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Stress in America, Like COVID-19, Impacts All Americans

With thirteen days to go until the U.S. #2020Elections day, 3rd November, three in four Americans say the future of America is a significant source of stress, according to the latest Stress in America 2020 study from the American Psychological Association. Furthermore, seven in 10 U.S. adults believe that “now” is the lowest point in the nation’s history that they can remember. “We are facing a national mental health crisis that could yield serious health and social consequences for years to come,” APA introduces their latest read into stressed-out America. Two in three people in the U.S. say that the

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Women’s Health Policy Advice for the Next Occupant of the White House: Deal With Mental Health, the Pandemic, and Health Care Costs

2020 marked the centennial anniversary of the 19th Amendment to the U.S. Constitution, giving women the right to vote. In this auspicious year for women’s voting rights, as COVID-19 emerged in the U.S. in February, women’s labor force participation rate was 58%. Ironic timing indeed: the coronavirus pandemic has been especially harmful to working women’s lives, the Brookings Institution asserted last week in their report in 19A: The Brookings Gender Equality Series. A new study from Tia, the women’s health services platform, looks deeply into COVID-19’s negative impacts on working-age women and how they would advise the next occupant of

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The COVID-19 Pandemic Has Accelerated Our Demand for Wellness – Learning from Ogilvy

Every company is a tech company, strategy consultants asserted over the past decade. The coronavirus pandemic has revealed that every company is a health and wellness company now, at least in the eyes of consumers around the world. In The Wellness Gap, the health and wellness team at Ogilvy explores the mindsets of consumers in 14 countries to learn peoples’ perspectives on wellness brands and how COVID-19 has impacted consumers’ priorities. A total of 7,000 interviews were conducted in April 2020, in Asia, Europe, Latin America, and North America — including 500 interviews in the U.S. The first chart illustrates

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Black Health Should Matter More in America: The Undefeated Survey on Race and Health

In 2020, most Black people, men and women alike, feel it is a bad time to be Black in America. More than twice as many Black men believed that in 2020 compared with 2006. More than four times as many Black women believed that it’s a bad time to be Black in America in 2020 versus 2011, we learn in  The Undefeated Survey on Race and Health from Kaiser Family Foundation (KFF). KFF collaborated with The Undefeated, ESPN’s project that focuses on sports, race, and culture. The Undefeated program was started in May 2016, and has become a thought leader

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In the Past Ten Years, Workers’ Health Insurance Premiums Have Grown Much Faster Than Wages

For a worker in the U.S. who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. The first chart illustrates the growth of the premium shares split by employer and employee contributions. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. The worker’s contribution share was 29% in 2010, and 26% in 2020. Single coverage reached $7,470 in 2020 and was $5,049 in 2010. Roughly the same proportion of companies offered health benefits to

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Financial Health Is On Americans’ Minds Just Weeks Before the 2020 Elections

Financial health is part of peoples’ overall health. As Americans approach November 3, 2020, the day of the real-time U.S. Presidential and down-ballot elections, personal home economics are front-of-mind. Twenty-seven days before the 2020 elections, 7 in 10 Americans say their financial health will influence their votes this year, according  to the doxoINSIGHTS survey which shows personal financial health as a key voter consideration in the Presidential election. Doxo, a consumer payments company, conducted a survey among 1,568 U.S. bill-paying households in late September 2020. The study has a 2% margin of error. U.S. voters facing this year’s election are

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Social Determinants of Health Travel in Groups – At the Root Is Household Income

The U.S. health care community is collectively embracing the concept of social determinants of health that have become so obvious in understanding the disparities of health outcomes wrought by the coronavirus pandemic. Research from the Harvard Chan School of Public Health conducted with the Robert Wood Johnson Foundation and NPR illustrates the fact that people who are at risk for one social determinant of health tend to be challenged by a bucket of them. The survey research reported in The Impact of Coronavirus on Households With Children, published on 30th September, found that 61% of U.S. households with children had

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Redefining PPE As Primary Care, Public Health, and Health Equity – The Community PPE Index

In May 2020, the Oxford English Dictionary (OED) re-visited the acronym, “PPE.” As OED evolves the definition of PPE, the wordsmiths could borrow from OSHA’s website, noting that PPE, “is equipment worn to minimize exposure to hazards that cause serious workplace injuries and illnesses. These injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. Personal protective equipment may include items such as gloves, safety glasses and shoes, earplugs or muffs, hard hats, respirators, or coveralls, vests and full body suits.” Perhaps Definition 3 in the OED could be updated by a blog

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DIY Health Care and Self-Care Accelerating in the Pandemic

The coronavirus pandemic has spawned many side-effects re-shaping consumers’ everyday lives. Among them, more time at home, DIY life-flows, and financial well-being are driving growth of self-care health care. An article in the latest Drug Store News talks about consumers growing more health-conscious, adopting natural, homeopathic products. “It’s about more than washing your hands,” David Salazar explains. “Fending off illness has become a state of mind for many consumers throughout the COVID-19 pandemic.” In feeling dis-empowered in the face of the pandemic – with the first shock of the Great Lockdown and stay-at-home mandates – we’ve taken on more do-it-yourself behaviors, from

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Health Citizenship in the America. If Not Now, When?

On February 4th, 2020, in a hospital in northern California, the first known inpatient diagnosed with COVID-19 died. On March 11th, the World Health Organization called the growing prevalence of the coronavirus a “pandemic.” On May 25th, George Floyd, a 46-year-old Black man, died at the hands of police in Minneapolis. This summer, the Dixie Chicks dropped the “Dixie” from their name, and NASCAR cancelled the confederate flag from their tracks. Today, nearly 200,000 Americans have died due to the novel coronavirus. My new book, Health Citizenship: How a virus opened hearts and minds, launched this week. In it, I

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Only in America: The Loss of Health Insurance as a Toxic Financial Side Effect of the COVID-19 Pandemic

In terms of income, U.S. households entered 2020 in the best financial shape they’d been in years, based on new Census data released earlier this week. However, the U.S. Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019, with about 30 million Americans not covered by health insurance. In fact, the number of uninsured Americans rose by 2 million people in 2018, and by 1.9 million people in 2017. The coronavirus pandemic has only exacerbated the erosion of the health insured population. What havoc a pandemic can do to minds, bodies, souls, and wallets. By September 2020,

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Americans Worry About Medical Bankruptcy, As Prescription Drug Costs Play Into Voters’ Concerns

One in two people in the U.S. are concerned that a major health event in their family would lead to bankruptcy, up 5 percent points over the past eighteen months. In a poll conducted with West Health, Gallup found that more younger people are concerned about medical debt risks, along with more non-white adults, published in their study report, 50% in U.S. Fear Bankruptcy Due to Major Health Event. The survey was fielded in July 2020 among 1,007 U.S. adults 18 and older. One of the basic questions in studies like these is whether a consumer could cover a $500

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The Burden of Depression in the Pandemic – Greater Among People With Fewer Resources

