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The She-Cession – a Financially Toxic Side-Effect of the Coronavirus Pandemic

Along with the life-threatening impact of the coronavirus on physical health, and the accompanying mental health distress activated by self-distancing comes a third unintended consequence with the pandemic: a hard hit on women’s personal economies. The recession of the pandemic is considered by many economists as a “She-Cession,” a downturn in the economy that’s negatively impacting women more acutely than men. This is markedly different than the Great Recession of 2008, the last major financial crisis: that financial decline was coined a “ManCession,” taking a more significant toll out of more typically men’s jobs like construction and manufacturing where fewer

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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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More Americans Pivot to Distancing and Mask-Wearing in the Hot Summer of 2020

With growing coronavirus case hotspots in southern and western states, more Americans perceive the pandemic is worsening this summer, shown by a Gallup poll published 20 July 2020. Gallup titles the analysis, Americans’ social distancing steady as pandemic worsens. The first table organizes Gallup’s data by demographics, illustrating a significant gap between how women perceive the exacerbating pandemic compared with men. In early June, roughly one-third of both men and women saw COVID-19 was getting “worse”; five weeks later, in the second week of July, men and women’s perceptions were 12 points apart with more women concerned about the situation

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Most Virtual Care Consumers, Satisfied With Visits in the COVID Era, Expect It for Future Care

Within days of the coronavirus pandemic emerging in the U.S., health care providers set up virtual care arrangements to convene with patients. Three months into the COVID-19 crisis, how have patients felt about these telehealth visits? In Patient Perspectives on Virtual Care, Kyruus answers this question based on an online survey of 1,000 patients 18 years of age and older, conducted in May 2020. Each of these health consumers had at least one virtual care visit between February and May 2020. The key findings were that: Engaging in a virtual visit was a new-new thing for 72% of people Patients’

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Beyond Care and Outcomes, Hospitals Must Deliver on Civics, Inclusivity, Equity, and Value – Lown Institute’s Best Hospitals

The core business of hospitals is patient care, often baked with teaching and research. But wait — there’s more, asserts the Lown Institute in their approach to ranking America’s Best Hospitals in 2020. The Institute’s methodology for assessing what’s “best” addresses ten pillars. Several of these are the “stick-to-the-knitting” components of the Webster Dictionary definition of hospital work: patient outcomes, clinical outcomes, avoiding overuse, patient safety, and a recent focus, patient satisfaction. Community benefit has been part of a hospital’s life, especially in the not-for-profit world where hospitals must demonstrate goodwill generated for and provided in the neighborhoods in which

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Stressed Out By COVID and Civil Unrest – the APA’s Stress in America Survey, Part 2

“Now” is the lowest point in history that most Americans can remember: 7 in 10 people in the U.S. feel this way, up from 56% in 2018 and 2019. Furthermore, 4 in 5 people in the U.S. say the future of America is a significant source of stress, as discussed in Stress in the Time of COVID-19, Volume Two, a report covering a poll of U.S. adults sponsored by the American Psychological Association. APA’s Stress in America research has been one of my annual go-to’s for better understanding U.S. residents through the lens of health consumers and, especially this year

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Health Insurance and Demand for Masking, Testing and Contact Tracing – New Data from The Commonwealth Fund

The coronavirus pandemic occasioned the Great Lockdown for people to shelter-at-home, tele-work if possible, and shut down large parts of the U.S. economy considered “non-essential.” As health insurance for working-age people is tied to employment, COVID-19 led to disproportionate loss of health plan coverage especially among people earning lower incomes, as well as non-white workers, explained in the Commonwealth Fund Health Care Poll: COVID-19, May-June 2020. The Commonwealth Fund commissioned interviews with 2,271 U.S. adults 18 and over between 13 May and 2nd June 2020 for this study. The survey has two lenses: first, on health insurance coverage among working

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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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Americans Across Political Party Worry About Prescription Drug Prices – Especially to Deal with COVID-19

Nine in ten Americans is concerned about the price of prescription drugs in the wake of the coronavirus pandemic, Gallup and West Health found in their survey on the cost of healthcare, published today. A majority of people across political party share this concern: overall, 88% of U.S. adults are concerned about rising drug prices in response to COVID19, split across party ID with: 94% of Democrats, 86% of Independents, and 84% of Republicans. By demographics, more women than men are concerned about rising costs for the three health care spending categories the survey studied: drug prices, insurance premiums, and

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Economic Anxieties Rise, Medical and Vacation Plans Delayed: the COVID-19 Consumer in June 2020

