Required reading: TIME Magazine’s Bitter Pill Cover Story
Today’s Health Populi is devoted to Steven Brill and his colleagues at TIME magazine whose special report, Bitter Pill: Why Medical Bills Are Killing Us, is required reading for every health citizen in the United States. Among many lightbulb moments for readers, key findings from the piece are: Local hospitals are beloved charities to people who live in their market – Brill calls these institutions “Non-Profit Profitmakers). They’re the single most politically powerful player in most Congressional districts The poor and less affluent more often pay the high chargemaster (“retail list”) price for health products and services vs. the wealthy
Living paycheck to paycheck: what it means for health
While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average
Health reform, costs and the growing role of consumers: PwC’s tea leaves for 2013
PwC has seen the future of health care for the next year, and the crystal ball expects to see the following: Affordable Care Act implementation, with states playing lead roles The role of dual eligibles Employer’s role in health care benefits Consumers’ role in coverage Consumers’ ratings impact on health care Transforming health delivery Population health management Bring your own device Pharma’s changing value proposition The medical device industry & tax impact. In their report, Top health industry issues of 2013: picking up the pace on health reform, PwC summarizes these expectations as a “future [that] includes full implementation of
Think about health disparities on Martin Luther King Day 2013
On this day celebrating Martin Luther King, Jr., I post a photo of him in Detroit in 1963, giving a preliminary version of his “I Have a Dream” speech he would give two months later in Washington, DC. As I meditate on MLK, I think about health equity. By now, most rational Americans know the score on the nation’s collective health status compared to other developed countries: suffice it to say, We’re Not #1. But underneath that statistic is a further sad state of health affairs: that people of color in the U.S. have lower quality of health than white
Americans’ top financial concerns are money for retirement and health care
It’s the morning after the historic 2012 Presidential Election, with President Barack Obama winning a second term in the face of a sputtering economy and eventual Fiscal Cliff as of December 31, 2012. As we toast with our beverage of choice that night, we will also be worrying about our top financial concerns: how we’ll fund our retirements, and how we’ll pay for health care eventually, and now while we’re actively employed. The Harris Poll of November 5, 2012, reveals that 3 in 4 people in the U.S. who aren’t yet retired worry they won’t have enough money to slow
The 3 cliffs of health care
As I prepare remarks to present a talk about health reform and the pharmaceutical market landscape for tomorrow, Election Day, it struck me that the health industry is now facing 3 Cliffs: the patent cliff, the health care cost cliff, and the Fiscal Cliff. The patent cliff represents about $290 billion worth of sales losses to the pharmaceutical industry between 2012 and 2018. The first chart illustrates that dramatic slope downward, with this year, 2012, being the height of patent losses for the industry. EvaluatePharma, a UK consultancy, says that falling revenue for a pharma is usually a precursor to
Obama would get health-issue voters’ votes
Bob Blendon and his can-do team at the Harvard School of Public Health have done the heavy lifting for us by analyzing 36 telephone polls (that’s “polls,” not “poles”) looking at the role of health reform in the 2012 election cycle. I knew Bob Blendon when I was affiliated for a decade with Institute for the Future, and Blendon was affiliated as well as health politics consultant to the health team. He is the guru on this topic, so when I spotted his article, Understanding Health Care in the 2012 Election in this week’s New England Journal of Medicine, I dashed
Consumers blame insurance and pharma for health costs, but love their primary care doctors
The 78% of U.S. adults with primary care physicians (think: medical homes) are very satisfied with their doctors’ visits. The main reasons for this high level of satisfaction include communication (listening, talking), customer service (caring, personable), and clinical (good diagnosis and treatment). More women than men have a primary care physician relationship, more college grads do, and more people with incomes of $75,000 a year or more do, as well. 90% of those 55 and over have a primary care doctor – a stat heavily influenced by the fact that Medicare coverage kicks in for older people. This consumer profile
From fragmentation and sensors to health care in your pocket – Health 2.0, Day 1