In the U.S., symptoms of depression were three-times greater in April 2020 in the COVID-19 pandemic than in 2017-2018. And rates for depression were even higher among women versus men, along with people earning lower incomes, losing jobs, and having fewer “social resources” — that is, at greater risk of isolation and loneliness. America’s health system should be prepared to deal with a “probable increase” in mental illness after the pandemic, researchers recommend in Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic in JAMA Network Open. A multidisciplinary team knowledgeable in medicine, epidemiology, public health,

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How COVID-19 Is Reshaping Cities and Inspiring Healthcare Innovation

The coronavirus pandemic added a new concept to our collective, popular lexicon: “social distancing” and “physical distancing.” This was one pillar for the public health prescription we were given to help mitigate the spread of a very tricky, contagious virus. A major negative impact of our sheltering in place, working from home, and staying indoors has been a sort of clearing out of cities where people congregate for work, for culture, for entertainment, for education, for travel and tourism…for living out our full and interesting lives and livelihoods. Intel gave Harbor Research a mandate to “re-imagine life in a post-pandemic

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Pharma’s Future Relevance Depends on Empathy, Messaging, Partnering, and Supporting Patients and Providers

COVID-19 is re-shaping all industries, especially health care. And the pharma industry is challenged along with other health care sectors. In fact, the coronavirus crisis impacts on pharma are especially accelerated based on how the pandemic has affected health care providers, as seen through research from Accenture published in Reinventing Relevance: New Models for Pharma Engagement with Healthcare Providers in a COVID-19 World. For the study, Accenture surveyed 720 health care providers in general practice, oncology, immunology, and cardiology working in China, France, Japan, the United Kingdom, and the U.S., in May and June 2020. Top-line, Accenture points to four

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Health Insurance Affordability in the Time of the Coronavirus Pandemic

The coronavirus pandemic has revealed many flaws in the U.S. healthcare system, first and foremost the nation’s patchwork public health infrastructure and health inequities in mortality rates due to COVID-19. The Commonwealth Fund‘s biennial report, published as the pandemic continues into and beyond the third quarter of 2020, sheds light on another weakness in U.S. healthcare: the cost of health insurance relative to working Americans’ relatively flat incomes. I explored the details of this study in a post titled Health Insurance Affordability: A Call-to-Action for Healthcare Industry Stakeholders in the Pandemic, published on the Medecision Liberation blog site. The survey

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My ABCovid-19 Journal – Day 1 of 5, “A” through “E”

My friends… It’s time in this pandemic journey that I take a full week to re-charge and bask in the midst of nature, a lake, farm-to-table food, wine-making, and the love of and therapeutic time with my wonderful husband. My gift to you all this week, 10th – 14th August, is to share with you pages from my “ABCovid-19 Journal” that I created/curated in the first weeks of the coronavirus pandemic. We all have our hacks for managing stress and discomfort, and in the first weeks of COVID-19, this was my life-saver. Journaling is one of my self-care strategies; think

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The Racial Divide Due to COVID-19 Also Applies to Healthcare and Pharma Costs

Into the sixth month of the coronavirus pandemic in the U.S., it’s clear that COVID-19 has wreaked a greater mortality and morbidity impact on people of color than on white adults. A new Gallup-West Health poll found that the coronavirus also concerns more non-white Americans than whites when it comes to the cost of health care and medicines to deal with the effects of COVID-19. Considering the cost of COVID-19 treatment, across all U.S. adults, 40% of people are concerned (extremely/concerned), and 41% are “not at all concerned.” Broken down by race, there is a stark difference in levels of

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We Are All About Hygiene, Groceries, and Personal Care in the Midst of the Coronavirus Pandemic

Pass me the Clorox…tip the UPS driver…love thy grocer. These are our daily life-flows in the Age of COVID-19. Our basic needs are reflected in the new 2020 Axios-Harris Poll, released today. For the past several years, I’ve covered the Harris Poll of companies’ reputation rankings here in Health Populi. Last year, Wegmans, the grocer, ranked #1; Amazon, #2. In the wake of the COVID-19 pandemic, U.S. consumers’ basic needs are emerging as health and hygiene, food, and technology, based on the new Axios-Harris Poll on the top 100 companies. This year’s study was conducted in four waves, with the

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The Unbearable Heaviness of Healthcare in America – the Change Healthcare/Harris Poll

The phrase, “burden of health care,” has two usual meanings: one, to do with the massive chronic care burden, and the other, involving costs. There’s a third area of burden in U.S. health care — the onerous patient experience in finding and accessing care, assessed in the 2020 Change Healthcare – Harris Poll Consumer Experience Index. Two in three U.S. consumers feel like “every step of the healthcare process is a chore.” That burdensome patient experience leads to one in two people in America avoiding seeking care, the poll found. That’s not just self-rationing health care due to costs, but due

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Return-To-School Is Stressing Out U.S. Parents Across Income, Race and Political Party

The worse of the coronavirus pandemic is yet to come, most Americans felt in July 2020. That foreboding feeling is shaping U.S. parents’ concerns about their children returning to school, with the calendar just weeks away from educators opening their classrooms to students, from kindergarten to the oldest cohort entering senior year of high school. The Kaiser Family Foundation’s July 2020 Health Tracking Poll focuses on the COVID-19 pandemic, return-to-school, and the governments’ response. KFF polled 1,313 U.S. adults 18 and older between July 14 to 19, 2020. The first line chart illustrates Americans’ growing concerns about the coronavirus, shifting

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The Median Hospital Charge In the U.S. for COVID-19 Care Ranges From $34-45K

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. FAIR Health based these numbers on private insurance claims associated with COVID-19 diagnoses, evaluating patient demographics (age, gender, geography), hospital charges and estimated allowed amounts, and patient comorbidities. They used two ICD-10-CM diagnostic codes for this research: U07.1, 2019-nCoV acute respiratory disease; and, B97.29, other coronavirus as the cause of disease classified elsewhere which was the original code

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A Toxic Side Effect of the Coronavirus: Financial Unwellness

One in two people in the U.S. say their financial health has been negatively impacted by the COVID-19 pandemic, through job loss, income disruption, or reduced work hours. The 2020 Financial Wellness Census, from Prudential found that one-half of U.S. adults are anxious about their financial future as of May 2020, an increase from 38% in late 2019. Prudential surveyed 3,000 U.S. adults across three generational cohorts: Millennials, Gen X, and Baby Boomers. The economic hit from the pandemic has disproportionately impacted people of color, younger people, women, small business owners, gig workers, and people working in retailer harder than

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Trust Is a Key Social Currency for COVID-Embattled Consumers

The coronavirus pandemic has re-shaped patients into consumers, concerned about managing the risk of contracting the virus, millions of people experiencing months of sheltering, working, learning, and cooking at home. Combine these new life-flows with conflicting information about the nature, severity, and life-span of COVID-19: From three levels of government leaders: The President and the Executive Branch at the Federal Level, Governors of States, and Mayors of cities; Public health agencies, especially the U.S. Centers for Disease Control and the World Health Organization; Mass media; and, Social media. Re-entering life in the “next normal” requires a large dose of trust,

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Juneteenth 2020: Inequality and Injustice in Health Care in America

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death,” Martin Luther King, Jr., asserted at the second meeting of the Medical Committee for Human Rights in Chicago on March 25, 1966. This quote has been shortened over the five+ decades since Dr. King told this truth, to the short-hand, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Professor Charlene Galarneau recently enlightened me on Dr. King’s original statement in her seminal essay, “Getting King’s Words Right.” Among