Some 6 in 10 people in the U.S. have been financially impacted by COVID-19. Those most negatively affected by the pandemic tend to be younger, Gen Z age group and African-American, 63% of whom felt financial pressure directly due from the virus and the national economic lockdown. By late May 2020, 34% of black Americans had lost their jobs compared with 21% in late April, compared with 18% of white consumers, reported in The COVID-19 Pandemic’s Financial Impact on U.S. Consumers, survey research from TransUnion. This post describes data from TransUnion’s Wave 9 report, which polled 2,086 U.S. adults 18

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Americans’ Concerns About the US Healthcare System Loom Larger Than Worries About Their Own Care

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this

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Addressing Health Equity Must Include Digital Equity Beyond Access To Medical Services and Insurance

The 21st Century Cures Act emphasizes patients’ control of personal health information. ONC rules issues in March 2020 called for more patient-facing health tools and apps to bolster health consumer engagement and empowerment. But the emergence of the coronavirus in the U.S. revealed many weakness in the American health care system, one of which has been health inequities faced by millions of people — especially black Americans, who have sustained higher rates morbidity and mortality for COVID-19. There have also been digital health divides found in the COVID-19 pandemic, discussed in a timely essay in JAMA, Digital Health Equity as

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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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Health Care In the COVID-19 Era – PwC Finds Self-Rationing of Care and Meds Especially for Chronic Care

Patients in the U.S. are self-rationing care in the era of COVID-19 by cutting spending on health care visits and prescription drugs. The coronavirus pandemic’s impact on health consumers’ spending varies depending on whether the household is generally a healthy family unit, healthy “enthusiasts,” dealing with a simple or more complex chronic conditions, or managing mental health issues. PwC explored how COVID-19 is influencing consumers’ health care behaviors in survey research conducted in early April by the Health Research Institute. The findings were published in a May 2020 report, detailing study findings among 2,533 U.S. adults polled in early April

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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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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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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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Honor Your Doctor – It’s National Doctors Day Today (and EveryDay)

Today, March 30, is National Doctors Day. We honor doctors annually on this day. But every day, we must honor physicians for bolstering the health and wellness of our fellow Americans, our beloved families and friends, and our selves. The Coronavirus Pandemic reminds us of the precious and scarce resource that is our national supply of physicians in America — numbering about 750,000 active clinicians in the U.S. according to the U.S. Bureau of Labor Statistics. Even before the COVID-19 crisis, physicians in America had been feeling increasingly burned out and depressed. The 2020 WebMD survey on the state of

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West Virginia Was the Last State to ID a COVID-19 Positive Patient; The States’ Residents Are At Highest Risk for Severe Reaction to C19

Gallup has estimated 11 Million in U.S. at Severe Risk If Infected With COVID-19 in research published today. And the health citizens of West Virginia would be at greatest risk for having a severe reaction to the coronavirus. A “severe reaction” here means being critically ill or dying. The forecast doesn’t focus on the whole number of people in the US. who would be at-risk of contracting the coronavirus; the 11 million is the total number of Americans who have a “very high chance of becoming critically ill or dying” if 100% of the country were infected with C19. This

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Wistful Thinking: The National Health Spending Forecast In a Land Without COVID-19

U.S. health care spending will grow to 20% of the national economy by 2028, forecasted in projections pre-published in the April 2020 issue of Health Affairs, National Health Expenditure (NHE) Projections. 2019-28: Expected Rebound in Prices Drives Rising Spending Growth. NHE will grow 5.4% in the decade, the model expects. But…what a difference a pandemic could make on this forecast. This year, NHE will be $3.8 trillion, growing to $6.2 trillion in 2028. Hospital care spending, the largest single component in national health spending, is estimated at $1.3 trillion in 2020. These projections are based on “current law,” the team

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In the US COVID-19 Pandemic, A Tension Between the Fiscal and the Physical

“Act fast and do whatever it takes,” insists the second half of the title of a new eBook with contributions from forty leading economists from around the world. The first half of the title is, Mitigating the COVID Economic Crisis.  The book is discussed in a World Economic Forum essay discussing the economists’ consensus to “act fast.” As the U.S. curve adds new American patients testing positive for the coronavirus, the book and essay illustrate the tension between health consumer versus the health citizen in the U.S.  For clinical context, as I write this post on 24th March 2020, today’s U.S.

