Transparency and credit cards: how doctors can talk to patients about money
In the emerging era of participatory health, fanned by the fiscal flames of the recession and increasing out-of-pocket costs, there’s an important communications component to consider: participatory health economics. The chart illustrates why. Out-of-pocket health costs are steadily increasing for households. Thus, it is reasonable for health citizens to want to know how much health goods and services will cost them before they partake of the service — whether a prescription drug, a stay in rehab, a surgical procedure, or a course of chemo. For some time, providers have had a difficult time effectively fulfilling this role. Thanks to the
Meaningful USe – or, whose health is it, anyway?
When I Googled “meaningful use” this morning just before writing this post, the search yielded over 10 million results. Googling “meaningful use and patient” gets you over 1 million results. Dr. Ted Eytan wrote a post on his blog, Ted Eytan, MD, on May 28, 2009, which captures the core of meaning of “meaningful use.” He titled the post, “Is It Meaningful If Patients Can’t Use It?”The bottom line: it’s not meaningful, Dr. Ted says, if patients can’t see everything. Dr. Ted met with a group of healthy thinkers in Washington DC this week to discuss patient empowerment in health;
More workers are engaging in healthier lifestyles in the recession, says NBGH
Insured workers in the U.S. are cost-sensitive to health care. The recession has been negatively impacting workers’ health: physically, emotionally, financially. However, there may be a silver lining here: that workers are making health improvement a greater priority than they did in 2008. The National Business Group on Health’s report on The Recession’s Toll on Employees’ Health presents results of a survey among workers age 22 to 64, finding good news amidst the not-so-good: that while some employees choose not to receive health treatment to save money on out-of-pocket costs, large percentages of workers are trying to lose weight and
Americans may be thinking healthy, but not acting healthy
Thinking healthy isn’t the same as acting healthy. The gap between what lifestyle behaviors people perceive build health, versus what actually contributes to health, can lead to less than optimal health outcomes. Based on Yankelovich’s 2009 Health & Wellness Segmentation Study, only one-half of people believe that taking medicines as prescribed is “very important” to maintaining health. Only six in 10 believe that exercising regularly is very important to health. One in six people also believe that getting regular physicals and eating a well-balanced diet are very important to maintaining health. Yankelovich found that people identified other lifestyle behaviors as
To delay is deadly – no progress 10 years since "To Err is Human"
Ten years later, a million lives lost, billions of dollars wasted, is the tag line of a report looking back at the decade since IOM‘s seminal report, To Err is Human, was published in November 1999. Consumers Union has asked, what progress has been made since IOM calculated that 98,000 lives are lost each year due to medical errors committed in the U.S. health system? CU’s finding: To Err is Human – To Delay is Deadly — the title of the report. In the report, CU asserts that preventable medical harm still accounts for over 100,000 deaths a year in
The elongating path to universal coverage
The road to universal coverage will be paved more slowly as the Obama administration comes to terms with the impact of the recession on the general economy, the national deficit, and RealHealthPolitik. An interview with Peter Orszag in this morning’s Financial Times (London’s daily business newspaper) featured a sentence that gave me a double take; it was, “The president has said he wants a path to universal coverage.” A path is not an end-game or an outcome: it is a process, a journey. I believe that Orszag, the head budgeteer and Director at the Office of Management and Budget, carefully
Recession economics of the family physician
1 in 2 family physicians is seeing fewer patients since the recession began in January 2008. At the same time, 3 in 4 physicians have seen an increase in the number of uninsured patients. Patients who are covered by employer-sponsored insurance and private health plans are in short supply. Welcome to the new health economics for family physicians, where there are more patients without health insurance, more Medicaid patients, and more Medicare patients. As a result, patients are: – Telling family physicians about concerns over ability to pay for health care– Cutting prescription dosages– Cancelling appointments– Forgoing needed preventive care.
Putting the "P" back into PHR
“I want the computer to know who I am,” is the title of a research article in the June 2009 issue of the Journal of General Internal Medicine. This is also a fair statement for what’s wrong with so much in the current state of the art in health information systems. The four authors, all associated with the great health institutions around Boston (Harvard, Beth Israel Deaconess Medical Center, Brigham and Women’s, and MIT), conducted eight focus groups with health citizens and professionals to learn about their perceptions of the role of PHRs and electronic health data. They found that
God bless the child without health insurance, from a Rasmussen Reports poll
Them thats got shall get Them thats not shall lose So the Bible said and it still is news Mama may have, papa may have But God bless the child that’s got his own. So wrote and sang Billie Holiday in 1939. Seventy years later, you can take this classic blues tune as the anthem for the perceptual chasm between people who have and don’t have health insurance in the U.S. Uninsured people tend not to like their health care very much. If you’re insured, you’re pretty happy about your health care coverage. In a national survey of 1,000 U.S.
The costs of chronic disease, and the key role of self-care
In 2008, the U.S. government spent $700 billion on the banking bailout, known as TARP and nearly $600 billion on chronic disease.Heart disease, asthma, cancer and diabetes are among the many conditions that make up chronic disease in the U.S. Together, chronic conditions impact 45% of the population; more than 133 million Americans has at least one chronic condition.According to the Milken Institute, by 2023, the U.S. will experience a more than 50% growth in cancer, mental disorders, and diabetes, and over 40% increase in cases of heart disease.What’s also going to drive up health spending in America is “metabolic
Generic drug dispensing reached 2 in 3 prescriptions (64.1%) in 2008 from 59.7% in 2007. Drug trend, defined as growth in prescription drug spending, increased 3.3%. What’s driving spending up? Diabetes therapies, rheumatological drugs, seizure drugs, antiviral drugs, and cancer and transplant drugs. What’s pushing spending down? Generic drugs for lowering lipids and OTCs for allergy meds. Welcome to Medco’s Drug Trend Report, unveiled at the company’s Symposium this week. The report analyzes trends, up and down, in prescription drug spending and utilization. This year, one of the key upward trend drivers is stunning: that the obesity epidemic is a
Going broke in eight years – the recession has blown old assumptions away for health and social security
“The financial outlook for the HI trust fund is significantly less favorable than projected in last year’s annual report.” So we are told on page 16 of the 245-page 2009 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (the “Trustees Report,” in shorthand). This is the 44th annual State of the Nation’s Health Finances report that goes to Congress — by name, the Honorable Nancy Pelosi, Speaker of the House, and the Honorable Joseph Biden, President of the Senate — with respect, from The Trustees –Tim Geithner, Secretary of
Can GE bring good things to life and health once again?