The first day of the Health 2.0 Conference in San Francisco kicked off with a video illustrating the global reach of the Health 2.0 concept, from NY and Boston to Mumbai, Madrid, London, Tokyo and other points abroad. Technology is making the health world flatter and smarter…and sometimes, increasing problematic fragmentation, which is a theme that kept pinching me through the first day’s discussions and demonstrations. Joe Flowers, health futurist, offered a cogent, crisp forecast in the morning, noting that health care is changing, undergoing fundamental economic changes that change everything about it. These are driving us to what may
3 in 5 physicians would quit today if they could
Being a doctor isn’t a happy profession in 2012: 3 in 5 doctors say that, if they could, they’d retire this year. Over three-fourths of physicians are pessimistic about the future of their profession. 84% of doctors feel that the medical profession is in decline. And, over 1 in 3 doctors would choose a different professional if they had it all to do over again. The Physicians Foundation, a nonprofit organization that represents the interests of doctors, sent a survey to 630,000 physicians — every physician in the U.S. that’s registered with the AMA’s Physician Master File — in March-June
U.S. health insurance updates from Kaiser, EBRI and the Census Bureau; uninsurance related to poor health
The average annual premiums for employer-sponsored health insurance in 2012 are double what they were a decade ago in terms of both total premium and worker contribution increases. The picture shows the story, according to the 2012 Employer Health Benefits Survey from the Kaiser Family Foundation (KFF). This annual survey polls small, mid-size and large employers to assess their updates for providing health insurance and prescription drug coverage to active and retired employees. The percentage growth of health costs in the past year were a “modest” 4%, according to KFF. Modest is a relative term: this single digit increase is indeed much
Converging for health care: how collaborating is breaking down silos to achieve the Triple Aim
On Tuesday, 9 July 2012, health industry stakeholders are convening in Philadelphia for the first CONVERGE conference, seeking to ignite conversation across siloed organizations to solve seemingly intractable problems in health care, together. Why “converge?” Because suppliers, providers, payers, health plans, and consumers have been fragmented for far too long based on arcane incentives that cause the U.S. health system to be stuck in a Rube Goldbergian knot of inefficiency, ineffectiveness and fragmentation of access….not to mention cost increases leading us to devote nearly one-fifth of national GDP on health care at a cost of nearly $3 trillion…and going up.
The selling of a health plan, part two
Calling Don Draper, Donny Deutsch, and the spirit of David Ogilvy: the President needs you. The President must sell the Affordable Care Act to the American people now that Justice Roberts wrote the Supreme Court’s historic 5-4 majority opinion supporting the Act, and especially the individual mandate. He argued for the majority that while the mandate is unconstitutional under the Commerce Clause which would “command people to buy insurance,” he said that the mandate is a de facto tax, as people who would choose to opt out of insurance would have an alternative of paying an IRS fine. Senator Eric
58% of Americans self-rationing health care due to cost
Since the advent of the Great Recession of 2008, more Americans have been splitting pills, postponing needed visits to doctors, skipping dental care, and avoiding recommended medical tests due to the cost of those health care services. Call it health care self-rationing: the Kaiser Family Foundation (KFF) has been tracking this trend for the past several years, and the proportion of American adults rationing health demand is up to 58%. This KFF Health Tracking Poll interviewed 1,218 U.S. adults age 18 and older via landline and cell phone in May 2012. As the chart illustrates, 38% of people are “DIYing” health care
A health plan or a car: health insurance for a family of four exceeds $20K in 2012
The saying goes, “you pays your money and you makes your choice.” In 2012, if you have a bolus of $20,700 to spend, you can choose between a health plan for a family of four, or a sedan for the same family. That’s the calculation from the actuaries at Milliman, whose annual Milliman Medical Index is the go-to analysis on health care costs for a family of four covered by a preferred provider organization plan (PPO). While the 6.9% annual average cost increase is lower than the 7.3% in 2011, it is nonetheless, a record $1,335 real dollar increase at
Improving health care through Big Data: a meeting of the minds at SAS