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In A Nation “At War” with the C19 Virus, Partisan Healthcare Differences Persist

More Democrats would want to get tested for the coronavirus (C19) than would Republicans. And, more women than men believe that a vaccine to address the COVID-19 pandemic believe that treatment would be offered at no-or-low-cost under a Democratic president versus President Trump. These are two key insights gleaned from a look into U.S. adults’ perspectives on the C19 virus in the second week of March 2020. What Are Americans’ Views on the Coronavirus Pandemic? asks and answers an NBC News/Commonwealth Fund Health Care Poll published on 20th March 2020. NBC News and the Commonwealth Fund polled 1,006 people 18

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The COVID19 Consumer: #AloneTogether and More Health Aware

The number of diagnoses of people testing positive with the coronavirus topped 14,000 today in the U.S., Johns Hopkins COVID-19 interactive map told us this morning. As tests have begun to come on stream from California on the west coast to New York state on the east, the U.S. COVID-19 positives will continue to ratchet up for weeks to come, based on the latest perspectives shared by the most-trusted expert in America, Dr. Anthony Fauci. This report from the U.S. Department of Health and Human Services on the nation’s response to the coronavirus pandemic, published March 13, 2020, forecasts a

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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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Lockdown Economics for U.S. Health Consumers

The hashtag #StayHome was ushered onto Twitter by 15 U.S. national healthcare leaders in a USA Today editorial yesterday. The op-ed co-authors included Dr. Eric Topol, Dr. Leana Wen, Dr. Zeke Emanuel, Dr. Jordan Shlain, Dr. Vivek Murthy, Andy Slavitt, and other key healthcare opinion leaders. Some states and regions have already mandated that people stay home; at midnight last night, counties in the Bay Area in California instituted this, and there are tightening rules in my area of greater Philadelphia. UBS economist Paul Donovan talked about “Lockdown Economics” in his audio commentary today. Paul’s observations resonated with me as

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Telehealth and COVID-19 in the U.S.: A Conversation with Ann Mond Johnson, ATA CEO

Will the coronavirus inspire greater adoption of telehealth in the U.S.? Let’s travel to Shanghai, China where, “the covid-19 epidemic has brought millions of new patients online. They are likely to stay there,” asserts “The smartphone will see you now,” an article in the March 7th 2020 issue of The Economist. The article returns to the advent of the SARS epidemic in China in 2003, which ushered in a series of events: people stayed home, and Chinese social media and e-commerce proliferated. The coronavirus spawned another kind of gift to China and the nation’s health citizens: telemedicine, the essay explains. A

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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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Most Americans Concerned About Coronavirus Impact on Economy & Families, and Not a “Hoax”

Seven in 10 Americans are concerned about the coronavirus outbreak’s impact on the economy, and 6 in 10 people worried about someone they love getting sick from COVID-19. But most Americans also get the politicized nature of the coronavirus and say they’re less likely to vote for President Trump in November based on his handling of the public health threat, according to a just-released survey from Protect Our Care fielded by Public Policy Polling. Some of the data points which demonstrate that Americans are taking the emerging coronavirus pandemic quite seriously are that: 53% disagree that President Trump and his

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How Coronavirus Is Re-Shaping Consumer Behavior, From the Amusement Park to the Voting Booth

The coronavirus has shaken U.S. consumer confidence, both in terms of financial markets and personal health risks. COVID-19 is re-shaping peoples’ behavior and daily choices, from using public transit to choosing where to shop, based on Morning Consult’s National Tracking Poll #200276 conducted February 28-March 1, 2020. Morning Consult surveyed 2,200 U.S. adults, finding that 3 in 4 Americans were concerned about the coronavirus outbreak. The first chart from the survey shows various consumer activities by peoples’ likelihood of choosing to do them. Clearly, our daily life-flows outside of our homes have been impacted by our perceived risks of the coronavirus:

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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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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 Ill Health of Rural Hospitals in Four Charts

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

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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 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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USA Today Finds Hidden Common Ground Among Americans For Health Care

“We need to demand our health citizenship. That means our nation must approach medical treatment and data privacy as civil rights that protect everyone.” This is the start of my column, Americans, let’s claim our health care rights, published by USA Today today. USA Today is publishing a 10-part series called “Hidden Common Ground” addressing key issues where Americans can come together. Thus far, the series has covered climate change, and this month health care. Going forward, we’ll see analyses on jobs, gun rights and violence, and immigration through May’s publishing schedule. In their study conducted in December 2020, USA Today

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Come Together – A Health Policy Prescription from the Bipartisan Policy Center

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

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What’s Causing Fewer Primary Care Visits in the US?