Here’s a riddle that appeared in today’s Wall Street Journal and The New York Times:“It’s the most valuable thing on earth. All the money in the world can’t buy it. Those who have it don’t always appreciate it. Those who’ve lost it will do anything to get it back. What is it?” Readers of Health Populi should well know the answer to this riddle: it’s health. And what’s healthymagination? It’s GE’s new strategy to reinvent itself in health care. The three-legged strategic stool of healthymagination are: To lower the costs of health care To increase peoples’ access to health services
The inextricable link between health and education
Education leads to health. The link could not be clearer, based on a report from the Robert Wood Johnson Foundation (RWJF), Reaching America’s Health Potential: A State-by-State Look at Adult Health. This report follows up RWJF’s look into children’s health published in October 2008, Reaching America’s Health Potential Starts with Healthy Children: A State-By-State Look. A key paragraph in the report sums up the fact that health status is impacted by other factors beyond health care: “Being able to make healthy choices depends on physical and social conditions at home, in neighborhoods, at schools and at work. For example, a
Lower copays and health engagement: the latest from EBRI
In an era where employers and benefit plans are embracing consumer-driven health plans and health reimbursement accounts, enrollees have seen their out-of-pocket costs for health care increase. Higher cost burdens have led to many health consumers to behave as, well, consumers — self-rationing themselves off of various health services to conserve health spending. Most Americans believe that lowering cost sharing would increase health engagement — that is, better health behaviors — for people who are participating in wellness and health programs as well as for people on drug regimens managing chronic conditions. These findings come from the Employee Benefits Research
The recession is causing people to cancel visits to physicians
In this recession, the first health line item that Americans are eliminating from their budgets is visits to physicians. It’s clear that the economic downturn is forcing American health citizens to re-evaluate their demand for health services. Thomson Reuters’ latest survey into consumer health behavior, The Current Recession and Healthcare Consumers, examines these changed behaviors in detail. Thomson Reuters’ Center for Healthcare Improvement (CHI) began to explore this dynamic in June 2008. At that time, CHI found that survey respondents’ health insurance coverage was eroding and more jobs were being lost in households. Then out-of-pocket costs increased. As a result,
Epidemics and public health: the need for simple communication and medical homes for all
This chart appeared in Sunday’s New York Times in an opinion piece called, “American Epidemics, a Brief History” by Howard Markel and Sam Potts. Markel is a professor at my alma mater, the University of Michgian School of Public Health, and Potts is a graphic designer. Their point is neatly captured in this exquisite, simple diagram: that all epidemics in the U.S. share a few themes: 1. Epidemics lead to scapegoating of those thought to have caused the problem; the H1N1’s scapegoat du jour is immigrants. 2. Epidemics are often blamed on living “unclean” lives. 3. Epidemic literacy among people
The shortage of doctors and medical homes
Two hours’ drive north of Manhattan, it was nigh impossible for my dear friend to secure an appointment with her regular primary care doctor to treat a complicated sinus infection. Her PCP’s appointment scheduler told her she could get an appointment in five days. Not acceptable, my friend said, so she tried some alternatives, with no success. I suggested she go online and search Walgreens, CVS, and Walmart to locate the closest convenience clinic to her home. There was none in her area within an hour’s drive. So much for convenient and accessible health care. She finally phoned a doctor
The downturn generation: how will it impact health care demand?
The recession is shaping a new consumer segment, coined the Downturn Generation by Information Resources (IRI). Members of the Downturn Generation are transforming the ways they shop, eat, and care for their homes and themselves. 2 in 3 consumers believe their financial condition is worse than it was one year ago, and 71% say they have less wealth than they did. IRI identifies 3 segments: Optimists, who agree that “things will get better during the next 12 months” and have selectively cut back purchases; for them, sacrifices are a last resort. Maintainers, who agree that “the economy won’t get worse,
The rich think differently about health than the less affluent
Hint: people with less money think more often about health than the rich do. The new logic of health engagement is based in anxiety, according to DDB:1. Anxiety produces a desire for control 2. Believing we are healthy means we believe we are in control; health = control. 3. Anxiety produces a desire for health. This new logic trail of personal health comes from results found in a survey conducted by DDB, the global advertising and communications firm. Health is the New Wealth, DDB concludes, and titles the survey report.DDB’s thesis is that as the economy has proven to be
Medzio as Metaphor for the Future of Health 2.0
I have seen the future of Health 2.0, and it is Medzio. It’s flexible, it’s consumer-facing and -friendly, it integrates into the activities of daily living, it makes accessing health information easier and integrateable, and it’s fun. As an observer of health information tools for over two decades, the company known as A.D.A.M. has always been in my radar. I have respected their work in medical images from the early days of the firm’s inception, and when the Internet arrived in health care, A.D.A.M. smartly figured out where to play in that new media environment. Of all the offerings I
The public's belief in scientific uncertainty and the importance of the social health Internet
3 in 4 Americans believe that scientific evidence is not always clear when differentiating between different treatment options for their health. Yesterday, as I moderated the the kick-off Great Debate session of the Health 2.0 Conference, co-hosted by the Center for Information Therapy in Boston, I felt this was a key tension between the fields of Health 2.0 — the use of web 2.0 tools in health, especially among health citizens — and Information Therapy, which aims to ‘prescribe’ the right information at the right time for the right patient in the process of care. The public belief in scientific
Blaming the Mad Men for Our Economic Woes
There’s a new target in town when it comes to Americans’ blame-game for their economic woes: advertising. In a fascinating new Harris Poll, cleverly timed for publication on 2009 Tax Day, the Poll found that most Americans blame various media outlets for persuading them to buy things they didn’t need or couldn’t afford. It’s not just the big bad banks who pushed irrationally-modeled mortgages on us unsuspecting home buyers. And those greedy auto companies building big, bad oil-guzzling SUVs. It’s the Mad Men Who Made Us Do It. That is, spend too much money. There are variations across age groups
Looking for Drs. Schwab and Bogle in our workplaces
As employees assume more personal and financial burden for health and welfare, they also take on new attitudes and perceptions of value. This is one of the underlying precepts of the Health Populi blog, and it’s directly addressed in MetLife’s seventh annual Study of Employee Benefits Trends. While people take on more responsibility for health and retirement savings, they’re looking to employers for more counsel and support to help them manage the risks involved with both. In this regard, the chart illustrates a key finding from the study. There are large gaps in the perception of value between employees and
Mobility is hot in health – reading the Motorola Mobile Barometer
Mobile technologies will be more important to health organizations in 2009 than they were in 2008, for 8 in 10 health executives. Motorola has published the 2009 Enterprise Mobility Barometer for the health care industry, and the top line message is health mobility is in demand. Underlying mobility in health are the key investment areas for health providers in 2009: electronic health records (EHR), computerized physician order entry (CPOE), and medication administration to both streamline processes and reduce medication errors. Mobility in health apps relates to three aspects of health care: mobilizing the enterprise itself; freeing workers from immobile techs
The economic downturn — how hospitals are dealing
The outlook for the U.S. hospital sector will remain negative well into 2010, based on my reading of credit rating reports from Fitch, Moody’s and Standard & Poors. Hospitals are dealing with the recession adopting a broad and deep range of strategies, inventoried in a comprehensive survey issued by the Healthcare Financial Management Association (HFMA), How Hospitals Are Combating the Financial Downturn. One hat I wear in my work-life is as a health economist; sometimes, clients in the health arena engage me as an economist looking at the macroeconomy’s impact on the health microeconomy. One such client engagement found me
Can't get no health plan satisfaction – the importance of understanding benefits
You’re not so happy with your health plan if you purchase it as an individual or receive it through a small employer. That’s the top-line finding of J.D. Power‘s 2009 National Health Insurance Plan Study. What’s driving down health plan satisfaction is consumers’ lack of understanding of the benefit. “Members still tend to be least satisfied with the information and communications they receive from their health plan—the third-most-important factor in overall satisfaction,” said David Stefan, executive director of J.D. Power’s health practice. Consumers rate seven factors in J.D. Powers’ study: Coverage and benefits Provider choice Information and communication Claims processing
Onto the mainland and Main Street – American Well comes to Minnesota
Into the Mainstream and onto the U.S. Mainland, American Well will be offered in Minnesota by the Blue Cross and Blue Shield of Minnesota (BCBSMN) health plan. This is a market signal that online health has come to Main Street. When American Well first launched in the state of Hawaii, some critics said that was an anomalous market, a one-off that didn’t represent the breakthrough that others of us believed it to be. Furthermore, others have criticized that American Well’s model could not play a role in the future of the primary care medical home. American Well has countered this
PEHRs as disruptive health technology, Christensen says
Is Clayton Christensen right? On April 8, 2009, the Disruptive Harvard Professor was interviewed in Harvard Business School’s Working Knowledge saying that Personal Electronic Health Records (PEHRs) can, “help us manage our own health care” and be “transformative in lots of unexpected ways.” By his definition in The Innovator’s Prescription, a disruptive innovation transforms a product or service that historically has been very complicated and expensive into something that is affordable and simple to use. Health care us certainly complex and expensive, particularly as it’s delivered in the U.S. Can PEHRs help move American health care towards affordability and simplicity?
