So no wonder that some of my old colleagues are frustrated.
怪不得我过去的同事们那么沮丧。
At BCG, we looked at this,
在BCG（波士顿咨询公司），我们分析了这个问题，
and we asked ourselves,
我们问自己，
this can't be the right way of managing healthcare.
这样管理医疗保健的方法肯定是不正确的。
And so we took a step back and we said,
所以我们退一步想,
What is it that we are trying to achieve?
我们到底想要取得什么成效？
Ultimately, in the healthcare system,
归根结底，在医疗保健系统里，
we're aiming at improving health for the patients,
我们的目标是要改善病人的身体状况，
and we need to do so at a limited,
而且是要在一定限度内
or affordable, cost.
或者说能负担得起的情况下。
We call this value-based healthcare.
我们称之为以价值为基础的医疗保健。
On the screen behind me, you see what we mean by value:
在我身后的屏幕上你们可以看到我所谓价值就是：
outcomes that matter to patients relative to the money we spend.
对病人有用的结果除以看病的费用。
This was described beautifully in a book in 2006 by Michael Porter and Elizabeth Teisberg.
这在一本2006年出版的由Michael Porter和Elizabeth Teisberg合著的书里解释得非常清楚。
On this picture, you have my father-in-law surrounded by his three beautiful daughters.
在这张照片里，你们可以看到我的岳父和他的三个漂亮的女儿。
When we started doing our research at BCG,
我们开始在BCG做研究的时候，
we decided not to look so much at the costs,
我们决定先不看费用是多少，
but to look at the quality instead,
而是看质量。
and in the research, one of the things that fascinated us was the variation we saw.
在研究中，（医院之间）悬殊的治疗质量相当引人注目。
You compare hospitals in a country,
比较同一个国家里的不同医院
you'll find some that are extremely good,
你会找到一些做的非常好的医院，
but you'll find a large number that are vastly much worse.
但是也有大量医院做的极为糟糕。
The differences were dramatic.
这之间的差异非常显著。
Erik, my father-in-law,he suffers from prostate cancer,
我的岳父，Erik，患有前列腺癌，
and he probably needs surgery.
很可能需要手术。
Now living in Europe, he can choose to go to Germany that has a well-reputed healthcare system.
他住在欧洲，他可以选择去德国治疗，那里有声望不错的医疗保健系统。
If he goes there and goes to the average hospital,
如果他去了德国的一家普通医院，
he will have the risk of becoming incontinent by about 50 percent,
他将面临大小便失禁的风险，差不多有五十百分的几率，
so he would have to start wearing diapers again.
那他将有可能要重新开始穿尿布。
