As I’ve had some time now to think about the presentations at the recent WHIT 3.0 conference, a couple comments are in order.

The conference was almost totally focused on what was happening in U.S. health care. This made it exciting and relevant to us. But I can’t help thinking that we still need to better integrate a global perspective on health care. As I’ve talked about a number of times, our public discourse in health care is often too insular, too self-serving and thus irrelevant when it comes to the rest of the world; that the world, and health care with it, is changing in dramatic ways. And we are not paying enough attention to the above two points.

Health care is a complicated business. The seemingly intractable problems in health care are not all due to recalcitrance, ignorance or incompetence — or even the dominance of special interests. As much as I recognize that innovations in technology and consumerism are incredibly important to fixing health care, traditionally conservative health institutions have evolved their nature due to deeply embedded aspects of human nature and how we collectively define who we are and our responsibilities to each other. Information technology innovators still have to develop a more nuanced appreciation of these dynamics. We can build it, but they might not come. The true difficulty of fundamental change in health care should not be underestimated since it involves changes in mass behavior and culture. The social cost of these changes and the propensity of things to go very wrong should instill a certain caution in our thinking.