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Saving Money as a Financial Vaccine: BlackRock Finds Consumer Savings Drain and Etsy Sellers Not Saving Much

“Americans are feeling incredible financial pressure as a result of the COVID outbreak,” John Thompson, Chief Program Officer with the Financial Health Network. One in three people in the U.S. has skipped or stopped paying a bill, and over half of Americans have used emergency savings, according to a survey from the BlackRock Emergency Savings Initiative (ESI). BlackRock, the investment firm, allocated $50 million in February 2019 to form the ESI, focused on helping people with lower incomes to bolster savings and financial health. BlackRock partners in the ESI with the Financial Health Network, CommonWealth, the Center for Advanced Hindsight Common

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Financial Insecurity Among U.S. Workers Will Worsen in the Pandemic — Especially for Women

Millions of mainstream, Main Street Americans entered 2020 feeling income inequality and financial insecurity in the U.S. The coronavirus pandemic is exacerbating financial stress in America, hitting women especially hard, based on PwC’s 9th annual Employee Financial Wellness Survey COVID-19 Update. For this report, PwC polled 1,683 full-time employed adults between 18 and 75 years of age in January 2020. While the survey was conducted just as the pandemic began to emerge in the U.S., PwC believes, “the areas of concern back in January will only be more pronounced today,” reflecting, “the realities of the changing employee circumstances we are

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Stress in America – COVID-19 Takes Toll on Finances, Education, Basic Needs and Parenting

“The COVID-19 pandemic has altered every aspect of American life, from health and work to education and exercise,” the new Stress in America 2020 study from the American Psychological Association begins. The APA summarizes the impact of these mass changes on the nation: “The negative mental health effects of the coronavirus may be as serious as the physical health implications,” with COVID-19 stressors hitting all health citizens in the U.S. in different ways. Beyond the risk of contracting the virus, the Great Lockdown of the U.S. economy has stressed the U.S. worker and the national economy, with 7 in 10

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How COVID-19 Is Driving More Deaths of Despair

In the current state of the COVID-19 pandemic, we all feel like we are living in desperate times. If you are a person at-risk of dying a Death of Despair, you’re even more at-risk of doing so in the wake of the Coronavirus in America. Demonstrating this sad fact of U.S. life, the Well Being Trust and Robert Graham Center published Projected Deaths of Despair from COVID-19. The analysis quantifies the impact of isolation and loneliness combined with the dramatic economic downturn and mass unemployment with the worsening of mental illness and income inequity on the epidemic of Deaths of

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TransUnion Reveals the Home Economics and Social Determinants of COVID-19

  Today, 7th May 2020, the U.S. Bureau of Labor Statistics announced that about 3.17 million jobs were lost in the nation in the last week. This calculated to an unemployment rate of 15.5%, an increase of 3.1% points from the previous week. Total jobs lost in the COVID-19 pandemic, starting from the utterance of the “P” word, has been ___ in the I.S. The virus’s global impact has led to what IMF called the Great Lockdown, resulting in economic inertia and contraction since Asia and Europe reported the first patients diagnosed with the coronavirus. The economic impact the world

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How COVID-19 is Hurting Americans’ Home Economics in 2020

Beyond the physical and clinical aspects of the COVID-19 pandemic are financial hits that people are taking in the shutdown of large parts of the U.S. economy, impacting jobs, wages, and health insurance rolls. Some 1 in 2 people in the U.S. who have had their income impacted by the coronavirus have either fallen behind in paying off credit card debt or other bills, had problems paying for utilities, have lagged in paying for housing (rent or mortgage), been challenged paying for food, or other out-of-pocket costs. We learn about these fiscal hits from COVID-10 from the latest Health Tracking Poll

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Health, Wealth & COVID-19 – My Conversation with Jeanne Pinder & Carium, in Charts

The coronavirus pandemic is dramatically impacting and re-shaping our health and wealth, simultaneously. Today, I’ll be brainstorming this convergence in a “collaborative health conversation” hosted by Carium’s Health IRL series.  Here’s a link to the event. Jeanne founded ClearHealthCosts nearly ten years ago, having worked as a journalist with the New York Times and other media. She began to build a network of other journalists, each a node in a network to crowdsource readers’-patients’ medical bills in local markets. Jeanne started in the NYC metro and expanded, one node at a time and through many sources of funding from not-for-profits/foundations,

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The Patient-as-Payor in the Coronavirus Pandemic

One in three working age people in the U.S. lost their job as a response to the COVID-19 pandemic, some of whom lost health insurance and others anxious their health coverage will be threatened, revealed in a survey from The Commonwealth Fund published on April 21, 2020. 2 in 5 people in America who are dealing with job insecurity are also health insurance insecure, the study found, as shown in the pie chart. The Commonwealth Fund commissioned the poll among 1,001 U.S. adults 18 to 64 years of age between 8-13 April 2020. Nearly all Americans believe the dots of

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In the U.S., the Spread of Infectious Disease Now Seen As Bigger Threat Than Terrorism – Pew

The spread of infectious disease is the new terrorism in the eyes of Americans. The most significant major threat to the U.S. is infectious disease, four in five Americans said in March 2020, closely followed by terrorism (in general), the spread of nuclear weapons, and cyberattacks from other countries. For the study, the Pew Research Center commissioned a telephone survey conducted among 1,000 U.S. adults in March 2020. Large majorities of people are also highly concerned about China’s growing power and influence, global climate change, Russia’s power and influence, the condition of the global economy, and global poverty. The percent

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Americans’ Sense of Well-Being Falls to Great Recession Levels, Gallup Finds

It’s déjà vu all over again for Americans’ well-being: we haven’t felt this low since the advent of the Great Recession that hit our well-well-being hard in December 2008. As COVID-19 diagnoses reached 200,000 in the U.S. in April 2020, Gallup gauged that barely 1 in 2 people felt they were thriving. In the past 12 years, the percent of Americans feeling they were thriving hit a peak in 2018, as the life evaluations line graph illustrates. Gallup polled over 20,000 U.S. adults in late March into early April 2020 to explore Americans’ self-evaluations of their well-being. FYI, Gallup asks consumers

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The Coronavirus Impact on American Life, Part 2 – Our Mental Health

As the coronavirus pandemic’s curve of infected Americans ratchets up in the U.S., people are seeking comfort from listening to Dolly Parton’s bedtime stories, crushing on Dr. Anthony Fauci’s science-wrapped-with-empathy, and streaming the Tiger King on Netflix. These and other self-care tactics are taking hold in the U.S. as most people are “social distancing” or sheltering in place, based on numbers from the early April 2020 Kaiser Family Foundation health tracking poll on the impact of the coronavirus on American life. While the collective practice of #StayHome to #FlattenTheCurve is the best-practice advice from the science leaders at CDC, the NIAID

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The Coronavirus Impact on American Life, Part 1 – Life Disrupted, and Money Concerns

