Voting for change in healthcare

Modern healthcare is undemocratic, antisocial and thus largely unresponsive to its patients’ needs. Never before has healthcare been so far removed from the people it services. It is time to bring democracy to health care. Our fragmented systems of silos of clinicians, administrators, funders, policy makers and governments make it almost impossible for voters to have a voice in who will lead healthcare to a healthier place.

All health officials should be elected by their constituent populations.

The current fad of encouraging patient participation does little to improve the potential of healthcare to respond to the changing needs of our societies. It merely provides more ballast to a system that is sinking and, in its place, the media is assuming dominance. The recent worldwide concern over measles highlights how a little media attention at the grassroots level can achieve more immunization awareness than decades of public health education, legislation and intervention.

Our digital age has made this possible for us to engage in selecting who is to lead and  who is to deliver our healthcare.  It is no different from electing our government officials. The old argument that voters cannot competently select healthcare leaders because such leaders require skills the general public cannot assess, cannot hold true when voters can access health information at a fingertip. Besides, we have been electing politicians for decades without delving into the complexities of governance.

We need healthcare for the people, by the people and of the people. It is time that all health officials are elected by their constituent populations. Just as our politicians are elected for fixed terms and must go directly to voters to prove their worthiness, so should our leaders in healthcare. Indeed, if healthcare officials had to stand for public office, they would have to communicate their ideas and goals to the public.  One of the beauties of democracy is that if elected leaders are ineffective, the voter has the power to vote them out.

Director generals of health, heads of hospitals, hospital trusts, reimbursement agencies, public health insurers, guideline development committees and departmental heads should be no less accountable.

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