4. Disruptive innovations will lead the way to reform. Disruptive innovations are a historically proven mechanism for driving the healthcare system into crisis and toward a system
that is higher in quality, more convenient, and lower in cost. More investment in technologies that simplify complex problems—and
less investment in high-end, complex technologies—will result in innovations that historically could be performed only by
expensive specialists being performed by a larger population of less-skilled people.
5. Reassess spending in research. Medical progress has brought many benefits, but with a financial burden that may be more than societies are able to bear.
New technological advances have accounted for the bulk of cost increases. But in spite of the increased spending, R&D productivity
is down in the pharma industry. This exodus may have severe consequences in the fight against infectious diseases. The trend
should not be to curtail R&D, but to optimize efficiency of healthcare delivery systems and contain operational costs.
For six more heretical thoughts on healthcare from Dr. Klietmann, visit
Wolfgang Klietmann, MD is a clinical pathologist and medical microbiologist for infectious diseases. He is an appointed lecturer and faculty member
at Harvard Medical School and serves as vice president of the Harvard Business School Health Industry Alumni Association.
Until 2001, Klietmann was on staff in the Department of Pathology at Massachusetts General Hospital. For five years, he headed
a research group at the Max-Planck-Institute for Virus Research and served on the medical faculty at the University of Tuebingen
(Germany). Klietmann was founder and physician-in-chief of a leading German institute of laboratory medicine, which was successfully
bought out by the pharmaceutical industry. He is a member of the scientific advisory board of BioCal Technology.