Nearly 3 in 4 Americans see their lives disrupted by the coronavirus pandemic, according to the early April Kaiser Family Foundation Health Tracking Poll. This feeling holds true across most demographic factors: among both parents and people without children; men and women alike; white folks as well as people of color (although fewer people identifying as Hispanic, still a majority). There are partisan differences, however, in terms of who perceives a life-disruption due to COVID-19: 76% of Democrats believe this, 72% of Independents, and 70% of Republicans. Interestingly, only 30% of Republicans felt this way in March 2020, more than

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Estimates of COVID-19 Medical Costs in the US: $20K for inpatient stay, $1300 OOP costs

In the midst of growing inpatient admissions and test results for COVID-19, Congress is working as I write this post to finalize a round of legislation to help Americans with the costs-of-living and (hopefully) health care in a national, mandated, clarifying way. Right now in the real world, real patients are already being treated for COVID-19 in American hospitals. Patients are facing health care costs that may result in multi-thousand dollar bills at discharge (or death) that will decimate households’ financial health, particularly among people who don’t have health insurance coverage, covered by skinny or under-benefited plans, and/or lack banked

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Waking Up a Health Consumer in the COVID-19 Era

With President Trump’s somber speech from the Oval Office last night, we wake up on 12th March 2020 to a ban on most travel from Europe to the U.S., recommendations for hygiene, and call to come together in America. His remarks focused largely on an immigration and travel policy versus science, triaging, testing and treatment of the virus itself. Here is a link to the President’s full remarks from the White House website, presented at about 9 pm on 11 March 2020. Over the past week, I’ve culled several studies and resources to divine a profile of the U.S. consumer

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The Book on Deaths of Despair – Deaton & Case On Education, Pain, Work and the Future of Capitalism

Anne Case and Angus Deaton were working in a cabin in Montana the summer of 2014. Upon analyzing mortality data from the U.S. Centers for Disease Control, they noticed that death rates were rising among middle-aged white people. “We must have hit a wrong key,” they note in the introduction of their book, Deaths of Despair and the Future of Capitalism. This reversal of life span in America ran counter to a decades-long trend of lower mortality in the U.S., a 20th century accomplishment, Case and Deaton recount. In the 300 pages that follow, the researchers deeply dive into and

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“How’s Life?” for American Women? The New OECD Report Reveals Financial Gaps on International Women’s Day 2020

March 8 is International Women’s Day. In the U.S., there remain significant disparities between men and women, in particular related to financial well-being. The first chart comes from the new OECD “How’s Life?” report published today (March 9th) measuring well-being around the country members of the OECD. This chart focuses on women versus men in the United States based on over a dozen key indicators. Top-line, many fewer women feel safe in America, and earnings in dollars and hours worked fall short of men’s incomes. This translates into lower socioeconomic status for women, which diminishes overall health and well-being for

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Job #1 for Next President: Reduce Health Care Costs – Commonwealth Fund & NBC News Poll

Four in five U.S. adults say lowering the cost of health care in America should be high priority for the next American president, according to a poll from The Commonwealth Fund and NBC News. Health care costs continue to be a top issue on American voters’ minds in this 2020 Presidential election year, this survey confirms. The first chart illustrates that lowering health care costs is a priority that crosses political parties. This is true for all flavors of health care costs, including health insurance deductibles and premiums, out-of-pocket costs for prescription drugs, and the cost of long-term care. While

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The High Cost-of-Thriving and the Evolving Social Contract for Health Care

Millions of Americans have to work 53 weeks to cover a year’s worth of household expenses. Most Americans haven’t saved much for their retirement. Furthermore, the bullish macroeconomic outlook for the U.S. in early 2020 hasn’t translated into individual American’s optimism for their own family budgets. (Sidebar and caveat: yesterday was the fourth day in a row of the U.S. financial markets losing as much as 10% of market cap, so the global economic outlook is being revised downward by the likes of Goldman Sachs, Vanguard, and Morningstar, among other financial market prognosticators. MarketWatch called this week the worst market

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Tools for Paying Medical Bills Don’t Help Health Consumers Manage Their Financial Health

There’s a gap between the supply of digital health tools that hospitals and health systems offer patients, and what patients-as-consumers need for overall health and wellbeing. This chasm is illustrated in The future of the digital patient experience, the latest report from HIMSS and the Center for Connected Medicine (CCM). The big gap in supply to patients vs. demand by health consumers is highlighted by what the arrow in the chart below points to: managing payments and paying bills. Nowhere in the top 10 most commonly provided digital tools is one for price transparency, cost comparing or cost estimating.  In the

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Americans’ Top 2 Priorities for President Trump and Congress Are To Lower Health Care and Rx Costs

Health care pocketbook issues rank first and second place for Americans in these months leading up to the 2020 Presidential election, according to research from POLITICO and the Harvard Chan School of Public Health published on 19th February 2020. This poll underscores that whether Democrat or Republican, these are the top two domestic priorities among Americans above all other issues polled including immigration, trade agreements, infrastructure and regulations. The point that Robert Blendon, Harvard’s long-time health care pollster, notes is that, “Even among Democrats, the top issues…(are) not the big system reform debates…They’re worried about their own lives, their own

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The Federal Reserve Chairman Speaks Out on Health Care Costs: “Spending But Getting Nothing”

On February 12, 2020, the Chairman of the Federal Reserve Bank of the U.S. submitted the Semiannual Monetary Policy Report to Congress and testified to the Senate Banking Committee. Chairman Jerome Powell detailed the current state of the economy, discussing the state of the macroeconomy, GDP growth, unemployment, inflation, and projections for 2022 and beyond. The top line data points are shown in the first chart. After his prepared remarks, Chairman Powell responded to questions from members of the Senate Banking Committee. Senator Ben Sasse (R-Neb.) asked him about health care costs’ impact on the national U.S. economy. The Chairman

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Health@Retail Update: Kroger and Hy-Vee Morph Grocery into Health, Walmart’s Health Center, CVS/housing and More

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

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Health Care Costs Concern Americans Approaching Retirement – Especially Women and Sicker People

Even with the prospect of enrolling in Medicare sooner in a year or two or three, Americans approaching retirement are growing concerned about health care costs, according to a study in JAMA Network Open. The paper, Health Insurance Affordability Concerns and health Care Avoidance Among US Adults Approaching Retirement, explored the perspectives of 1,028 US adults between 50 and 64 years of age between November 2018 and March 2019. The patient survey asked one question addressing two aspects of “health care confidence:” “Please rate your confidence with the following:” Being able to afford the cost of your health insurance nad

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The State of the Union for Prescription Drug Prices

Tonight, President Trump will present his fourth annual State of the Union address. This morning we don’t have a transcript of the speech ahead of the event, but one topic remains high on U.S. voters’ priorities, across political party – prescription drug prices. Few issues unite U.S. voters in 2020 quite like supporting Medicare’s ability to negotiate drug prices with pharmaceutical companies, shown by the October 2019 Kaiser Family Foundation Health Tracking Poll. Whether Democrat, Independent, or Republican, most people living in America favor government intervention in regulating the cost of medicines in some way. In this poll, the top

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Most Americans Regardless of Income Say It’s Unfair for Wealthier People to Get Better Health Care

In America, earning lower or middle incomes is a risk factor for having trouble accessing health care and/or paying for it. But most Americans, rich or not, believe that it’s unfair for wealthier people to get better health care, according to a January 2020 poll from NPR, the Robert Wood Johnson Foundation and Harvard Chan School of Public Health, Life Experiences and Income Equality in the United States. The survey was conducted in July and August 2019 among 1,885 U.S. adults 18 or older. Throughout the study, note the four annual household income categories gauged in the research: Top 1%

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The Suicide Rate in America Increased by 40% between 2000 and 2017. Blue Collar Workers Were Much More At Risk.