HIMSS, Day 2 – here comes Everybody – but where are they going?
Clay Shirkey wrote the book, Here Comes Everybody, and yesterday he focused his theme on ‘Here Comes Every Patient.’ Shirkey’s theme is that “everybody” — from my 12 year old daughter and her Gen X/Gen Y mentors, to the 80-year old grandma who Googles — is pressuring institutions and organizations to deal with them on their terms. The implications for the health system here are huge.What’s encouraging from the institutional standpoint were some observations made by two hospital CIOs during the HIMSS press conference covering this year’s annual survey of hospital CIOs. Denni McColm of the rural Missouri Citizens Memorial
HIMSS, Day 1 – from "Momentous" to HIT Momentum
If it’s April in Chicago and it’s snowing it must be HIMSS. Say, what? Usually the annual meeting of the Healthcare Information and Management Systems Society (HIMSS) is held in February in some lovely southern climate, like Florida, Georgia or Southern California. This year, the HIMSS organizers thought they’d try out the association’s home base in the Windy City and the gargantuan McCormick Place. On purpose, the HIMSS exec’s postponed the Chicago meeting to April to avoid the usual February climate and Lake effects. Sounds like good planning, no? We expect 2-4 inches of snow overnight, and it’s the week
Chronic conditions and medical debt grow, and some employers get targeted
Americans’ problems paying medical bills are increasing, especially for those people managing chronic conditions. In 2007, 3 in 10 people with chronic conditions were in families with problems paying medical bills, compared to 21% of people in 2003. According to Financial and Health Burdens of Chronic Conditions Grow, a Tracking Report from The Center for Studying Health System Change (HSC) published in April 2009, there were 20 million chronically ill adults with medical bill problems in 2007 – and one in 4 of them went without a prescription because of cost. HSC’s report focuses on working–age adults, 65% of whom
Unemployment and uninsurance – no recovery in sight?
The ‘official’ US unemployment stats for March will be published on April 3, but several data sources assert that the US labor market worsened again in March. One from ADP, the company that processes one in six payments for US workers, calculates a loss of 668,000 jobs in March ’09. Dow Jones Newswires’ survey predicts that private-sector jobs in the US fell 742,000 in March. There is ‘no recovery in sight’ when it comes to health coverage for workers in America, according to the title of a report by Ken Jacobs and Dave Graham-Squire from the UC Berkeley Center for
Health providers are most trusted for handling health information
As electronic health records get a starring role in the economic stimulus package in the U.S., Americans are thinking through who to trust with their personal health data. 3 in 4 Americans trust health providers above all other “data stewards” for handling their personally identified information, according to a BBC America survey conducted by The Harris Poll, published March 30, 2009. The least trusted handlers for personal information are social networking sites such as Facebook and MySpace, and Search and Portal sites like Google and Yahoo! There are differences in trust factors across generations. The older the American, the less
So many Top Hospitals lists, so little time
Thomson published its Top 100 Hospitals list this week, which felt like a déjà vu all over again. Didn’t I just see AARP’s top hospitals, along with similar rankings from US News and HealthGrades in recent months?Is this an embarrassment of riches? Or just more heavy-lifting for confused American health citizens?The Thomson Reuters 100 Top Hospitals National Benchmarks study is based on the company’s “National Balanced Scorecard” which focuses on nine measures: mortality, medical complications, patient safety, average length of stay, expenses, profitability, cash-to-debt ratio, patient satisfaction, and adherence to clinical standards of care. Thomson has conducted this study since
Consumers adapt to health @ home in the transformational economy
Two of the top new products launched in 2008 were Zyrtec and alli, according to IRI in their March report, 2008 New Product Pacesetters: The Role of Innovation in a Down Economy. In fact, non-food new product introductions were more successful than food intros in 2008. IRI says this is due to shoppers “taking their personal care into their own hands.” For example, in-sourcing spa treatments to the home instead of spending time (and money) at the spa, and buying home remedies instead of seeing the doctor. Health-at-home is also permeating foodstuffs that are in breakthrough products. The chart shows
Put away $240K for health care in retirement, Fidelity says
In 2009, the cost of health care for a 65-year old couple entering retirement is 50% more than it was in 2002, according to Fidelity Investments. The nest-egg required for retirement health is $240,000, give or take tens of thousands depending on your health risks. In just the past year, this cost increased 6.7%, from $225K. Fidelity has measured the cost of health care in retirement since 2002, when the cost was $160,000. Note the assumptions behind this number: Fidelity assumes that retirees will not have employer-sponsored retiree health benefits, but will take up Medicare. Thus the $240K takes into
EHRs – not about the machine, but the data liquidity
This week’s New England Journal of Medicine provides something of a real-world mini-primer for everyone’s radar on electronic health records and the HITECH funding included in ARRA, the economic stimulus bill. The cautionary paragraph, offered by Mandl and Kohane in their essay, No small change for the health information economy, is: “We take it as a given that health care software must be interoperable and secure and must protect patient privacy. But these qualities are not sufficient to produce an optimal system, which must evolve on a health care platform that extends beyond PCHRs to include other critical infrastructural components,
Workplace benefits: for workers, it's all about financial security
The economy is re-shaping both employers’ and employee’s views on workplace benefits. Most employers continue to value their most important asset: the human capital that is inherent in their employees. This is good news. Retaining employees is the #1 benefits objective for American employers, according to MetLife’s 7th annual Employee Benefits Trends Study. Now, for the #2 and #3 objectives for employers as revealed by MetLife’s survey: due to the economic downturn, employers are looking for more productivity out of their employees, while controlling costs. At the same time, employees are concerned about their financial security. MetLife has found that
2/3 of people want a health plan in every pot
2 in 3 Americans believe that, “we must make it a priority to give every single American quality affordable health care,” according to a poll from Rasmussen Reports. There are dramatic differences on the issue of universal health coverage between Democrats and Republicans, however. 90% of Democrats agree that health for all is a national priority, compared with 37% of Republicans and 55% of Independents. Democrats put health care at #1; Republicans and Independents cite reducing the deficit as a first priority. Health Populi’s Hot Points: Watch for the 63% number to increase in the next few months if unemployment
mHealth – the phone as health app platform
As the Internet disrupted health care information in the late 1990s through the 2000s, watch out for the phone to make the health world flat, taking off from Tom Friedman’s phrasing about The World. There are parts of the world using simple SMS text messaging in public health: to enable peoples’ positive health behaviors. In parts of Africa, safe-sex messaging and medication reminders help people prevent the spread of HIV/AIDS. In Europe, Nokia has tested a wide range of these applications, and Vodafone has been successful in getting teenage diabetics to respond to text messages via phones in an NHS
People with chronic conditions are delaying care: frustration leads to dis-engagement
