HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lamm, R. D. Search for Related Content PubMed Articles by Lamm, R. D. Related Collections Professional affairs

J Thorac Cardiovasc Surg 2007;134:835-838
© 2007 The American Association for Thoracic Surgery

Editorial

Rebuilding the house of health care

University of Denver, Center for Public Policy and Contemporary Issues, Denver, Colo.

Received for publication May 8, 2007; accepted for publication May 23, 2007.

^_* Address for reprints: Richard L. Lamm, LLB, CPA, University of Denver, Center for Public Policy and Contemporary Issues, 2199 So University Blvd, Denver, CO 80208. (Email: rlamm@du.edu).

The first 300 words of the full text of this article appear below.

"If you are going to live in your father’s house, you must rebuild it."

Johann Wolfgang von Goethe

"In every age," writes Bronowski in The Ascent of Man, "there is a turning point, a new way of seeing and asserting the coherence of the world."¹ The great earthshaking controversies of human history, those between science and religion, church and state, or divine right of kings and democracy, have all been characterized as a "new way of seeing and asserting the coherence of the world."¹ Better advice could not be given for the state of US health care at the beginning of the 21st century: We need "new eyes" and new ways of thinking about our indispensable, but organizationally dysfunctional, health care system.

One of our human dilemmas is to distinguish between the world as it is, rather than as we think it is. Columnist and thinker Walter Lippman warned: "At the core of every moral code, there is a picture of human nature, a map of the universe and a version of history."² Our view of the world and what to expect from it depends greatly on the mental map we have of the world. These mental maps control our most fundamental thinking.

Our mental maps guide us through the bewildering complexities of life. Our mental maps, like real maps, must leave out many concrete features to enable us to make sense of the world around our us and our place in it.³ They help us to form our vision of the world. "Visions are indispensable, but dangerous—precisely to the extent that we confuse them with reality itself."⁴ Visions paint with a broad brush, and often the world changes but our visions do not. Similar to the fast-changing maps of the former Soviet Union over the last 20 years, . . . [Full Text of this Article]