Americans who have commercial health insurance (say, through an employer or union) are rarely thought to face barriers to receiving health care — in particular, primary care, that front line provider and on-ramp to the health care system. But in a new study published in the Annals of Internal Medicine, commercially-insured adults were found to have visited primary care providers (PCPs) less often, and 1 in 2 had no PCP visits in one year. In Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008-2016, the researchers analyzed data from a national sample of adult health

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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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A Uniting Issue in the United States is Lowering Prescription Drug Costs

Health care continues to be the top-ranked voting issue in the U.S. looking to the November 2020 Presidential and Congressional elections. The Kaiser Family Foundation conducts the monthly poll which gauges U.S. adults’ perspectives on health care, and this month’s January 2020 Kaiser Health Tracking Poll explores Americans’ views on broad healthcare reform plans and specific medical policy issues. Overall, Americans point to prescription drug costs and the preservation of the Affordable Care Act’s protections for people with pre-existing conditions, the first chart tells us. Third and fourth on voters’ minds are protecting patients from surprise medical bills and better

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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 Pace of Tech-Adoption Grows Among Older Americans, AARP Finds – But Privacy Concerns May Limit Adoption

One in two people over 50 bought a piece of digital technology in the past year. Three in four people over fifty in America now have a smartphone. One-half of 50+ Americans use a tablet, and 17% own wearable tech. The same percentage of people over 50 own a voice assistant, a market penetration rate which more than doubled between 2017 and 2019, AARP noted in the 2020 Tech and the 50+ Survey published in December 2019. For this research, AARP worked with Ipsos to survey (online) 2,607 people ages 50 and over in June and July 2019. Across all

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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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Consumers Seek Benefits From Food, a Personal Social Determinant of Health

As consumers in the U.S. wrestle with accessing and paying for medical benefits, there’s another sort of health benefit people increasingly understand, embrace, and consume: food-as-medicine. More people are taking on the role of health consumers as they spend more out-of-pocket on medical care and insurance, and seeking food to bolster their health is part of this behavior change. One in four Americans seek health benefits from food, those who don’t still seek the opportunity to use food for weight loss goals, heart health and energy boosting, according to the 2019 Food & Health Survey from the International Food Information

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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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In 2020, PwC Expects Consumers to Grow DIY Healthcare Muscles As Medical Prices Increase

The new year will see a “looming tsunami” of high prices in healthcare, regulation trumping health reform, more business deals reshaping the health/care industry landscape, and patients growing do-it-yourself care muscles, according to Top health industry issues of 2020: Will digital start to show an ROI from the PwC Health Research Institute. I’ve looked forward to reviewing this annual report for the past few years, and always learn something new from PwC’s team of researchers who reach out to experts spanning the industry. In this 14th year of the publication, PwC polled executives from payers, providers, and pharma/life science organizations. Internally,

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Food As Medicine: Grocery Stores Expand as Health Destinations While the Federal Government Cuts Food Stamps

There’s something like cognitive dissonance as I prepare my 2020 Health Populi TrendCast of what to expect in the health/care ecosystem in the new year. One of my key pillars for health-making is food-as-medicine, and that opportunity in this moment resonates in this holiday season with Dickens’ “Best of Times, Worst of Times” context-setting that kicks off Great Expectations. In the “best of times” part of the food+health equation, we recognize the growing role of grocery stores, food-tech and food manufacturers in the health/care landscape. A current example comes from Kroger, partnering with Ascension’s health system in Tennessee, enhancing the organization’s

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Being Transparent About Healthcare Transparency – My Post on the Medecision Blog

With new rules emanating from the White House this month focusing on health care price transparency, health care costs are in the spotlight at the Centers for Medicare and Medicaid Services. A hospital transparency mandate will go into effect in January 2021 as a final rule, and a second rule with a focus on health plans and friendly explanations-of-benefits will receive comments in the Federal Register until January 14, 2020. As patients continue to grow muscles as payors and health consumers, transparency is one key to enabling people to “shop” for those health care and medical products and services that

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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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Hospitals Suffer Decline in Consumer Satisfaction

While customer satisfaction with health insurance plans slightly increased between 2018 and 2019, patient satisfaction with hospitals fell in all three settings where care is delivered — inpatient, outpatient, and the emergency room, according to the 2018-2019 ACSI Finance, Insurance and Health Care Report. ACSI polls about 300,000 U.S. consumers each year to gauge satisfaction with over 400 companies in 46 industries. For historic trends, you can check out my coverage of the 2014 version of this study here in Health Populi. The 2019 ACSI report bundles finance/banks, insurance (property/casualty, life and health) and hospitals together in one document. Health