1 in 4 people with chronic conditions (25%) are delaying care. The percent of people delaying care is even higher for Baby Boomer women (39%) and Latinos (43%). Delaying care crosses all income groups; 22% of people with household incomes of at least $50,000 also delay care. In “Re-Forming Health Care: Americans Speak Out about Chronic Conditions and the Pursuit of Healthier Lives,” the National Council on Aging highlights a survey of 1,000 people over 44 years of age with chronic conditions and reveals the tough challenge they face in managing their care. At the extreme, patients feel a sense
Employers give wellness one more shot in this year of economic decline
Even though profitability for American business will be elusive in 2009, many employers are increasing employee wellness programs — and not cutting budgets for these programs. According to Buck Consultants’ survey, employers can find that wellness programs actually help employees deal with the very issues that the economic downturn creates. Since the beginning of the economic downturn in the U.S., Buck’s survey found that employees’ use of wellness programs increased for over one-half of employers. The key metrics for measuring success of thesee programs are cost-effectiveness, changing employee behavior, and measuring health status. Nearly one-half of employers said they were
Consumer engagement is growing in health and driven by costs
A few more consumers are engaging with their health and health care system, according to Deloitte’s second survey into health care consumers in the U.S. Perhaps that’s because 9 in 10 Americans believe that health care costs are a threat to their personal financial security — regardless of whether they have health insurance or whether they’re sick.Deloitte’s 2009 Survey of Health Care Consumers, in this second year of the study, finds health citizens more anxious and more critical of their health system.As the angst grows, though, so, it seems, do behaviors that demonstrate greater health engagement — at least for
Stressful times for States and Health Care in 2009-11
Don’t assume that State Medicaid programs will cover the vulnerable populations this and next year. Even with the stimulus funding provided in ARRA, Governors will be hard-pressed to cover all of the growing demands for health care among citizens in their states. Governors’ budgets are severely constrained due to declining tax receipts and increasing financial obligations, especially for education and health care. According to the Center for Budget and Policy Priorities (CBPP), the American Recovery and Reinvestment Act (ARRA) includes about $140 billion in fiscal relief to the States. However, this funding will cover only about 40% of the $350
Consumer engagement 30 years on: still experimenting
When citizens have more financial skin in the health care game, do they behave more like consumers — looking for and finding value-based health care? And will that behavior lower health care costs? According to 30 years of this social experiment, the jury is still out. But value-based plans may be emerging as a useful model to promote rational use of care that works, while increasing consumer satisfaction. The Employee Benefit Research Institute (EBRI) held a forum to debate the track record of consumer-directed health plans in December 2008, Outlook for Consumer/Patient Engagement in Health Care—30 Years into the Experiment.
Health costs as a global competitive disadvantage – the Business Roundtable speaks
“The problem with the U.S. health care market is that it doesn’t really function as a market – it leaves major consumer needs unmet, costs unchecked by competition and basic practices untouched by the productivity revolution that has transformed every other sector of the economy.” That quote isn’t from a Marxist-leaning, left-wing political operative — it was spoken by Ivan Seidenberg, the Chairman and CEO of Verizon, the telecommunications firm that sits as #17 on the 2008 Fortune 100 list. As one of the largest companies in the world, and certainly in telecomms, Seidenberg has to compete in a global
Hospitals' fiscal health is eroding
The current economic state of the American consumer-citizen is directly impacting the fiscal health of the American hospital.As fewer patients are seeking care for hospital services, providers are struggling to make ends meet. Over 50% of hospitals had a negative total margin in the fourth quarter of 2008; the year before, 31% of hospitals had a negative total margin.The Colorado Hospital’s DATABANK project has compared financial data for 658 U.S. hospitals and published their findings in, The Impact of the Economic Crisis on Health Services for Patients and Communities.While these data do not represent all U.S. hospitals, this report can
Most Americans are worried about affording health care
2 in 3 Americans are concerned about being able to afford health care and prescription drugs. While middle-aged Americans aged 45-54 are the most concerned (76% of the cohort), even 54% of younger people between 18 and 34 years of age are worried about health care costs.HarrisInteractive/HealthDay’s latest suvey into personal health economics finds that people are delaying or avoiding consuming care due to cost. The most common health encounters Americans are avoiding due to cost include:– Dental visits (34%) – Physician visits (28%)– Not receiving a medical test, treatment or follow-up recommended by a doctor (23%)– Prescription drug fills
The economic downturn's impact on employer-sponsored health benefits
Employers providing health insurance to employees continue to focus on workers’ health and productivity, despite economic decline and the need to cut costs. This is good news for 2009. 2010 may be a different story, depending on the length and depth of the recession. Hewitt’s 10th Annual Health Care Report, Challenges for Health Care in Uncertain Times 2009, surveyed over 340 employers in January 2009. 75% of employers said they planned to focus on improving employee health and productivity in the next 3 to 5 years. 19% (1 in 5) said they would stop directly providing health care benefits. This
As DTC ads recede, Rx-email grows for value and support
Most people who receive email messages from pharmaceutical companies tend to like it. 9 in 10 believe it’s a good way to learn about new products entering the market — nearly as many people as those who like receiving travel offers via email. This finding comes from Epsilon‘s Email Branding Study, released in early March 2009. Consumers see a very valuable aspect of email from pharma companies is receiving coupons to use in paying for prescription drugs, as well as learning about products. A third value of email from drug companies is receiving a source of support in personal medical
Patient Satisfaction with Docs is Up, and Quality Could Follow
Patients have spoken, and they really like their care providers. It’s good news for medical practices that patient satisfaction is on the rise, and has been for the past year. As practices pay attention to consumer-facing issues like waiting room times, ease of scheduling, and, yes, exam room manners, patients get more satisfied with care. This survey dovetails nicely with a study published in the March 3, 2009, issue of the Annals of Internal Medicine, which finds that patients who are more connected to a physician were most likely to receive recommended care. The study, Patient-Doctor Connectedness and the Quality
The #1 fear among Americans in the recession is job loss; health costs follow
American consumer sentiment over the past year feels and looks like a rollercoaster ride in freefall, ever driving downward as the chart shows. It’s jobs and health costs forcing the downward trajectory. More than stock market declines and saving for retirement, Americans fear two things most in this recession: losing their job, and the costs of health care. 38% of Americans cite unemployment as their biggest concern in early February 2009. Unemployment fears are shared by both men and women. Younger Americans are more concerned about losing a job (50%) than older people (22%) — who are more concerned about
Why care about regional variations in health costs?