Some 500 data analytics gurus representing the health care ecosystem including hospitals, physician practices, life science companies, academia and consulting came together on the lush campus of SAS in Cary, North Carolina, this week to discuss how Big Data could solve health care’s Triple Aim, as coined by keynote speaker Dr. Donald Berwick: improve the care experience, improve health outcomes, and reduce costs. Before Dr. Berwick, appointed as President Obama’s first head of the Centers for Medicare & Medicaid Services, Clayton Christensen of the Harvard Business School, godfather of the theory of disruptive innovation in business, spokee about his journey
It’s the prices and the technology, stupid: why U.S. health costs are higher than anywhere in the world
The price of physician services, proliferation of clinical technology and the cost of obesity are the key drivers of higher health spending in the U.S., according to The Commonwealth Fund‘s latest analysis in their Issues of International Health Policy titled, Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality, published in May 2012. The U.S. devotes 17.4% of the national economy to health spending, amounting to about $8,000 per person. The UK devotes about 10%, Germany 11.6%, France, 11.8%, Australia 8.7%, and Japan, 8.5%. On the physician pay front, primary care
Patient engagement and medical homes – core drivers of a high-performing health system
It was Dr. Charles Safran who said, “Patients are the most under-utilized resource in the U.S. health system,” which he testified to Congress in 2004. Seven years later, patients are still under-utilized, not just in the U.S. but around the world. Yet, “when patients have an active role in their own health care, the quality of their care, and of their care experience improves,” assert researchers from The Commonwealth Fund in their analysis of 2011 global health consumer survey data published in the April/June 2010 issue of the Journal of Ambulatory Care Management. This analysis is summarized in International Perspectives on
Public health is valued by Americans, but health citizens balance personal responsibility with a Nanny State
While most Americans largely believe in motorcycle helmet laws, seatbelt-wearing mandates, and regulations to reduce sale in packaged foods, most are also concerned about the nation turning into the United States of Nanny. The Harris Interactive/Health Day poll of March 20, 2012, finds a health citizenry “pro” most public and safety regulations, from banning texting while driving to requiring the HPV vaccination (e.g., Gardasil). Specifically, as the chart shows, – 91% of U.S. adults are for banning texting while driving – 86% are for requiring vaccination of young children against mumps, measles, and other diseases – 86% also like to
The state of health IT in America: thinking about the Bipartisan Policy Center report on health IT
There are few issue areas within the Beltway of Washington, DC, that have enjoyed more support across the political aisle than health care information technology. In 2004, George Bush asserted that every American would/should have an electronic medical record by 2014. Since then, Democrats and Republicans alike have supported the broad concept of wiring the U.S. health information infrastructure. With the injection of ARRA stimulus funds earmarked in the HITECH Act to promote health providers’ adoption of electronic health records, we’re now on the road to Americans getting access to their health information electronically. It won’t be all or even
The Trust Deficit – what does it mean for health care?
Technology, autos, food and consumer products — two-thirds of people around the globe trust these four industries the most. The least trusted sectors are media, banks and financial services. Welcome to the twelfth annual poll of the 2012 Edelman Trust Barometer, gauging global citizens’ perspectives on institutions and their trustworthiness. This survey marks the largest decline in trust in government in the 12 years the Barometer has polled peoples’ views. Interestingly, trust in government among US citizens stayed stable. The top-line finds a huge drop in global citizens’ trust in government, with a smaller decline for business. There’s an interplay
Stop SOPA
Health Populi’s Hot Points: Please stop censorship in the United States of America. Click on this hyperlink to easily contact your Congressional representatives and express your opinion on SOPA and PIPA – two laws that would limit basic freedom in the marketplace of ideas and commerce.
Health spending in America – self-rationing slows cost increases
The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9% in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts. Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which
Health insurance: employers still in the game, but what about patient health engagement?