The rate of suicide in the U.S. rose from 12.9 per 100,000 population to 18.0 between 2000 and 2017, a 40% increase. Those workers most at-risk for suiciding were men working in construction and mining, maintenance, arts/design/entertainment/sports/media, farming and fishing, and transportation. For women, working in construction and mining, protective service, transportation, healthcare (support and practice), the arts and entertainment, and personal care put them at higher risk of suicide. The latest report from the CDC on Suicide Rates by Industry and Occupation provides a current analysis of the National Violent Death Reporting System which collects data from 32 states,

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Income Inequality is Fostering Mis-Trust, the Edelman 2020 Trust Barometer Observes

Economic development has historically built trust among nations’ citizens. But in developed, wealthier parts of the world, like the U.S., “a record number of countries are experiencing an all-time high ‘mass-class’ trust divide,” according to the 2020 Edelman Trust Barometer. For 20 years, Edelman has released its annual Trust Barometer every year at the World Economic Forum in Davos, recognizing the importance of trust in the global economy and society. Last year, it was the employer who was the most-trusted touch-point in citizens’ lives the world over, I discussed in Health Populi one year ago. This year, even our employers can’t

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Physicians in America – Too Many Burned Out, Depressed, and Not Getting Support

Some one in three physicians is burned out, according to the Medscape’s National Physician Burnout & Suicide Report. The subtitle, “The Generational Divide,” tells a bit part of the subtext of this annual report that’s always jarring and impactful for both its raw numbers and implications for both patient care and the larger health care system in America. Nearly 1 in 2 physicians in Generation X, those people born between 1965 and 1979, feel burned out compared with roughly 4 in 10 doctors who are Millennials or Boomers. Furthermore, many more women than men physicians feel burned out: 48% of

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The 2020 Social Determinants of Health: Connectivity, Art, Air and Love

Across the U.S., the health/care ecosystem warmly embraced social determinants of health as a concept in 2019. A few of the mainstreaming-of-SDoH signposts in 2019 were: Cigna studying and focusing in on loneliness as a health and wellness risk factor Humana’s Bold Goal initiative targeting Medicare Advantage enrollees CVS building out an SDOH platform, collaborating with Unite US for the effort UPMC launching a social impact program focusing on SDoH, among other projects investing in social factors that bolster public health. As I pointed out in my 2020 Health Populi trendcast, the private sector is taking on more public health

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The Patient As Payor: Workers Covered by Employer Health Insurance Spend 11.5% of Household Incomes on Premiums and Deductibles

Workers covered by health insurance through their companies spend 11.5% of their household income on health insurance premiums and deductibles based on The Commonwealth Fund’s latest report on employee health care costs, Trends in Employer Health Coverage, 2008-2018: Higher Costs for Workers and Their Families. The topline of this study is that average annual growth in employer premiums rose faster between 2016 and 2017, by about 5% for both single and family plans. The bottom line for families is that workers’ premium payments grew faster than median incomes did over the ten years 2008 to 2018. Average deductibles also outpaced

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Despite Greater Digital Health Engagement, Americans Have Worse Health and Financial Outcomes Than Other Nations’ Health Citizens

The idea of health care consumerism isn’t just an American discussion, Deloitte points out in its 2019 global survey of healthcare consumers report, A consumer-centered future of health. The driving forces shaping health and health care around the world are re-shaping health care financing and delivery around the world, and especially considering the growing role of patients in self-care — in terms of financing, clinical decision making and care-flows. With that said, Americans tend to be more healthcare-engaged than peer patients in Australia, Canada, Denmark, Germany, the Netherlands, Singapore, and the United Kingdom, Deloitte’s poll found. Some of the key behaviors

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Longevity Stalls Around the World And Wealth, More Concentrated

Two separate and new OECD reports, updating health and the global economic outlook, raise two issues that are inter-related: that gains in longevity are stalling, with chronic illnesses and mental ill health affecting more people; and, as wealth grows more concentrated among the wealthy, the economic outlook around most of the world is also slowing. First, we’ll mine the Health at a Glance 2019 annual report covering data on population health, health system performance, and medical spending across OECD countries. The first chart arrays the x-y data points of life expectancy versus health spending for each of the OECD countries

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More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Several new studies reveal that more patients are feeling and living out their role as health care payors as medical spending vies with other household line items. This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. In research from HealthPocket, 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. One in four people in the

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A Tale of Two Americas as Told by the 2019 OECD Report on Health

It was the best of times, It was the worst of times, It was the age of wisdom, it was the age of foolishness, It was the epoch of belief, it was the epoch of incredulity, … starts Dickens’ Tale of Two Cities.  That’s what came to my mind when reading the latest global health report from the OECD, Health at a Glance 2019, which compares the United States to other nations’ health care outcomes, risk factors, access metrics, and spending. Some trends are consistent across the wealthiest countries of the world, many sobering, such as: Life expectancy rates fell in 19 of the

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The Link Between Wellness & Wealth Is Powerful for Everyone – and Especially Women

In the U.S., the link between wellness and wealth, money and health, is strong and common across people, young and old. But the impacts of money on health, well-being, and life choices varies across the ages, based on a study from Lively, a company that builds platforms for health savings accounts. The first chart illustrates that health care costs challenge people in many ways: the most obvious health care cost problems prevent people from saving more for retirement or paying down debt. Eight in 10 Americans concur that rising health care costs challenge their ability to save for retirement. Beyond the

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Great Expectations for Health Care: Patients Look for Consumer Experience and Trust in Salesforce’s Latest Research

On the demand side of U.S. health care economics, patients are now payors as health consumers with more financial skin in paying medical bills. As consumers, people have great expectations from the organizations on the supply side of health care — providers (hospitals and doctors), health insurance plans, pharma and medical device companies. But as payors, health consumers face challenges in getting care, so great expectations are met with frustration and eroding trust with the system, according to the latest Connected Healthcare Consumer report from Salesforce published today as the company announced expansion of their health cloud capabilities. This is

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Thinking About Health Care One Year From the 2020 Presidential Election

Today is 4th November 2019, exactly one year to the day that Americans can express their political will and cast their vote for President of the United States. Health care will be a key issue driving people to their local polling places, so it’s an opportune moment to take the temperature on U.S. voters’ perspectives on healthcare reform. This post looks at three current polls to gauge how Americans are feeling about health care reform 365 days before the 2020 election, and one day before tomorrow’s 2019 municipal and state elections. Today’s Financial Times features a poll that found two-thirds

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While Costs Are A Top Concern Among Most U.S. Patients, So Are Challenges of Poverty, Food, and Housing