Why was per capita spending on people enrolled in Medicare $2,500 more in East Long Island, NY, than in San Francisco in 2006? Did the folks in New York get better care and achieve better outcomes than those on the west coast? The answer is, “no.” Welcome to the world of health care cost variation, the topic of an important paper published in the February 26, 2009, issue of New England Journal of Medicine, “Slowing the Growth of Health Care Costs – Lessons from Regional Variation.” This research is important because it shines a light on the critical issue of
Citizens self-rationing care due to cost
Americans skipped recommended medical tests and procedures, cut pills, and skipped dental care due to cost in the past year. Welcome to the world of rationing, borne not from a government program, but of private sector market forces. With all due respect to Adam Smith, market forces don’t always work in the best interests of public health. The latest iteration of Kaiser Family Foundation‘s Health Tracking Poll published February 25, 2009, found that 53% of Americans did at least one self-rationing health behavior because of cost in the past year (roughly February 2008 to February 2009). The most common health
The New Black Box Warning: Lack of Health Insurance
A new black box warning has arrived on the U.S. health care scene: the lack of health insurance is hazardous to your health. In 2004, the Institute of Medicine (IOM) recommended that Congress act to get the U.S. to universal health coverage by 2010. Today, the rate of uninsurance in the U.S. increases by the month as health costs continue to rise. Thus, the IOM notes today in a new report, “there is no evidence to suggest that the trends driving loss of insurance coverage will reverse without concerted action.” The Institute’s latest report into the nation’s state of health
Does "patient knowledge" lead to inappropriate care? Better empowering health information-seeking patients
4 in 10 cancer patients sought information via the Internet, according to a new study to be published in the April 1, 2009, issue of the peer-reviewed journal, Cancer. The downside of information-seeking cancer patients, according to the study, is that 1 in 4 of these patients received the drugs off-label — that is, for a use not approved by the FDA. In these cases, the cancer drugs have been used for patients in both late and early stages of cancer– the latter for which a drug might not be approved for use. The study looked at the relationship between
The economy is rationing health IT spending – implications for ARRA
We’re living in the hype cycle of the HIT portion of the economic stimulus package. Lest we get too carried away, a survey sponsored by NCR reminds us that hospitals are rationing their health IT spending in 2009.Only 15% of hospital leaders say the economy is having ‘no effect’ on their IT spending. Otherwise, 36% are cautious; 14% are slowing down spending; 19% of leaders are postponing ‘some’ purchases; and, 16% are postponing all non-essential projects. Hospitals are facing declining revenues in the recession. Coupled with rising joblessness, hospitals’ financial health is eroding. The negative impact of hospitals’ declining fiscal
Health Brands Aren't Very Social
In the top 100 most social brands determined by Vitrue, not a single one is directly related to health or health care.Among the most visible industry sectors in top 100 are: Automobile manufacturers (Ford, Honda, Lincoln, GM and Mercedes rank highest among the autos). All-things-Apple including the #1 socially-ranking iPhone, #3 Apple corporate, #7 iPod, and the Mac itself at #16. Broadcasters including #2 ranked CNN, MTV, Turner, Fox News, and ABC all in the top 25. Food is very social, with Starbucks, Coke, Pepsi, McDonalds, Subway, Red Bull, Wendy’s, Burger King, Sprite, Chili’s, KFC and Taco Bell in the
Health and mobile phones – not a luxury in the economic downturn
The Mobile Phone Congress is buzzing in Barcelona, and there are signs that the sector is healthier than other parts of the global economy. Despite the downturn in economies ’round the world, mobile phones are a bright spot bringing happy ringtones to the otherwise dismal forecast in consumer spending. According to Nielsen’s research into the mobile phone market released at the Congress, U.S. and European mobile consumers plan to increase their adoption of mobile data services in the next two years. Nearly 71% of consumers expect to use the mobile Internet on a daily basis. According to Tellabs, “mobile data
Americans support elements of ObamaHealth – but lack faith in Congress
Federal negotiations on prescription drug prices, covering kids’ health care, and requiring insurance companies to accept people with pre-existing health conditions are among the most popular elements of President Obama’s health reform platform among all Americans. However, tempering the public’s majority support for these health plan ideas, Americans don’t have much confidence in Congress these days. Based on a poll taken by Rasmussen Reports on the stimulus package, two in three Americans say they trust their own judgment on economnic matters ore than they trust the average member of Congress. According to Rasmussen, “voters believe that no matter how bad
Patients are driving generic drug use; doctors follow through
Virtually all doctors are worried that patients aren’t filling their prescriptions. In addition to not filling Rx’s, physicians are most concerned about patients’ skipping doses, splitting pills, discontinuing other treatments, sharing prescriptions, and taking expired meds.Physician survey on generic drug use, a survey from Epocrates, the clinical decision support company. As the chart shows, doctors’ choices to prescribe generic drugs are often driven by their patients. In one out of 4 instances, physicians say either the patient prefers a generic or the patient asks for a generic drug. In 1 in 5 doctors, they “always” prescribe generics if available. Doctors
Disease management in Medicare won't solve the long-term deficit problem in the U.S.