U.S. employers’ health insurance-response to the nation’s economic downturn has been to shift health costs to employees. This has been especially true in smaller companies that pay lower wages. As employers look to the implementation of health reform in 2014, their responses will be based on local labor market and economic conditions. Thus, it’s important to understand the nuances of the paradigm, “all health care is local,” taking a page from Tip O’Neill’s old saw, “all politics is local.” The Center for Studying Health System Change (HSC) visited 12 communities to learn more about their local health systems and economies, publishing their
The average annual health costs for a U.S. family of four approach $20,000, with employees bearing 40%
Health care costs have doubled in less than nine years for the typical American family of four covered by a preferred provider health plan (PPO). In 2011, that health cost is nearly $20,000; in 2002, it was $9,235, as measured by the 2011 Milliman Medical Index (MMI). To put this in context, The 2011 poverty level for a family of 4 in the 48 contiguous U.S. states is $22,350 The car buyer could purchase a Mini-Cooper with $20,000 The investor could invest $20K to yield $265,353 at a 9% return-on-investment. The MMI increased 7.3% between 2010 and 2011, about the same
Even the most wealthy, healthy U.S. citizens worry about future health access and finance
It is no surprise that sicker, poorer people in the U.S. have concerns about how they’ll access and pay for health care in the future. What stands out in the latest Commonwealth Fund Survey of Public Views of the U.S. Health System, published in an April 11, 2011, Issue Brief, is that most U.S. health citizens in the healthiest, wealthiest demographic groups worry about accessing and paying for health care in the future. The chart highlights these findings: overall, 7 in 10 people worry about not getting high-quality care when they will need it, or that they won’t be able to pay
Robert Reich connects the dots between the macroeconomy, angst, politics and health care costs
“I’m not a class warrior. I’m a class worrier,” Robert Reich told a standing-room only crowd of thousands of health IT geeks as he delivered the first keynote address of the annual meeting of HIMSS, the Healthcare Information Management and Systems Society. This year’s crowd will have reached about 31,000 people interested in health information technology’s transformative role in health care. The 31K represents an 18% increase in attendance from last year’s crowd. The HIMSS economy is strong. Robert Reich warns, however, that the U.S. macroeconomy is far from healthy…and health care costs will be a long-term threat to the
How health price sticker shock can prevent preventive care – the case of my colonoscopy
An Explanation of Benefits (EOB) came in the U.S. mail yesterday. A plain piece of white 8.5″ x 11″ printed in tiny font with black ink, the logo of my health insurance company in the upper left of the form, and several lines of words and numbers showing me names of providers and facilities, dollar amounts billed, dollar amounts discounted, dollar amounts paid to the providers, and dollar amounts that were the patient’s responsibility — that would be me. The procedure was for a colonoscopy, for preventive screening and base lining for future reference. The good news: my colon looks just fine, and I’ll be reminded
U.S. employers put health care cost containment at the top of reform priorities
1 in 5 among all U.S. employers (22%) would likely drop health insurance coverage and let workers buy a plan through a health insurance exchange. However, most employers would expand wellness programs driven by incentives in health reform. Employers’ perspectives on the Affordable Care Act/health reform are mixed, according to a survey conducted by the Midwest Business Group on Health, co-sponsored by the National Business Coalition on Health, Business Insurance and Workforce Management. Not surprisingly, these views vary by whether the firm is large (>500 employees) or small. More large employers support the creation of Health Insurance Exchanges and would expand wellness services;
The States’ fiscal crisis and health care: a day of reckoning for Medicaid before 2014?
It will be A Day of Reckoning, 60 Minutes, the CBS News weekly program, called it. This is the impending economic collapse of U.S. state economies, caused by over-borrowing, pension accounting, lower tax revenues during the recession, expanding services, and Next to the housing collapse of the past few years, this may be the largest threat to the American economy, according to Meredith Whitney, a Wall Street analyst quoted in the story. Chris Christie, Governor of New Jersey, says this is, “not an income problem, it’s a benefit problem.” When we think benefits and States, we think health care — specifically,
Are Influentials less keen on connecting health? Practice Fusion says ‘yes’
I posted here yesterday on Practice Fusion‘s survey on consumers’ views of remote health monitoring, discussing a key finding that older Americans are less keen on the idea than younger people. The company sent me more detailed survey data which I’ve dug into, and discovered a counter-intuitive finding worth exploring: “Influential” people appear less interested in remote health monitoring than the mainstream American. Who are these “Influentials?” GfK Roper, who conducted the study on behalf of Practice Fusion, bases this consumer segment on an index built on political and social activities engaged in over the past year: writing a letter to
Impeaching health reform: reflections on the night before 2010 mid-term election results
I find myself in London, England, on November 2, 2010, for a week of business in two European nations that extend universal health care to their citizens: the UK and Denmark. The Hill’s Healthwatch blog writes today that, “House Republicans will bring early vote on repeal of health reform.” Haley Barbour, head of the Republican Governors Association, exclaimed, “I think if [Republicans] don’t fully repeal and replace it, they will make such big changes in it over the next three years that you won’t recognize it.” Here in the UK, the Guardian newspaper published a column opining that, “At a macro level,
Is health care a blue or a red brand?