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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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Social Determinants of Health – My Early Childhood Education and Recent Learnings, Shared at the HealthXL Global Gathering

My cousin Arlene got married in Detroit at the classic Book Cadillac Hotel on July 23, 1967, a Sunday afternoon wedding. When Daddy drove us back out to our suburban home about 30 minutes from the fancy hotel, the car radio was tuned to WWJ Newsradio 950, all news all the time. As soon as Daddy switched on the radio, we were shocked by the news of a riot breaking out in the city, fires and looting and gunshots and chaos in the Motor City. Two days later, my father, who did business with Mom-and-Pop retail store owners in the

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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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Will Technology Cure Americans’ Health Care System Ills? Considering Google and Ascension Health’s Data Deal

“Google’s ‘Project Nightingale’ Gathers Personal Health Data on Millions of Americans,” the Wall Street Journal reported in today’s paper and on the WSJ.com website. The story started with the scenario that, “Search giant is amassing health records from Ascension facilities in 21 states; patients not yet informed.” Here’s Ascension’s press release on the collaboration, described in the title as “healthcare transformation.” Note: this release was written after the Wall Street Journal published this story. And, according to the WSJ reporting, “Neither patients nor doctors have been notified. At least 150 Google employees already have access to much of the data

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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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Will Consumers Cross the Cost-and-Trust Chasm Between Prescription Drugs and Hospitals?

People in the U.S. rank prescription drugs, lab tests, emergency room visits, dental and vision care, preventive services, chronic disease management and mental health care as the “most essential” health care services, according to the 2019 Survey of America’s Patients conducted by The Physicians Foundation. When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election. The Physicians Foundation surveyed 2,001 U.S. adults between 27 and 75 years

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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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Learning from Dr. Eric Topol, Live from Medecision Liberation 2019

“Bold thinking is great. Bold doing is better,” Dr. Eric Topol introduced his talk yesterday at Medecision’s Liberation 2019 conference. I have the opportunity, for which I’m so grateful, of not only attending this meeting but playing a role as a speaker, a sometimes stage “emcee,” and a keynote speaker. And as an attendee, I learn so much from other speakers, fellow attendees, and Medecision staff all sharing perspectives during breakouts and networking breaks. In mode of attendee (and self-confessed collegial-groupie of Dr. Topol’s), I took in his remarks taking notes as fast as I could thanks to Mom teaching

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What the 2019 Nobel Prize Winners in Economics Teach Us About Health

The three winners of the 2019 Nobel Prize for Economics — Banerjee and Duflo (both of MIT) and Kremer (working at Harvard) — were recognized for their work on alleviating global poverty.” “Over 700 million people still subsist on extremely low incomes. Every year, five million children still die before their fifth birthday, often from diseases that could be prevented or cured with relatively cheap and simple treatments,” The Nobel Prize website notes. To respond to this audaciously huge challenge, Banerjee, Duflo and Kremer asked quite specific, granular questions that have since shaped the field of development economics — now

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Wasted: $1 of Every $4 Spent on Health Care In America

A study in JAMA published this week analyzed research reports that have measured waste in the U.S. health care system, calculating that 25% of medical spending in America is wasted. If spending is gauged at $3.8 trillion, waste amounts to nearly $1 trillion. If spending is 18% of the American gross domestic product (GDP), then some 4.5% of the U.S. economy is wasted spending by the health care system and its stakeholders. In “Waste in the US Health Care System,” a team from Humana and the Univrsity of Pittsburgh recalibrated the previous finding of 30% of wasted spending to the 25%,

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Prelude to Health 2.0 2019: Thinking Consumers At the Center of Digital Health Transformation

“Digital transformation” is the corporate strategy flavor of the moment across industries, and the health are sector isn’t immune from the trend. As this 13th year of the annual Health 2.0 Conference kicks off this week, I’m focused on finding digital health innovations that engage people — consumers, caregivers, patients, health citizens all. This year’s conference will convene thought leaders across a range of themes, and as is the Health 2.0 modus operandi, live demo’s of new-new things. As Health 2.0 kicks off today in pre-conference sessions, there is useful context described in a new report from the American Hospital

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Most U.S. Voters Support Building on the ACA, Not Medicare For All, As Fewer Americans Have Insurance Coverage

The vast majority of Americans favor lowering the cost of prescriptions, keeping the Affordable Care Act’s provisions to cover pre-existing conditions, lower overall medical costs, and protect people from surprise medical bills, according to the KFF Health Tracking Poll – September 2019: Health Care Policy In Congress And On The Campaign Trail. The big headline in this poll following last night’s third Democratic Presidential debate is that 55% of Democrats and Democrat-leaning Independent voters prefer a candidate that will build on the Affordable Care Act (ACA) versus a President that would replace the ACA with a Medicare For All plan (M4A).

