A few weeks ago, I was at a cocktail party of sorts and was asked the obligatory, "so, what do you do, Tony?"

"I'm in healthcare"

This complete stranger then proceeded to share her life story, and that she was from Canada. Oh, how she misses the healthcare system in Canada. If only America could figure out that a single-payor system is the only way to go... What do you think? And on and on she went. Then she asked me, "What is wrong with our healthcare system?"

So, you're at a cocktail party with about 30 seconds to explain all the complexity of our healthcare system. How do you do it?

I think I mumbled on for a few moments about incentives, and she kindly moved on unmoved by my answer.

I guess I'm not the only one who struggles with how to answer this. At CHEF's annual meeting, James Orlikoff shared with us his many similar experiences. After many tries, this is how he explains our healthcare system.

Our healthcare system is like a huge aircraft carrier. It took decades and decades to build, and it took decades and decades to get going full-speed ahead. The problem was that it was headed in the direction of ineffiency whereby we rewarded inefficiency. (as an aside: we also work in a field that is probably the most complex in the world - there are 538 separate licenses in our field and each one speaks a different language)

Starting in 1985, we started a course correction with managed care. With DRGs (aka da revenue's gone), managed care, and the insurance industry boom, we started punishing inefficiencies. But even with 25 years, we've only come a small way as these aircraft carriers are hard to turn around.

Any other good analogies out there for how to describe our healthcare system?