Rising health care costs continue to concern most Americans, with one in two people believing they’re one sickness away from getting into financial trouble, according to the 2019 Survey of America’s Patients conducted for The Physicians Foundation. In addition to paying for “my” medical bills, most people in the U.S. also say that income inequality and inadequate social services significantly contribute to high medical spending for every health citizen in the nation. The Physicians Foundation conducts this study into Americans’ views on the U.S. health care system every other year. This year’s poll was conducted in September 2019 and included input

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Health Consumer Behaviors in the U.S. Stall, Alegeus Finds in the 2019 Index

In the U.S., the theory of and rationale behind consumer-directed health has been that if you give a patient more financial skin-in-the-game — that is, to compel people to spend more out-of-pocket on health care — you will motivate that patient to don the hat of a consumer — to mindfully research, shop around, and purchase health care in a rational way, benefit from lower-cost and high-quality healthcare services. For years, Alegeus found that patients were indeed growing those consumer health muscles to save and shop for health care. In 2019, it appears that patients have backslid, according to the

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The Hospital CFO in the Anxiety Economy – My Talk at Cerner’s Now/Next Conference

As patients have taken on more financial responsibility for first-dollar costs in high-deductible health plans and medical bills, hospitals and health care providers face growing fiscal pressures for late payments and bad debt. Those financial pressures are on both sides of the health care payment transaction, stressing patients-as-payors and health care financial managers alike. I’m speaking to health industry stakeholders on patients-as-payors at Cerner’s Now/Next conference today about the patient-as-payor, a person primed for engagement. That’s as in “Amazon-Primed,” which patients in their consumer lives now use as their retail experience benchmark. But consumers-as-patients don’t feel like health care today

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Worrying About Paying for Health Care Is the Norm in America

Among stresses facing people at least 50 years of age, health care costs rank top of mind compared with other issues like long-term care, health insurance, Social Security, taxes, and being read to retire. Worries about health care costs are particularly stressful among future retirees, 8 of 10 of whom share this top concern along with 7 in 10 recent retirees and 6 in 10 people retired for at least a decade. Health care stress cuts in two ways: most people are worried about paying for health care, as well as experienced an unanticipated decline in their health, according to

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Worrying About Possible Recession Compels Health Consumers to Seek Less Care

Four in ten U.S. patients said the state of the economy changes how often they seek health care, according to a new study from TransUnion, the credit agency that operates in the health care finance space. Nearly two-thirds of patients said that knowing their out-of-pocket expenses in advance of receiving health care services influenced the likelihood of their seeking care. Given reports from mass media, business press and regional Federal Reserve press releases, the short-to-midterm economic outlook may be softening, which is the signal that TransUnion is receiving in this health consumer poll. The other side of this personal health

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Health Care Providers Grow Consumer-Facing Muscles Driven by Retail & Tech-Health Competition

As patients continue to morph into health care payers, they’re increasingly expecting value-for-money, transparency, and customer experiences that show respect, bolster trust, and deliver quality services. Is that so much to ask from health care providers? Sure is, as it turns out, based on this year’s annual report from Kaufman Hall, the 2019 State of Consumerism in Healthcare: The Bar is Rising. For several years, Kaufman Hall have developed an Index of healthcare consumerism based on several pillars that, together, gauge health care providers’ performance on consumer health engagement. Providers fall into one of four tiers, ranging from Tier 1

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Getting More Personal, Virtual and Excellent – the 2020 NBGH Employer Report

In 2020, large employers will be “doubling down” efforts to control health care costs. Key strategies will include deploying more telehealth and virtual health care services, Centers of Excellence for high-cost conditions, and getting more personal in communicating and engaging through platforms. This is the annual forecast for 2020 brought to us by the National Business Group of Health (NBGH), the Large Employers’ Health Care Strategy and Plan Design Survey. The 42-page report is packed with strategic and tactical data looking at the 2020 tea leaves for large employers, representing over 15 million covered lives. Nearly 150 companies were surveyed

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From Health Consumers to Health Citizens – a U.S. Patient Rights Moonshot?

Issue No. 4 of StartUp Health Magazine is dedicated to 8 Health Moonshot Principles. StartUp Health sees these moonshots taken together as, “a blueprint for achieving the impossible.” There’s an aspect of U.S. health care that currently feels impossible to achieve, and that’s consensus on what would constitute a sound approach to covering all Americans for health care as a civil right and whether the nation can “afford” doing so. On pages 22-23 of the digital magazine, you’ll find my essay, “From Health Consumers to Health Citizens.” This write-up summarizes the plotline of my book titled HealthConsuming, which features that

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Health Care Bills’ Financial Toxicity – Remembering the Jones’ of Whatcom County, WA

“In an extreme example of angst over expensive medical bills, an elderly Washington couple who lived near the U.S.-Canadian border died in a murder-suicide this week after leaving notes that detailed concerns about paying for medical care,” USA Today reported on August 10, 2019. Five years ago, financial toxicity as a side-effect was noted by two Sloan Kettering Medical Center in a landmark report on 60 Minutes in October 2014. Epidemiologist Peter Bach and oncologist Leonard Saltz told CBS’s Lesley Stahl, “A cancer diagnosis is one of the leading causes of personal bankruptcy…We need to take into account the financial

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100 Million People in America Lack Broadband — an On-Ramp to Health and Safety

One in three Americans does not have a broadband connection, according to a new report from the NPD Group. This means that about 100 million people in the U.S. can’t benefit from telehealth and other digital health connections that can bolster self-care, home care, and lower cost care. Most of these folks in the broadband-digital divide live in rural America/ “The so-called digital divide, between those that can or cannot make the best use of the Internet, can be clearly felt in rural markets where the lack of broadband impacts everything from entertainment to the educational system,” Eddie Hold, President

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Finances Are the Top Cause of Stress, and HSAs Aren’t Helping So Much…Yet

If you heed the mass media headlines and President Trump’s tweets, the U.S. has achieved “the best economy” ever in mid-July 2019. But if you’re working full time in that economy, you tend to feel much less positive about your personal prospects and fiscal fitness. Nearly nine in 10 working Americans believe that medical costs will rise in the next few years as they pondering potential changes to the Affordable Care Act. The bottom line is that one-half of working people are more concerned about how they will save for future health care expenses. That’s the over-arching theme in PwC’s

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Americans’ Financial Anxiety Ties to Personal Cash Flow and Health Care

“The Dow Jones Industrial Average was on the brink of claiming a thousand-point milestone for the first time since January 2018, ending the longest period without crossing such a psychologically significant level since the blue-chip benchmark crossed the 19,000 threshold three weeks after Donald Trump was elected president in November 2016,” Mark DeCambre of MarketWatch wrote yesterday morning. He noted that President Trump, “tweeted a simple call-out to the intraday record: ‘Dow just hit 27,000 for first time EVER!'” clipped here from Twitter. Indeed, the U.S. macro-economy has nearly full employment and the stock market hit a high mark this

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Health Care and the Democratic Debates – Round 2 – Battle Royale for M4All vs Medicare for All Who Want It – What It Means for Industry