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Health Consumers Expect Healthcare to be Digital (and Secure), Philips Future Health Index Finds

Health care system financing, delivery, and workflows widely vary across nations around the world. Philips surveyed health care professionals and consumers living in 15 countries, from North America to Asia, and found that these health systems share one over-arching objective: to provide quality care with improved experiences for both patients and healthcare professionals. Being Philips, what underpins that quality and experience is technology; Philips explored telehealth, AI, digital health records (DHRs), and other digital health tools that can engage patients. Philips published results from this global study in The Future Health Index 2019, themed “Transforming healthcare experiences, exploring the impact

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Growing Support for Medicare for All – But Do People Really Understand What It Means?

Two new data points converge that beg the question in the title of this post. These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?” Not so very much, Eligibility.com found out. Let’s start with the Morning Consult poll results, which compare support for Medicare for All from January 2019 and August 2019. The headline number from this poll is seen in

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Talking “HealthConsuming” on the MM&M Podcast

Marc Iskowitz, Executive Editor of MM&M, warmly welcomed me to the Haymarket Media soundproof studio in New York City yesterday. We’d been trying to schedule meeting up to do a live podcast since February, and we finally got our mutual acts together on 6th August 2019. Here’s a link to the 30-minute conversation, where Marc combed through the over 500 endnotes from HealthConsuming‘s appendix to explore the patient as the new health care payor, the Amazon prime-ing of people, and prospects for social determinants of health to bolster medicines “beyond the pill.” https://www.pscp.tv/MMMnews/1eaJbvgovBYJX Thanks for listening — and if you

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What the Pew Report on Trust and Distrust in America Means for Health/Care, El Paso and Dayton — Pogo Rears His Head Again

Two in three Americans believe their trust in each other has been shrinking. And most people connect the dots between that low level of trust and America’s ability to solve problems. It’s been well-documented that Americans’ trust in institutions, and especially government and media, has eroded over the past decade. I’ve tracked that social trend here in Health Populi each year since covering the Edelman Trust Barometer, which has traced the downward sloping curve on trust globally and certainly in the U.S. The precipitous decline in trust in America among fellow Americans is described in Pew Research Gr0up’s report, Trust

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Telehealth Awareness, Access and Adoption: Updates from J.D. Power, the ATA and FAIR Health

When you think “J.D. Power,” your mind probably imagines reviews of automotive performance, retail shopping experiences, or perhaps even health insurance plan customer service. Expanding its report-card role in the health ecosystem. J.D. Power has undertaken a survey on consumer satisfaction with 31 telehealth providers across 15 measures, which will be published in November 2019. In advance of the full report, the organization released a summary on telehealth access and satisfaction, which I’ll discuss in this post. I’ll also weave in the latest insights from the ATA 2019 State of the States report updating legislative/regulatory telemedicine activity at the U.S.

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Love ACA Provisions, Not the ACA – KFF Poll Reveals American Voters’ Views on Health Care Reform

Today is the bridge day between The Battle of the Democratic Primary Candidates Debate #2 Part 1 and tonight, Part 2. So it’s a good time to take stock of U.S. voters’ views on health care, through the lens of the Kaiser Family Foundation’s Health Tracking Poll for July 2019 published yesterday. Health care is the top issue Democrats want to hear about in the debates, well ahead of climate change, women’s issues, immigration and gun policy. Let’s start with an overall context statistic from this poll: that is that 86% of insured U.S. adults like their health insurance plan

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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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Retail Pricing in U.S. Health Care? Why Transparency Is Hard to Do

“It’s the prices stupid,” Uwe Reinhardt and Gerard Anderson and colleagues asserted in the title their seminal Health Affairs manifesto on U.S. healthcare spending. Sixteen years later, yesterday on 8th July 2019, a Federal U.S. judge blocked, in the literal last-minute, a DHHS order mandating prescription drug companies to publish “retail prices” of medicines in direct-to-consumer TV ads. I was getting this post on transparency together just before that announcement hit the press, so this post would have had a different nuance yesterday compared with today. And that’s how health care politics and economics in America roll these days. Welcome to

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Gaps in Health Equity in America Are Growing

There’s been a “clear lack of progress on health equity during the past 25 years in the United States,” asserts a data-rich analysis of trends conducted by two professors/researchers from UCLA’s School of Public Health. The study was published this week in JAMA Network Open. The research mashed up several measures of health equity covering the 25 years from 1993 through 2017. The data came out of the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System looking at trends by race/ethnicity, sex and income across three categories for U.S. adults between 18 and 64 years of age.

