Thread by @ASlavitt

NEW: The Triple Aim* is under threat. From what I call the Triple Threat of health care: inequality, profit motive, and politics.

My new piece in @JAMA_current

*If you don’t know what that means, see below.

newsatjama.jama.com/2018/11/08/jam…

@JAMA_current The Triple Aim is the mantra health care is supposed to marching towards— better patient experience, better health & lower costs.

It is the right goal. So why don’t we get there? 2/

Because there are three forces that prey on the health care system like vultures that are more powerful and limit our ability to achieve the goals of the Triple Aim. 3/

The first threat is the vastness of the inequality of care based on race, income and zip code.

There is a 12 year life expectancy difference between wealthy zip codes and NEIGHBORING poor ones.

This will undermine the entire health care system 4 millions until we change. 4/

The second threat is the obsession with revenue, which in many parts of health care can hamper the focus on patient care, sometimes overtly, sometimes subtly. 5/

The third threat is our broken and corrosive politics which work against the public health in so many ways & can’t get fixed until public officials become more responsive to the needs of the public.

Our midterm election featured this theme prominently. /6

If we want better care for more people more affordably, we won’t get there until we have strategies to defeat the inequalities, the money, and the political process that so dominates our system.

We can do these things if we begin by identifying them wherever they exist. /end