Peter Orszag, the Director of the Office of Management and Budget, has said that Medicare will be the long-term driver of a U.S. economic deficit. Underneath that forecast, it’s the cost of managing chronic disease for Medicare enrollees that’s the main fiscal challenge. Quality of Care, and Health Expenditures Among Medicare Beneficiaries, published in the February 11 2009 Journal of the American Medical Association (JAMA), analyzes the patient outcomes and costs gathered in 15 Medicare disease management pilots conducted between April 2002 and June 2005. Dr. Deborah Peikes and colleagues looked at DM programs targeting heart disease, diabetes, and chronic
Searching for prescription drug info online – from the clinical to the financial
The number of people searching for prescription drug information online has tripled in five years, according to the latest insights from Manhattan Research‘s ePharma Consumer study. 90 million Americans looked for Rx information in 2008, compared with 25 million in 2003, Mark Bard, the president of Manhattan Research (MR), told a group of webinar attendees on 9th February 09. Bard and his team at MR call these 90 million, “ePharma Consumers.” Fewer than 50 million people searched online for any health information in 2002; that reached 150 million in 2008. MR’s database is very rich and large, enabling the firm
Women, jobs, coupons – what's growing online is a reflection of the economy
Observing the growth in Internet web site traffic is a perfect reflection of what’s going on in the economy. In 2008, the greatest growth in site-types was in job search, women’s-oriented content, coupons, and politics. Online gaming and gambling also gained a lot of eyes in 2008. And, visitors to online classified ads grew by 27%, while traditional print channels – notably newspapers – took a direct hit. In classifieds, it’s about people trying to save and make money through the purchase and sale of used items, according to comScore‘s report, “The comScore 2008 Digital Year in Review.” The big
The State of America's Health Care, Through the Eyes of Physicians
America’s internal medicine physicians have a prescription for reforming the U.S. health system. It’s a chicken-in-every-pot solution of: 1. A primary care doctor, and 2. Affordable and accessible health care for all. This solution comes out of the American College of Physicians‘ (ACPs’) view that primary care is in crisis mode in the U.S. The signs of crisis, according to the ACP, are: Too many uninsured and under-insured people. Too few primary care physicians. Getting a poor return-on-investment on health spending. Putting wasteful administrative burdens on doctors that take away from time to care. Not putting the patient at the
Wine and vitamins: what consumers are buying in the recession
Americans’ purchases at the grocery store are shifting based on the economic downturn. The headline from NielsenHealth is that consumers are searching for quality and value when shopping. And, people are cooking more at home and purchasing staple goods to have in the pantry. Americans are also buying more wine and vitamins. Dried vegetables and grains along with salads are also up. Could it be that the recession is driving consumers toward some healthy food habits? Perhaps, at least for some. At the beginning of each year, there’s an upward blip driven by New Year’s weight loss resolutions in the
Consumers demand transparency and authenticity in financial services: implications for health
In this $819 bailout, post-Lehman Bros., post-Madoff, era, Americans are looking for clear, jargon-free, transparent information. According to a survey from Siegel+Gale, the branding consultancy, the two new “marketing imperatives” are transparency and authenticity. While the financial market implosion is top-of-mind among consumers in this economic downturn, it’s not only financial statements that Americans criticize. After mortgage applications, the second most difficult-to-understand form is the explanation of benefits (EOB) for a health insurance claim. And fifth on this list of difficult financial forms is the Medicare statement, after Federal tax returns and investment account statements. These and other findings about
"Managed consumerism" – a look at the past decade of consumer-driven health from two gurus
“The performance of consumer-driven health care has fallen short of both the aspirations of its proponents and the fears of its critics,” according to a review of the state of consumer-directed health care published in Health Affairs. Jamie Robinson of UC-Berkeley and Paul Ginsburg of the Center for Studying Health System Change examine the first decade of consumer-driven health care (CDH). Early in the paper, the authors assert that there isn’t a Grand Unified Theory of CDH: it can be viewed through the various lenses of “philosophical advocates,” business entrepreneurs with profit motives, and policy change agents looking to incorporate
Only 1 in 10 unemployed people buy into COBRA
Because of high premiums, only 9 percent of unemployed workers have COBRA coverage. Maintaining Health Insurance During a Recession: Likely COBRA Eligibility, a study from The Commonwealth Fund (CMWF), clarifies how COBRA is actually used by unemployed people in the U.S. CMWF calculates that: – Two of three working adults are eligible to buy into COBRA under the 1985 Consolidated Omnibus Budget Reconciliation Act (COBRA) if they became unemployed. – Under COBRA, workers pay 4 to 6 times their current premium for health benefits. – Thus, only 9 percent of unemployed workers have COBRA coverage due to the high price
Prescription drugs as a luxury good in the U.S.
Drugs are becoming a luxury product in the U.S. for a growing number of citizens. The Center for Studying Health System Change (CSHSC) found that the proportion of Americans under age 65 who are having problems paying for prescription drugs grew from 10.3% in 2003 to 13.9% in 2007. This is a 35% increase.This finding comes from the Center’s tracking report, More Nonelderly Americans Face Problems Affording Prescription Drugs.CSHSC dug into data from the Center’s 2007 Health Tracking Household Survey to come up with this finding. The survey data reveals that, in 2007, 36.1 million Americans did not get prescription
Vitamin-takers are more health-engaged
150 million Americans take vitamins and other supplements every year. These people place health care issues as a top-two priority in their lives. The economy, as regular Health Populi readers know, has been Issue #1 for the majority of Americans since mid-2008. The 2008 CRN Consumer Survey on Dietary Supplements confirms this. The Council for Responsible Nutrition (CRN) is the trade group in Washington, D.C., that represents dietary supplement manufacturers and suppliers to the industry. The interesting wrinkle in this survey is that the CRN measured differences between citizens who take supplements and those who do not. As the chart
The growing affordability gap in health care
The affordability gap — that is, the difference between workers’ earnings and active employee health care costs — continues to increase. Health care costs have increased more than 150% over the past eight years, while employee wages have risen only 37%.For two decades, Towers Perrin has been tracking health costs in the U.S. On this 20th anniversary of its health cost survey, the benefits consulting firm finds that an individual retiring at age 60 will need $250,000 saved to pay health care premiums and out-of-pocket costs. 20 years ago, that same retiree needed $40,000 in savings to fund health care
Prospects for health reform – the economy both drives and splits consensus
The economy, the economy, and the economy — and a dash of Iraq and health care — are on American citizens’ minds when it comes to what they want President Obama to address when he takes office.Kaiser Family Foundation (KFF) and the Harvard School of Public Health (HSPH) have come together once again — as they’ve done since 1992 — to gauge Americans’ interest in health as a priority for the President and Congress. In this poll, conducted in December 2008, health is seen by people as integral to the economy. The chart illustrates that 30% of people had a
Job losses, uninsurance and underinsurance
“People who are underinsured end up facing almost identical problems as the uninsured. The difference is, they paid for the privilege.”This observation by Karen Pollitz, director of the Health Policy Institute at Georgetown University, is a harbinger of what will happen very quickly among workers in the U.S. in 2009 — employed and laid-off.Three pieces of data are the dots to connect that get you to Pollitz’s Maxim: – The pace of job losses and depth of the recession – COBRA costs. – $1,000 — the new deductible. The Federal Reserve of Minneapolis analyzed 10 post-war recessions since 1948 and