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A Matter of Trust, Perception, Risk, and Uncertainty – The Big Issues Raised by the Acquisition of PatientsLikeMe and Other Patient Data Transactions

By Susannah Fox, Jane Sarasohn-Kahn and Lisa Suennen I’ve lived long enough to have learned The closer you get to the fire the more you get burned But that won’t happen to us Cause it’s always been a matter of trust           A Matter of Trust, by Billy Joel If you’re in health care and don’t live under a rock, you have probably heard that United Health Group (UHG) has acquired PatientsLikeMe (PLM).  After the announcement, there was a lot of sound and fury, some of which signified nothing, as the saying goes, and some which signified a lot.

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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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Health Care and the Democratic Debates – Part 1 – Medicare For All, Rx Prices, Guns and Mental Health

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

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Healthcare Costs Inspire Employer Activism and Employee Dissatisfaction – What PwC Found Behind the Numbers

In the U.S. each year between 2006 and 2016, employees’ healthcare cost sharing grew 4.5%. In that decade, Americans’ median wages rose 1.8% a year, PwC notes in their annual report, Medical cost trend: Behind the numbers 2020 from the firm’s Health Research Institute. Medical cost trend is the projected percent growth in healthcare costs over a year based on an equivalent benefit package from one year to the next. As the first chart shows, trend will grow 6% from 2019 to 2020. This is an increase of 0.3 percentage points up from 5.7% for 2019, which was flat from

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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 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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Two-Thirds of Americans Say Healthcare Doesn’t Work Well, in RealClear Politics Poll

Health care is the top issue facing the U.S. today, one in three Americans says, with another one-fourth pointing to the economy. Together, health care + the economy rank the top issues for 62% of Americans. Health care and the economy are, in fact, intimately tied in every American’s personal household economy I assert in my book, HealthConsuming: From Health Consumer to Health Citizen. This poll from RealClear Politics, conducted in late April/early May 2019, makes my point that the patient is the consumer and, facing deductibles and more financial exposure to footing the medical bill, the payor.   Fully

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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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Scaling the Social Determinants of Health – McKinsey and Kaiser’s Bold Move

People who are in poor health or use more health care services are more likely to report multiple unmet social needs, such as food insecurity, unsafe neighborhoods, lack of good housing, social isolation, and poor transportation access, found through a survey conducted by McKinsey. The results are summarized in Addressing the Social Determinants of Health. The growing recognition of the influence of social determinants reached a tipping point last week with the news that Kaiser-Permanente would work with Unite US to scale services to people who need them. The mainstreaming of SDoH speaks to the awareness that health is made

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Prescription Drug Costs In America Through the Patient Lens, via IQVIA, GoodRx and a New $2 Million Therapy

Americans consumed 17.6 prescriptions per person in 2018, two in three of which treated chronic conditions. Welcome to Medicine Use and Spending in the U.S. , the annual review of prescription drug supply, demand and Rx pricing dynamics from the IQVIA Institute for Human Data Science. In a call with analysts this week in which I participated, the Institute’s Executive Director Murray Aitken discussed the report which looks back at 2018 and forward to 2023 with scenarios about what the U.S. prescription drug market might look like five years from now. The report is organized into four sections: medical use

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Assessing the GAO’s Report on Single-Payer Healthcare in America: Let’s Re-Imagine Workflow

Calls for universal health care, some under the banner of Medicare for All,” are growing among some policy makers and presidential candidates looking to run in 2020. As a response, the Chairman of the House Budget Committee in the U.S. Congress, Rep. John Yarmuth (D-Ky.), asked the Congressional Budget Office (CBO) to develop a report outlining definitions and concepts for a single-payer health care system in the U.S.         The result of this ask is the report, Key Design Components and Considerations for Establishing a Single-Payer Health Care System, published on 1st May by the CBO. The report provides

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Will Health Consumers Morph Into Health Citizens? HealthConsuming Explains, Part 5