Looking at this photo of the 2020 Democratic Party Presidential candidate debater line-up might give you a déjà vu feeling, a repeat of the night-before debate. But this was Round 2 of the debate, with ten more White House aspirants sharing views — sometimes sparring — on issues of immigration, economic justice, climate change, and once again health care playing a starring role from the start of the two-hour event. The line-up from left to write included: Marianne Williamson. author and spiritual advisor John Hickenlooper, former Governor of Colorado Andrew Yang. tech company executive Pete Buttigieg, Mayor of South Bend,

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IKEA Garners the Top Health & Wellness Award at Cannes Lions 2019 – the Expanding Health/Care Ecosystem

“Health is now everyone’s business,” Shaheed Peera, Executive Creative Director of Publicis LifeBrands, said this week at the 2019 Cannes Lions awards. Shaheed also led the Health & Wellness jury at Cannes Lions 2019, the mission of which is to, in the words of the award’s portal, “celebrate creativity for personal wellbeing.” The Grand Prix Lions award for Health & Wellness went to IKEA for the company’s ThisAbles campaign. ThisAbles is a project pioneered by IKEA’s team in Israel, looking to improve everyday living for people with special needs through  well-designed IKEA products. IKEA collaborated with non-profit organizations to develop

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Americans Could Foster a Health Consumer Movement, Families USA Envisions

Employers, health care providers, unions, leaders and — first and foremost, consumers — must come together to build a more accessible, affordable health care system in America, proposes a call-to-action fostered by a Families USA coalition called Consumers First: The Alliance to Make the Health Care System Work for Everyone. The diverse partners in this Alliance include the American Academy of Family Physicians, AFSCME (the largest public service employees’ union in the U.S.), the American Benefits Council (which represents employers), the American Federation of Teachers (AFT), First Focus (a bipartisan children’s advocacy organization), and the Pacific Business Group on Health

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People Want to Flourish, Not Just Live – Speaking Health Politics to Real People

“How should we define ‘health?'” a 2011 BMJ article asked. The context for the question was that the 1948 World Health Organization definition of health — that health is, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”– was not so useful in the 21st century. The authors, a global, multidisciplinary team from Europe, Canada and the U.S., asserted that by 2011, human health was marked less by infectious disease and more by non-communicable conditions that could be highly influenced, reversed and prevented through self-care by the individual and public health policy

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How Consumers’ Belt-Tightening Could Impact Health/Care – Insights from Deloitte’s Retail Team

Over the ten years between 2007 and 2017, U.S. consumer spending for education, food and health care substantially grew, crowding out spending for other categories like transportation and housing. Furthermore, income disparity between wealthy Americans and people earning lower-incomes dramatically widened: between 2007-2017, income for high-income earners grew 1,305 percent more than lower-incomes. These two statistics set the kitchen table for spending in and beyond 2019, particularly for younger people living in America, considered in  Deloitte’s report, The consumer is changing, but perhaps not how you think. The authors are part of Deloitte Consulting’s Retail team. The retail spending data

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Health Care Costs Still Americans’ Top Financial Worry Among All Money Concerns

Health care costs rank ahead of Americans’ money-worries about low wages and availability of cash, paying for college, house payments, taxes, and debt, according to the latest Gallup poll on peoples’ most important family financial problems in 2019. Medical costs have, in fact, ranked at the top of this list for three years in a row, with a five percentage point rise between 2018 and 2019. No other financial concern had that growth in increase-of-money-worries in the past year. Health care costs rank the top financial problem for people across all income levels. One in five families (19%) earning under

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How Consumers Look At Social Determinants of Health for Cancer, Diabetes and Mental Health

Enlightened health/care industry and public policy stakeholders have begun to embrace and address social determinants of health. These are the inputs that bolster health beyond health care services: they include economic stability like job security and income level (and equity), education, and access to healthy food, food security, safe neighborhoods, social support, clean environments (water and air), and in my own update on SDoH factors, access to broadband connectivity. As physician leaders in the AMA, technology advocates from AMIA, and numerous health plans focus efforts on strengthening social determinants, what do people – consumers, patients, caregivers — think about these

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The 3 A’s That Millennials Want From Healthcare: Affordability, Accessibility, Availability

With lower expectations of and satisfaction with health care, Millennials in America seek three things: available, accessible, and affordable services, research from the Transamerica Center for Health Studies has found. Far and away the top reason for not obtaining health insurance in 2018 was that it was simply too expensive, cited by 60% of Millennials. Following that, 26% of Millennials noted that paying the tax penalty plus personal medical expenses were, together, less expensive than available health options. While Millennials were least likely to visit a doctor’s office in the past year, they had the most likelihood of making a

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A Dose of Optimism Is a Prescription for Financial Health, Says Frost Bank

People define their personal health and well-being broadly, well beyond physical health. Mental wellness, physical appearance, social connections, and financial wellness all add into our self-health definitions. Mind Over Money is a consumer study conducted by Frost Bank, working with FleischmanHillard, connecting the dots between optimism and financial health. The top-line of the study is that people who are optimists have roughly two-thirds fewer days of financial stress per year than pessimists. Put another way, pessimists stress about finances 62% of the year, shown in the first chart from the study. This translates into 62% of optimists having better financial

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Listen Up, Healthcare: Hear The Patient’s Voice!

Consider the voice of a patient before the advent of the Internet in the digital 1.0 world, and then the proliferation of social networks in v 2.0. One patient could talk with another over their proverbial neighborhood fence, a concerned parent at the PTA meeting with others dealing with a children’s health issue, or a recovering alcoholic testifying in person at an AA session. Today, the voice of the patient is magnified one-to-many, omnichannel and multi-platform — via video, blogs, podcasts, social networks, listservs….and, yes, still in live forums like AA meetings, church basements, Y-spaces, and the Frazzled Cafe meet-ups

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The United States of Diabetes: a $1,240 Tax on Every American

Pharmaceutical company executives are testifying in the U.S. Congress this week on the topic of prescription drug costs. One of those medicines, insulin, cost a patient $5,705 for a year’s supply in 2016, double what it cost in 2012, according to the Health Care Cost Institute. Know that one of these insulin products, Lilly’s Humalog,  came onto the market in 1996. In typical markets, as products mature and get mass adoption, prices fall. Not so insulin, one of the many cost components in caring for diabetes. But then prescription drug pricing doesn’t conform with how typical markets work in theory.

