If we’re going to get anywhere soon on health system change, we’re going to need to give more heft to proven solutions. Without proof, you’re left exposed to an acceptance that the the devil you know is better than the one that you don’t.

Health system change is difficult both because the time gap between decision and effect is significant, and because any change puts current players’ livelihoods on the line. Given that neither time nor human propensity for self-preservation is on your side, proven experience better be.

Countries tackling urgent health crises with far fewer resources have compelling experience to lend. As a recent Stanford Social Innovation Review article points out:

• Between the extremes of doing nothing and upending the entire system there “are a number of concrete adjustments that will save lives and dollars – in short order.”
• Reform is about optimization of resources. Broadening the health care workforce allows all players to “practice at the top of their license,” increasing job satisfaction and performance while lowering cost and improving outcomes.
• Most care takes place outside the formal health system. Establishment and development of local networks (e.g. promotoras) has been proven to lower costs, improve outcomes and lower the burden on scarce professional resources.

Last but not least, the authors warn that, “’Health’ is a bold, expansive aspiration. Let’s make sure that what we call ‘health care’ is broad enough to get the job done.” We couldn’t agree more.