, I actually filled up at a Gulf station?

Today, we are seeing the beginning of an end of another era. As the tide begins to sweep the post WWII generation closer to retirement, it is clear that the System is about to change. It is about to change or die, and, once again, the ole timers will wish for better days when they actually got reimbursements that, for at least a small amount of time, would allow them to pay the bills and make a little profit for the organization.

One problem with writing a blog like this is that it's easy to criticize, easy to point out, and easy to suggest, but it will take an engaged group of hard working, deep thinking leaders to set the path for the future, a path that pays attention to the infrastructure, that will work to ensure the bridges don't collapse, the discoveries aren't curtailed, and the future becomes all that it can be. That path should be inclusive, comprehensive and for the good of mankind. Hopefully, we can help make the directional signs for that journey because, our future depends on it.