The main problem with the U.S. health care system, the authors write, is it isn't a system. "Currently, a myriad of professionals and organizations provide health care, but no vision has ever been articulated for these disparate parts to function together and learn from each other," they write. "This paper describes a vision for all health care to function as a dynamic learning organizational system."
The core concept for the Mayo Clinic reform proposal comes from Peter Senge's book, The Fifth Discipline, in which he describes learning organizations as places "where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning to see the whole together."
The Mayo Clinic leaders are bringing forward their proposals because of their conviction that fundamental reform is required to ensure quality care in the future. "Health care as it exists in the United States today is not sustainable," says Dr. Cortese. "Health insurance premiums consistently increase faster than inflation or worker earnings, 46 million Americans lack insurance, and the percentage of employers offering health coverage dropped from 69 percent to 60 percent in the last five years. Nearly half of physician care is not based on best practices, and each year 98,000 Americans die from a medical error. And five years from now, when the first baby boomers qualify for Medicare, we will be on the cusp of a crisis if changes are not made."