The last chapter (8) of HealthConsuming considers whether Americans can become “health citizens.” “Citizens” in this sense goes back to the Ancient Greeks: I return to Hippocrates, whose name is, of course, the root of The Hippocratic Oath that physicians take. Greece was the birthplace of Democracy with a capital “D.” Hippocrates’ book The Corpus is thought to be one of the first medical textbooks. The text covered social, physical, and nutritional influences, and the concept of “place” for health and well-being. Here, the discussion detailed the roles of air and water for health. The Hippocratic texts also coached doctors to

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What We Know We Know About ZIP Codes, Food, and Deaths of Despair – HealthConsuming Explains, Part 3

“There’s a 15-year difference in the life expectancy between the richest and poorest Americans.” That’s the first sentence of Chapter 7 in my book, HealthConsuming: From Health Consumer to Health Citizen. This data point comes from research published in JAMA in April 2016 on the association between income and life expectancy in the U.S. (That’s endnote #399 in the back of the book, one of 519 notes I use to support the plotline). Today, the Brookings Institution convened a meeting on the funding for social determinants of health to address disparities, costs, and quality of healthcare in America. The overall

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Across All Political Parties, Likely Voters Over 50 Favor Cutting Prescription Drug Prices

People over 50 in the U.S. that are likely to vote in the 2020 Presidential election are keenly interested in lowering the cost of prescription drugs, according to a survey conducted by AARP in February and March 2019. Most people over 50 take prescription drugs daily; one-third take two or three Rx’s regularly, and one in five older people take six or more prescription medicines regularly. Thus, prescription drugs are part of most older Americans’ daily life-flows and household spending considerations. About two-thirds of older people who are likely to vote say that Rx prices are “unreasonable,” including 67% of

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Health/Care Everywhere – Re-Imagining Healthcare at ATA 2019

“ATA” is the new three-letter acronym for the American Telemedicine Association, meeting today through Tuesday at the Convention Center in New Orleans.  Ann Mond Johnson assumed the helm of CEO of ATA in 2018, and she’s issued a call-to-action across the health/care ecosystem for a delivery system upgrade. Her interview here in HealthLeaders speaks to her vision, recognizing, “It’s just stunning that there’s such a lag between what is possible in telehealth and what is actually happening.” I’m so keen on telehealth, I’m personally participating in three sessions at #ATA19. On Monday 15th April (US Tax Day, which is relevant

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Digital Health As A Basic Human Need – the Dentsu Digital Society Index 2019

We are all Homo informaticus these days, multi-channel, multi-platform beings using digital platforms. “Computing is not about computers anymore. It is about living,” Nicholas Negroponte wrote in Being Digital. He said that in 1995. In that quarter-century since Negroponte made that prescient observation, we come to better understand that being a Digital Society has its upsides and downfalls, alike. We need a “new needs model” for the digital age, asserts a new report, Human Needs in a Digital World, the 2019 Digital Society Index report from the Dentsu Aegis network. Taking Maslow’s Hierarchy of Needs as a basic construct, the Index

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World Health Day 2019: Let’s Celebrate Food, Climate, Insurance Coverage and Connectivity

Today, 7 April, is World Health Day. With that in mind, I devote this post to three key social determinants of health (SDOH) that are top-of-mind for me these days: food for health, climate change, and universal health coverage. UHC happens to be WHO’s focus for World Health Day 2019. [As a bonus, I’ll add in a fourth SDOH in the Hot Points for good measure and health-making]. Why a World Health Day? you may be asking. WHO says it’s, “a chance to celebrate health and remind world leaders that everyone should be able to access the health care they need,

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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 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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Most Americans Blame Drug Companies, Insurers, and Hospitals for High Health Care Costs

There’s little agreement between Democrats and Republicans on a plethora of issues in American public life. But one issue that brings U.S. citizens together is agreement that the cost of health care is too high in the country, and that pharma, health plans, and providers are to blame. Welcome to health politics in America as of March 2019, according to The Public and High U.S. Health Care Costs, a poll conducted by POLITICO and the Harvard T.H. Chan School of Public Health. The first chart illustrates the common ground shared by Americans by party affiliation, with vast majorities across parties playing

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Our Mobile Health Data: Shared, Identifiable, and Privacy-Deprived

As more mobile app users — consumers, patients, and caregivers — use these handy digital health tools, much of the data we share can be re-identified and monetized by third parties well beyond those we believe we’re sharing with. This compromised health data privacy scenario comes out of research published this month in the BMJ, Data sharing practices of medicines related apps and the mobile ecosystem: traffic, content, and network analysis. The researchers, faculty from the University of Toronto (Canada) and the University of Sydney (Australia), come from nursing, pharmacy, and computer science expertise — a sound combination of disciplines

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