Umair Haque always raises some interesting questions.  At least since I’ve started reading his blog, he’s focused on reconcieving business to be more sustainable, and in his post from Jan. 30th, he proposes four more pillars for smart growth:

1. Outcomes, not income
2. Connections, not transactions
3. People, not product
4. Creativity, not productivity

I find them intriguing, but as a recovering libertarian, a little alien. Well, since this blog is all about learning (for me in particular), I’m going to dive right in anyway and try to make sense of them in terms of health care and open systems.

Open systems really dovetail well with Haque’s four pillars.  The goal of open system is really about creating value by giving the user’s control.  That by itself satisfies 1, 3, and 4.  Number 2 actually enables the openness by making it possible to achieve a critical mass and make the system self sustaining.

Health care, on the other hand, is mired in closed, top down systems.  Insurance companies (or governments) are worried about income (or costs).  The focus is on proceedures, not outcomes.  And I don’t see how creativity can exist in such a system.

Of course, the system exists this way for a reason.  It’s not malice.  It’s just that high assurance requires some amount of bureaucracy.  On the other hand, anyone that can figure out how to build openness into, on top of, or around the system and apply Haque’s four pillars probably will stand to do a lot of good and maybe make some money in the process.