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What $285,000 Can Buy You in America: Medical Costs for Retirees in 2019

The average 65-year old couple retiring in 2019 will need to have a cash nest-egg of $285,000 to cover health care and medical expenses through retirement years, Fidelity Investments calculated. Fidelity estimates the average retiree will allocate 15% of their annual spending in retirement on medical costs. As if that top-line number isn’t enough to sober one up, there are two more caveats: (1) the $285K figure doesn’t include long-term care, dental services and over-the-counter medicines; and, (2) it’s an after-tax number. So depending on your tax bracket, you have to earn a whole lot more to net the $285,000

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Medical Costs Are Consuming Americans’ Financial Health

Spending on medical care costs crowded out other household spending for millions of Americans in 2018, based on The U.S. Healthcare Cost Crisis, a survey from West Health and Gallup. Gallup polled 3,537 U.S. adults 18 and over in January and February 2019. One in three Americans overall are concerned they won’t be able to pay for health care services or prescription drugs: that includes 35% of people who are insured, and 63% of those who do not have insurance.   Americans borrowed $88 billion in 2018 to pay for health care spending, West Health and Gallup estimated. 27 million Americans

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In the Modern Workplace, Workers Favor More Money, New Kinds of Benefits, and Purpose

Today, April 2nd, is National Employee Benefits Day. Who knew? To mark the occasion, I’m mining an important new report from  MetLife, Thriving in the New Work-Life World, the company’s 17th annual U.S. employee benefit trends study with new data for 2019. For the research, MetLife interviewed 2,500 benefits decision makers and influencers of companies with at least two employees. 20% of the firms employed over 10,000 workers; 20%, 50 and fewer staff. Companies polled represented a broad range of industries: 11% in health care and social assistance, 10% in education, 9% manufacturing, 8% each retail and information technology, 7%

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In the U.S., Patients Consider Costs and Insurance Essential to Their Overall Health Experience

Patients in the U.S. assume the role of payor when they are enrolled in high-deductible health plans. People are also the payor when dealing with paying greater co-payments for prescription drugs, especially as new therapeutic innovations come out of pipelines into commercial markets bearing six-digit prices for oncology and other categories. For mainstream Americans, “the math doesn’t add up” for paying medical bills out of median household budgets, based on the calculations in the 2019 VisitPay Report.  Given a $60K median U.S. income and average monthly mortgage and auto payments, there’s not much consumer margin to cover food, utilities, petrol,

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Medical Issues Are Still The #1 Contributor to Bankruptcy in the U.S., An AJPH Study Asserts

Medical costs in America are still the top contributor to personal bankruptcy in the U.S., a risk factor in two-thirds of bankruptcies filed between 2013 and 2016. That’s a sad fiscal fact, especially as more Americans gained access to health insurance under the Affordable Care Act, according to a study published this month in the American Journal of Public Health (AJPA). Between 2013 and 2016, about 530,000 bankruptcies were filed among U.S. families each year associated with medical reasons, illustrated in Table 1 from the study. The report, Medical Bankruptcy: Still Common Despite the Affordable Care Act, updates research from 2007 which

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Most Americans Across Party ID Favor U.S. Government Negotiation to Lower Rx Drug Costs

There’s little Americans, by political party, agree upon in 2019. One of the only issues bringing people together in the U.S. is prescription drug prices — that they’re too high, that the Federal government should negotiate to lower costs for Medicare enrollees, and that out-of-pocket costs for drugs should be limited. The Kaiser Family Foundation has been tracking this topic for a few years, and this month, their March 2019 Health Tracking Poll shows vast majorities of Democrats, Independents and Republicans all share these sentiments. It’s not that patients who take prescription drugs don’t appreciate them – most (58%) say medicines

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Open Table for Health: Patients Are Online For Health Search and Physician Reviews

Seeking health information online along with researching other patients’ perspectives on doctors are now as common as booking dinner reservations and reading restaurant reviews, based on Rock Health’s latest health consumer survey, Beyond Wellness for the Healthy: Digital Health Consumer Adoption 2018. Rock Health has gauged consumes’ digital health adoption fo a few years, showing year-on-year growth for “Googling” health information, seeking peer patients’ physician and hospital reviews, tracking activity, donning wearable tech, and engaging in live telehealth consultations with providers, as the first chart shows. The growth of tracking and wearable tech is moving toward more medical applications beyond fitness

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The Cost of Prescription Drugs, Doctors and Patient Access – A View from HIMSS19

Most patient visits to doctors result in a prescription written for a medicine that people retrieve from a pharmacy, whether retail in the local community or via mail order for a maintenance drug. This one transaction generates a lot of data points, which individually have a lot of importance for the individual patient. Mashed with other patients’, prescription drug utilization data can combine with more data to be used for population health, cost-effectiveness, and other constructive research pursuits. At HIMSS19, there’s an entire day devoted to a Pharma Forum on Tuesday 12 February, focusing on pharma-provider-payor collaborations. Allocating a full

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Calling Out Health Equity on Martin Luther King Day 2019

On this weekend as we appreciate the legacy of Martin Luther King, Jr., I post a photo of him in my hometown of Detroit in 1963, giving a preliminary version of the “I Have a Dream” speech he would deliver two months later in Washington, DC. Wisdom from the speech: “But now more than ever before, America is forced to grapple with this problem, for the shape of the world today does not afford us the luxury of an anemic democracy. The price that this nation must pay for the continued oppression and exploitation of the Negro or any other

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In U.S. Health Care, It’s Still the Prices, Stupid – But Transparency and Consumer Behavior Aren’t Working As Planned

I’m glad to be getting back to health economic issues after spending the last couple of weeks firmly focused on consumers, digital health technologies and CES 2019. There’s a lot for me to address concerning health care costs based on news and research published over the past couple of weeks. We’ll start with the centerpiece that will provide the overall context for this post: that’s the ongoing research of Gerard Anderson and colleagues under the title, It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt. It is bittersweet to

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The Consumer as Payor – Retail Health at CES 2019

All health/care is retail now in America. I say this as most people in the U.S. who have health insurance must take on a deductible of some amount, which compels that insured individual to spend the first dollar on medical services up until they meet their financial commitment. At that point, health insurance kicks in, and then the insured may have to spend additional funds on co-payments for general medicines and services, and coinsurance for specialty drugs like injectables and high-cost new therapies. The patient is a consumer is a payor, I asserted today during my talk on the expanding

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Costs, Consumerism, Cyber and Care, Everywhere – The 2019 Health Populi TrendCast

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

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Rationing Care in America: Cost Implications Getting to Universal Health Coverage

It would not be surprising to know that when the Great Recession hit the U.S. in 2008, one in three Americans delayed medical treatment due to costs. Ten years later, as media headlines and the President boast an improved American economy, the same proportion of people are self-rationing healthcare due to cost. That percentage of people who delay medical cost based on the expense has remained stable since 2006: between 29 and 31 percent of Americans have self-rationed care due to cost for over a decade. And, 19% of U.S. adults, roughly one-in-five people who are sick and dealing with

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Americans End 2018 Worried About Healthcare Costs

Nearly one-half of Americans are quite concerned they won’t have enough money to pay for medical care, according to the latest Gallup poll. Health insurance in-security is mainstream as of November 2018, when Gallup polled U.S. adults about views on healthcare costs. It’s a major concern among six in ten people that their health plan would require they pay higher premiums or a bigger portion of their healthcare expenses. It’s also a big concern for four in ten people that someone in their family would be denied health insurance covering for a pre-existing condition, or that they might have to

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While National Health Care Spending Growth Slowed in 2017, One Stakeholder’s Financial Burden Grew: The Consumer’s

National health care spending growth slowed in 2017 to the post-recession rate of 3.9%, down from 4.8% in 2016. Per person, spending on health care grew 3.2% to $10,739 in 2017, and the share of GDP spent on medical care held steady at 17.9%. Healthcare spending in America is a $3.5 trillion micro-economy…roughly the size of the entire GDP of Germany, and about $1 trillion greater than the entire economy of France. These annual numbers come out of the annual report from the Centers for Medicare and Medicaid Services, published yesterday in Health Affairs. Underneath these macro-health economic numbers is

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