How the new economy can motivate health engagement — for the better
There are ten New Rules of health engagement, according to the health communications guress Nancy Turett at Edelman:1 Provide deep content.2 Be transparent.3 Inform in real time.4 Participate actively in conversations across multiple channels.5 Engage in prevention, chronic health problems and access to health care.6 Take a holistic approach to health and well-being.7 Address people’s multiple stakes in health, including their personal ones.8 Be personal.9 Engage through health-expert channels and sources.10 Consider the risks of not engaging. You can reach more in-depth on these New Rules at the Edelman blog, Engage in Health, which spotlights their work on the Health
Employers' prescriptions for staying in the health care game
About 60% of Americans receive health insurance through their employers. Employers should continue to be the platform on which health benefits are provided in America, according to the American Benefits Council. In its report, Condition Critical: Ten Prescriptions for Reforming Health Care Quality, Cost and Coverage, the Council offers ten maxims it believes will bolster a sustainable health system. ABC is an association of Fortune 500 companies and others that sponsor or provide services to health plans. Together, they represent over 100 million Americans. The 10 “prescriptions” include: Building on existing, voluntary employer-based health coverage. Maintain a Federal framework –
"Free" antibiotics and wellness — a 2009 retail health update
‘Tis the season for free antibiotics. Retail health is not only promoting convenience; the sector is promoting ‘free’ health care in the form of antibiotics (at least until March 31st, 2009). The cheap/free drug trend began with Wal-Mart’s $4 generic program, which launched in 2006. Like proverbial dominoes falling, Target quickly joined Walmart. Then Kmart and food chains began to offer variations on the theme of cheap drugs. The latest retailer to join the free drug trend is Wegmans, the 72-store family-owned chain headquartered in upstate New York. I’m fortunate to have a Wegmans in my community, and I’m a
Health spending is the #1 threat to balancing the U.S. budget: findings from the CBO
The rate of growth of health spending is the single greatest threat to balancing the U.S. budget in the long term. That’s the key message in The Budget and Economic Outlook: Fiscal Years 2009 to 2019, the latest forecast from the Congressional Budget Office released on January 7, 2008. The report states that the three largest mandatory spending programs in America — Social Security, Medicare, and Medicaid — will grow by at least 8% in 2009. At the same time, the U.S. economy is expected to decline by 2.2% (this does not take into account any potential stimulus spending to
Hospitals suffer in the economic downturn
Hospitals reported an 8% increase in uncompensated care between the third quarters of 2007 and 2008. The economic downturn in the U.S. has already had a negative impact on the hospital sector, and will continue to do so in 2009.The American Hospital Association recently surveyed members, and found that the recession has negatively impacted hospitals in at least five ways:– Declining admissions– Falling elective surgery volumes– Reduced patient payments and growing bad debt– Declining investment income– Dried-up capital.For more details on the AHA survey, see my November Health Populi post, Hospitals Sickened by the Economy.Health Populi’s Hot Points: Hospitals will
Online trumps print for health information – Pharma's window of opportunity to build trust online
When it comes to health information, online trumps print. Online is the #1 source for health information among 83% of consumers; print attracts only 11% of people as the go-to source for health information. Broadcast is preferred by only 5% as the primary preferred health information source. Once online, it’s health-focused websites that get the lions’ share of search: 1 in 2 American adults use general health-focused Web sites 43% research specific conditions on ailment-focused sites 5% go to online communities 3% go to pharmaceutical companies’ branded drug sites. Prospectiv conducted this survey into Internet health habits in October 2008.
Health and health care in 2009 – a year of managing risks – forethoughts and wild cards
As we inevitably do this time of year, we prognosticate about the new year. This time around, it’s a toughie: there are too many uncertainties that preclude us from doing a straight-line forecast for 2009, especially in health and health care.Here are some trends and wild cards to keep in mind for 2009: the year of managing risks. How will the macroeconomy play out against health care in the new year? Keep in mind the Kaiser Family Foundation‘s metric on unemployment: an increase of 1% unemployment leads to 1.1 million uninsured, and 1 million more people added to Medicaid. This
Zucchini-Carrot-Potato Latkes – a Health Populi exclusive recipe!
Regular readers of Health Populi know that I’m an avowed foodie (and a champagne-y, too), a longtime member of Slow Food, and adherent to the locavore movement as much as possible.When I mentioned making self-created carrot/zucchini/potato latkes on Twitter on Chanukah Eve this past Sunday afternoon, I received a request for this recipe from one of my favorite Tweeters – Cheryl Greene of DrGreene.com. For those of you who don’t ‘get’ why Jews eat latkes at Chanukah, it’s to do with the miracle behind the holiday. Chanukah (alternatively spelled “Hanukkah”) is known as the Festival of Lights, celebrated for eight
HIT Predictions for 2009 on iHealthBeat
My annual forecast for health information technology in 2009 is up on iHealthBeat, the online publication of the California HealthCare Foundation that reports on the impact of technology on health care. Industry Predictions: What Are the Drivers Shaping Health Care IT in 2009? will tell you about the driving forces shaping health information technology for 2009 and beyond. This column can help inform your market and business planning efforts in this very hazy time. Among the issues you’ll hear about are: The role of health in the larger U.S. macroeconomy Team Obama’s views on investment in health IT The role
Combining Rx and OTCs can increase adverse events in older people
1 in 2 older Americans use prescription drugs and over-the-counter products together. 4% of them are at-risk of adverse drug interaction.The potential for adverse reactions is substantial; nearly 30% of older adults take at least 5 Rx medications on a regular basis. Older people are the biggest consumers of prescription meds and thus are more at-risk for adverse events in combining these drugs with other drugs, and with OTCs and supplements.These warnings come out of a study that will be published in the 24/31 December issue of JAMA. The researchers analyzed drug/OTC use among adults 57 years of age and
'Tis the season for health data – welcome to the State of the USA and HealthLandscape
‘Tis the season of health data projects. First, The State of the USA. There are 20 critical data points you need to know to understand, and then improve, the health of the U.S. A new and expansive data collection effort is underway that will inventory the most credible of these indicators so we have a true picture of the nation’s health. State of the USA, Inc (SUSA), is the organization that’s taking on this task. SUSA is a non-profit organization that will collect data on a broad range of issues, health and beyond. They’ve asked the Institute of Medicine for
Out of pocket health costs strain family budgets
There is very little cushion in family budgets for health care costs — even for families with insurance coverage. So says the Center for Studying Health System Change (CSHSC), which regular Health Populi readers know is one of my most valued sources on information on the microeconomy of health in the U.S.CSHSC’s latest Issue Brief is succinctly titled, Living on the Edge: Health Care Expenses Strain Family Budgets. Simply put, American families’ budgets are strained in the economic downturn; if you’re sick, managing chronic conditions, and fall into the middle to lower income earning groups, your budget for health care
What banks can bring to health care
Globally, the banking industry is in a deep funk. From enduring $billion exposures due to Mr. Madoff’s Ponzi scheme to exorcising bad debt, defaulted mortgages, and shedding employees, it appears that banking isn’t the business to be in for the moment. There is a hopeful growth area in banking, though — it’s health care. As employers who sponsor health insurance look to rationalize medical spending, more are looking to HSAs coupled with high-deductible health plans (HDHPs). In 2008, HSAs amounted to about $6 billion in the second quarter of 2008. As these plans get more uptake, financial services institutions will