Google is heavily favored by Democrats; Fox News Channel, no surprise, by Republicans. Citizens affiliated with a particular political party favor certain consumer brands, according to YouGov’s BrandIndex survey. For Democrats (the blue folks), favored brands include Sony and Amazon. For Republicans (the red voters), top brands include the History Channel, Fox, and Lowe’s. The Google vs. Fox News Channel rift between the parties is huge: 66% of Democrats rank Google on top; 71% of Republicans rank Fox News #1. Google doesn’t even fall into the Republicans’ top ten brand names, according to Advertising Age. There’s some crossover in brand-loving across the two
It’s still the economy for U.S. voters in November, with health reform a distant second
There’s more confusion among U.S. voters than ever about what health reform, the Accountable Care Act (ACA), means. The September 2010 Kaiser Health Tracking Poll reveals an electorate that’s not only confused, but quite split in their support — with those who oppose the law even stronger against it than the pro’s support it. The Kaiser Family Foundation (KFF) survey found that the percentage of ACA proponents actually increased by 4 percentage points between August and September, from 45% to 49%. 41% of registered voters are “unfavorable,” and 10% still have no opinion about the law. When it comes to
Anthem price hikes: poster child for an imperfect health market
Anthem is robo-calling enrollees to kvetch about health plan price hikes of up to 39%. Then they’re asking these customers whether they plan to dis-enroll — that is, to quit their health plan enrollment. The move would impact as many as 700,000 health citizens in California. Let me take you back to your freshman economics class (and if you didn’t take that class, let me enlighten you on the 101 version) of “the market.” A perfect market, Samuelson told us in his standard Econ 101 text, was dependent on: Lots of buyers and lots of sellers No-cost entry and no
Time is of the essence — ARRA as HIT-adoption stimulus bill
“The world changed yesterday at 1 pm Mountain time,” Steve Lieber, President of the Health Information Management Systems Society (HIMSS), told over 1,500 attendees of a webinar on February 18. These new times, Lieber said, “will require our vendor community to react a little bit differently and change business practices.” Lieber said that health information technology vendors will need to be, in his words, “more forthcoming” as well as “make absolute iron clad binding agreements.” The bottom line: time is of the essence, based the HIT details written within the 1,100 pages of
A statistical profile of the US on election day 2008; and freebies, galore!
Go get your treats today while you make your way to the polls: Starbucks is offering free coffee, Dunkin‘ Donuts has star-shaped cakes, and Ben & Jerry’s will offer free scoops between 5 and 8 pm. While you’re enjoying some sweet stuff, ponder some important statistics on this Election Day 2008…. Toyota will probably be crowned the #1 automaker in the world this week, as GM slips to second place. GM’s sales fell to their lowest level in 17 years. Last year, it outsold Toyota by a mere 3,000 cars. The U.S. GDP fell. Unemployment is expected to further
It’s tough to be a governor: managing the health care lab
The National Governors Association (NGA) is meeting in Philadelphia this week, where my City of Brotherly and Sisterly Love is witnessing some sobering discussions about health care. On the one hand, Bill Clinton called in his opening keynote speech for the states to be laboratories of democracy. But how much health-democracy can each governor afford when balancing their budget in the face of declining revenues? According to the NGA’s 2008 Fiscal Survey of the States (published June 2008), not a whole lot. Medicaid covers comprehensive and long-term care for over 62 million low-income Americans. Costs are shared
Health care inflation: thoughts on PwC’s health cost forecast for 2009
2009 will see health cost inflation of nearly 10%, according to PricewaterhouseCooper’s (PwC’s) report, Behind the Numbers: Medical Cost Trends for 2009. Medical inflation ran about 10% in 2007, as well. PwC says that since the mid-1960s, the biggest jumps in the percentage of GDP allocated to health care in the U.S. happen during and leading up to recessions. Thus, health care becomes more of a burden for both the private sector (employers and consumers) and for the government (public sector). Underneath this double-digit increase are both cautionary and hopeful trends: The recession: PwC notes that if
Thanks to Feedspot for identifying Health Populi as a top Public Health blog to follow in 2024...I must call out my Twitter following update is nearly 30,000 these days.... : )
Jane was named as a member of the AHIP 2024 Advisory Board, joining some valued colleagues to prepare for the challenges and opportunities facing health plans, systems, and other industry stakeholders. Looking forward to AHIP 2024 in Las Vegas come June 11-13, 2024.
Join Jane at AHIP's annual meeting in Las Vegas: I'll be speaking, moderating a panel, and providing thought leadership on health consumers and bolstering equity, empowerment, and self-care.