Principles of the 6P System in Healthcare


This post summarizes the six principles of healthcare derived from observations of the animal kingdom. These principles appear to be relevant and, more importantly, touted as important by healthcare systems all over the world and advocated by the World Health Organization as important components of a healthcare system.

Next, this post uses the six principles to suggest a scoring system that can be used to: (1) measure a given country’s healthcare system’s divergence from achieving an ideal healthcare system, (2) rank countries by how close they are to an ideal healthcare system and (3) guide allocation of healthcare budgets to resources that will help most in achieving an ideal healthcare system.

The next post will develop the mathematics for the scoring system.

What Animals Have Taught Us: Six principles of an ideal healthcare system

The previous post describes six striking principles of healthcare used in the world of aniOwl Teachingmals in the wild. Recall that animals far outnumber the human population. They have survived over several millennia with many living healthy lives. The principles are simple but it remains to be seen if these can have any value in the human world. We do know, however, that each principle is backed by the World Health Organization. In the next few posts, these principles will be described as the basis of an ideal healthcare system. This will be followed by a detailed description of each of the principles.

Let us see where wild animals can lead us humans who are educated and trained in the science and art of medicine.

The 6P scoring system is a six-principle based system – the building blocks of an ideal healthcare system. These principles are now discussed briefly and later are discussed in detailed by considering one principle at a time.

There are two ways to think about improving healthcare systems. One is to look at the status quo and then to ask the question – what incremental changes will improve on status quo. The second way is to look at an ideal healthcare system and then ask the question – how can we borrow elements from the ideal healthcare system and import them to various degrees to build a new healthcare system. The later approach allows us to think outside the limitations of existing systems and forge inroads into bringing us closer to an ideal healthcare system. It is an alternative but a game-changing approach.

The superior doctor prevents sickness;
The mediocre doctor attends to impending sickness;
The inferior doctor treats actual sickness.

- Chinese Proverb

Let us begin by suggesting a definition of an ideal healthcare system by its adherence to the six principles borrowed from the animal world. Although there may be more tenets to define an ideal healthcare system, and the construct remains open to finding more (for example cost efficiency may be an additional principle), there are at least six principles that cannot be ignored in a serious definition of an ideal healthcare system: 

The 6P Scoring System

Each one of these principles creates either a measurable, binary or an ordinal variable and together they contribute to the well-known indices of a country’s health status such as Infant mortality (IM), Healthy life expectancy (HALE).  There are several indices one could use to measure the health status of a country’s population (Parrish RG. Measuring population health outcomes. Prev Chronic Dis 2010;7(4):A71). For now, let us consider HALE as the goal.

Of these variables, 1 and 2 above can be measured by actual expenditure by the country towards preventive healthcare and capital (human and physical) expenditures respectively. 3 and 5 above are descriptive or subjective and may be obtainable as rankings based on a scale of 0-10 (0 being the worst and 10 the best). Number 4 can be measured using waiting times for patients to get access to healthcare in certain situations regarded as important (such as emergency room waiting times or elective surgery waiting times, or even just physical access to a healthcare provider or facility). Lastly 6 may be measured by the percentage of population that remains uninsured.

What is next?

The next post will describe the mathematical model which forms the basis of the 6P scoring system and provides the analysis necessary to compute the 6P score for each country. This will result in:

  1. A 6P score for each country. This score will denote how close a given country is to achieving an ideal healthcare system.
  2. A ranking of countries by how close they are to an ideal healthcare system.
  3. Ascribe relative importance to each of the six attributes in how they can contribute to an improvement in HALE and therefore guide allocation of healthcare budgets to resources that will help most in achieving an ideal healthcare system.


Leave a Reply

Your email address will not be published. Required fields are marked *