3. The goals of the system.

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The goals change every item listed below: parameters, feedback loops, information and self-organization.

A city council decision might be to change the goal of the lake from making it a free facility for public and private global use, to a more tourist oriented facility or a conservation area. That goal change will effect several of the below leverage points : information on water quality will become mandatory and legal punishments will be set for any illegal polluted effluent.


Goals come from paradigms and mindsets and they effect everything lower on Meadow’ list.

What are some of the goals (implicit or explicit)that direct our policies?

  1. Sustaining the professionals’ status and income.
  2. Sustaining the hospitals’ status and income.
  3. Sustaining Pharma’s income.
  4. Focusing on costs more than quality.
  5. Short term financial objectives and therefore short term strategies.

Goals effect what does not happen as well, for example:

  1. Ignoring the person as a key player in illness care, health and wellness.
  2. Ignoring effect of Adverse Childhood Events on health.
  3. Ignoring the effect of Human Flourishing and Patient Activation Measures on illness care, health and wellness.
  4. Ignoring whole community (population) health.
  5. Ignoring total system costs.

Better health system goals:

  1. Triple Aim:
    • Improve the health of the population (whole community);
    • Enhance the patient experience of care (including quality, access, and reliability); and
    • Reduce, or at least control, the per capita cost of care.
  2. Human Flourishing
    • The key driver of health
    • A key determinant of effectiveness of  illness “treatment””