Health Care Needs a Systems Overhaul
In his “From the Editor” column (Prism, October 2017), Mark Matthews raises the matter of the U.S.’s spending “twice as much per person—and a much bigger chunk of its gross national product”—as other major industrialized countries on health care and, despite that, achieving mixed results. As a Canadian engineer who has studied and lived in the United States, I would argue that your health care system is in need of much more than new and better technology. What it needs more than anything else is a major systems engineering overhaul in order to deliver the best health-care outcomes (life expectancy, general population health, and quality of life) for all Americans while making optimal use of the tremendous human, material, and financial resources at your disposal. A few decades ago, the American people set an ambitious goal of sending human beings to the moon and to bring them back safely to Earth. You achieved that goal in record time, and you are now setting your sights on the planet Mars. Compared with these lofty extraterrestrial goals, optimizing the engineering of something as down-to-earth as a national health-care system should be a walk in the park!
Regarding Debbie Chachra’s “Reinvention” column in the October issue, I would argue that dealing “with the unintended but not unforeseeable consequences of technology” has been on the radar screens of successive generations of engineers ever since one of them found a way to light and control fire. Throughout the ages, fire has been used to warm us and to cook our food but also, unfortunately, to destroy and kill. Our paramount responsibility as engineers is—and has always been—to protect the health and safety of people and, through our engineering work, to contribute to the improvement of their quality of life so that we can make the world a better place. And that has always meant considering both the good and the bad sides of all the technological coins that engineers have put at the disposal of humanity, whether it be fire or nuclear power. As Chachra emphasized in her “Not Always a Force for Good” article, we, as engineering educators, have a moral, ethical, and professional duty of transmitting this core responsibility to the women and men who will be tasked with engineering the world of tomorrow, on this planet and probably on others as well!
Faculty of Engineering
University of Ottawa