Cybercitizens' ranks expand as Americans face increasing health cost burdens
There is good news and bad news in the rich data mine that is the latest version of Manhattan Research’s Cybercitizen Health survey. On the positive side of eHealth, the number of Americans who are seeking health information online has more than doubled since 2002. On the downside, nearly 40 million Americans did not fill a prescription due to cost. This isn’t just for preparations that are available over-the-counter or those for nasal allergies. The top ten conditions that people not filling prescriptions haven’t filled cover a great many mental health conditions, along with pain and assorted other maladies that
The economy impacts health behaviors: more insights from AARP and the over-45s
1 in 2 people over 45 say they’ve taken a generic drug or over-the-counter (OTC) medication instead of a prescription drug due to the current economic situation. The AARP‘s report, Impact of the Economy on Health Behaviors, analyzes the survey responses of 820 Americans 45 years of age and older polled in October 2008. Asked what health behaviors they may done as a result of the declining economy, the most common reactions among 45+ Americans were: Taking a generic or OTC medication, 51% Delaying seeing a doctor, 22% Cutting back on other expenses, 21% Seeking assistance in getting prescription drugs
Let the children lead us…the sea is wide, our boat is small
Over 8 million American children under the age of 18 didn’t have health insurance in 2005. More than 2 million of these kids had parents who had health insurance through their employers. The growth of child poverty will inevitably increase during the economic recession in the U.S. What’s your hunch on how many more kids will lose access to health insurance — even if their parents keep their jobs? The study, Uninsured Children and Adolescents With Insured Parents, debunked the myth that kids of parents with health insurance have health coverage was published in October 22/29, 2008, in the Journal
Word-of-mouth remains the top consumer channel for finding a physician
With all of our (including my) talk about Health 2.0 and consumerism in American health care, the fact remains that most Americans rely on family and friends to find a primary care physician (PCP). That would be known as “word-of-mouth.” 27% of people rely solely on their friends’ and relatives’ opinions about PCPs. On the other hand, 2 in 5 people use multiple sources to find a PCP.When it comes to selecting a specialist, it’s a different picture. 2 in 3 Americans take their PCPs’ referral advice. Sicker people tend to go with their PCP’s recommendations. But 1 in 5
Americans still believe access and cost and the two key health concerns – but paradox between government vs. private
Gallup‘s latest poll of Americans’ top health concerns survey are firmly focused on access and cost. This has been true for each of the last seven years that Gallup has conducted this survey. These data echo the findings of Kaiser Family Foundation‘s last health tracking poll for the 2008 election season from October 2008.But there are are differences in the role that government should play in the system: while most Americans see that government’s role should expand in health care, 49% would still like to keep the current, private health insurance-based system. 49% of Americans prefer a “government-run system.”The continuum
Cyberchondria: a short history, Microsoft's systematic study, and Wikipedia could be health-risky
The concept of “cyberchondria” is not new. My first exposure to the term was through a study by Harris Interactive in 2002 which conducted a global cyberchondria study comparing health citizens online in the France, Germany, Japan and the U.S. The study defined cyberchrondriacs as “people who use the Internet for health purposes.” Harris’s poll found that these citizens tended to find health information online to be trustworthy, of good quality, easy to understand and easy to find. In 2002, 93% of cyberchondriacs in the U.S. and France found online health information to be trustworthy. The term cyberchrondria was used
Engage with Grace – toward improving the end-of-life journey for all
In this season of thanks, I am thankful to my wonderful parents, Chuck and Polly Sarasohn. They both had challenging end-of-life struggles — Dad in 2007, and Mom in 1979. I highlighted Dad’s unfortunate experience with an overlooked DNR order while in a congestive heart failure inpatient unit in an iHealthBeat column, Digital Diretives Could Aid End-of-Life Care, in June 2007. This post comes to you as part of a “blog rally,” as described in today’s Boston Globe. Several dozen bloggers in and beyond health are simultaneously posting this message to encourage dialogue around the dinner table about a topic
The Month of the Mom – Recession, Re-invention, Food and Health
Moms represent a $2.1 trillion market, according to the Marketing to Moms Coalition. “Dear Marketers, Recession is the mother of invention,” begins a full-page ad in the November 17, 2008, Advertising Age magazine. The ad promotes Cookie magazine, a monthly targeted to mothers with the tag-line, “Life. Style. Family.” I’ve thought a lot about Moms in the past two weeks in the context of marketing and health. The State of the American Mom report from the Marketing to Moms Coalition was released. This quantitative study examines the impact of mothers’ choices on retail preferences and household decision making. Two in
Will a $1,000 deductible ration health care utlization among the insured?
Employers shifted more out-of-pocket health costs to employees in 2008 while holding benefit cost increases to about 6%, according to Mercer, the benefits consulting firm. The most striking single piece of data that came out of Mercer’s annual National Survey of Employer-Sponsored Health Plans is that the median deductible for employees enrolled in a PPO reached $1,000 for the first time, after 7 years of hanging at $500. PPOs cover 69% of all enrolled employees in the U.S. (= 2 in 3 commercially insured Americans). Blaine Bos of Mercer points out that raising the deductible is one way for employers
Hospitals sickened by the economy, according to the American Hospitals Association
40% of American hospitals have seen drops in inpatient admissions, according to the American Hospital Association.In the AHA’s survey, Report on the Economic Crisis: Initial Impact on Hospitals, it’s clear that hospitals are already experiencing the effects of the economic downturn. CEOs are considering several cost-cutting tactics in dealing with this financial crisis: 56% of CEOs are postponing renovations or plans to increase capacity 45% are delaying purchase of clinical technology or equipment 39% are postponing investments in new information technology. The AHA polled 736 hospital CEOs, concluding the survey in November 2008. Additional data was available from AHA’s DATABANK
Forget ER, Gray's Anatomy, or even House; the Life and Times of an American Doctor feel more like The Biggest Loser
Nearly 1 in 2 practicing physicians would retire today if they had the financial means to do, according to physicians polled in the annual survey conducted for The Physicians Foundation and Merritt Hawkins & Associates, a physician search and consulting firm. This number holds for physicians both under and over the age of fifty.The survey, The Physicians’ Perspective: Medical Practice in 2008, provides the grueling details of what doctors are thinking these days about their profession, their businesses, prospects for the future, and information technology.The findings are grim. Based on a poll of 12,000 physicians, and open-ended responses from 4,000
Employers still want to be involved in health care
While the front pages of U.S. and business newspapers are featuring the story of the health-cost hampered Big (and increasingly smaller) 3 automakers looking for a mega-loan, most employers still want to play a key role in the U.S. health system. It’s the legacy of providing health care benefits to the ever-growing list of retirees from GM, Ford and Chrysler that’s crippling the industry. That, and a few other issues — among them, drivers’ preferences for gas-efficient, stylish and high performing cars. Simply put, lots of Americans prefer autos built overseas. Beyond the auto manufacturers, though, a new survey from
I'm in amazing company here with other #digitalhealth innovators, thinkers and doers. Thank you to Cristian Cortez Fernandez and Zallud for this recognition; I'm grateful.
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.