The Age for "Renegotiation"

Identifying the various stages of aging and the life transitions that occur with each is key to charting how policy makers, businesses, families, and individuals themselves can build systems to ease the inevitable march of time.

The search for a universal formula that defines “Aging Well” and identifies strategies for successfully managing life’s transitions soon comes up against one incontrovertible fact: everything must be “renegotiated.” Many times, those moments of renegotiation are accompanied by a sense of personal, familial, or societal crisis. There is usually a set of questions that must be asked and the answers often take us to an even a wider scope of queries.

I have the honor and privilege to serve as facilitator for the Philips Center for Health and Well-Being Active Aging Think Tank. I share here some of the intersections with my work at Harvard and that lend perspective to what we are doing and what we might contribute.

Renegotiation

Colleagues Barry C. Dorn, M.D., Eric McNulty and I just published a Second Edition of our book, Renegotiating Health Care: Resolving Conflict to Build Collaboration (San Francisco: Jossey-Bass Publishers, 2011). The premise of the book is that much in health care is changing: how those who are part of the system negotiate those changes will determine much about what the system can accomplish, the satisfaction derived from working in it, and the experience getting services from it.

We highlight four developments that are at the heart of many current changes in health care: 1) Changes in the health system overall, prompted in large measure by developments in financing, in the United States with passage in 2010 of the Affordable Care Act; 2) The evolution of technology, the difficulties in integrating new technologies into the system, and the opportunities that new capabilities can provide; 3) The negotiating patient, a better informed, more inquisitive, and therefore more active participant in negotiating the care they expect; and 4) Changing work and a changing work force driven both by the explosion of technical capacity and information as well as shifting demographics: fewer workers and more people expecting service.

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