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The Pandemic’s Death Rate in the U.S.: High Per Capita Income, High Mortality

The United States has among the highest per capita incomes in the world. The U.S. also has sustained among the highest death rates per 100,000 people due to COVID-19, based on epidemiological data from the World Health Organization’s March 28, 2021, update. Higher incomes won’t prevent a person from death-by-coronavirus, but risks for the social determinants of health — exacerbated by income inequality — will and do. I have the good fortune of access to a study group paper shared by Paul Sheard, Research Fellow at the Mossaver-Rahmani Center for Business and Government at the Harvard Kennedy School. In reviewing

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The Cost of Healthcare Can Drive Medical Rationing and Crowd Out Other Household Spending

One in five people in the U.S. cannot afford to pay for quality health care — an especially acute challenge for Black and Hispanic Americans, according to a West Health-Gallup poll conducted in March 2021, a year into the COVID-19 pandemic. “The cost of healthcare and its potential ramifications continues to serve as a burdensome part of day-to-day life for millions of Americans,” the study summary observed. Furthermore, “These realities can spill over into other health issues, such as delays in diagnoses of new cancer and associated treatments that are due to forgoing needed care,” the researchers expected. The first table

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Housing as Prescription for Health/Care – in Medecision Liberation

COVID-19 ushered in the era of our homes as safe havens for work, shopping, education, fitness-awaking, bread-baking, and health-making. In my latest essay written for Medecision, I weave together new and important data and evidence supporting the basic social determinant of health — shelter, housing, home — and some innovations supporting housing-as-medicine from CVS Health, UnitedHealth Group, AHIP, Brookings Institution, the Urban Land Institute, and other stakeholders learning how housing underpins our health — physical, mental, financial. Read about a wonderful development from Communidad Partners, working with the Veritas Impact Partners group, channeling telehealth to housing programs serving residents with

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How Fruits and Veg Can Make Health and Lower Costs – Calling Chef José Andrés to the White House

Springtime is finally emerging on the east coast of the U.S. and my local CSA farm is on my mind. It’s timely, then, to re-visit a research paper on subsidizing fruits and vegetables from a March 2019 issue of PLOS as an introduction to a new initiative growing out of The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) on produce prescriptions. Timely, too, that Chef José Andrés has been called to President Biden’s White House to help address food security in America. First, let’s look at the research in PLOS: Cost-effectiveness of financial incentives for

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The Ongoing Reality of COVID-19 – My Conversation with Dr. Michael Osterholm at SXSW

“So close and yet so far” feels like the right phrase to use a year after the World Health Organization used the “P-word,” “pandemic,” to describe the coronavirus’s impact on public health, globally. One year and over 550,000 COVID-related deaths in the U.S. later, we face a New Reality that Dr. Michael Osterholm and I are brainstorming today at the 2021 South-by-Southwest Festival. Usually held live and very up-close-and-personally crowded in Austin, Texas, this year we are all virtual — including the film, music, and interactive festivals alike. While I regret to not be in the same room as Dr.

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A BA Degree as Prescription for a Longer Life – Update on Deaths of Despair from Deaton and Case

“Without a four-year college diploma, it is increasingly difficult to build a meaningful and successful life in the United States,” according to an essay in PNAS, Life expectancy in adulthood is falling for those without a BA degree, but as educational gaps have widened, racial gaps have narrowed by Anne Case and Angus Deaton. Case and Deaton have done extensive research on the phenomenon of Deaths of Despair, the growing epidemic of mortality among people due to accidents, drug overdoses, and suicide. Case and Deaton wrote the book on Deaths of Despair (detailed here in Health Populi),  Case and Deaton

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How to Restore Americans’ Confidence in U.S. Health Care: Deal With Access and Cost

With a vaccine supply proliferating in the U.S. and more health citizens getting their first jabs, there’s growing optimism in America looking to the next-normal by, perhaps, July 4th holiday weekend as President Biden reads the pandemic tea leaves. But that won’t mean Americans will be ready to return to pre-pandemic health care visits to hospital and doctor’s offices. Now that hygiene protocols are well-established in health care providers’ settings, at least two other major consumer barriers to seeking care must be addressed: cost and access. The latest (March 2021) Kaiser Family Foundation Tracking Poll learned that at least one

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“Hope Springs Eternal” With the COVID Vaccine for Both Joe Biden and Most People in the U.S.

More Americans are happier in March 2021 than they’ve been for a year, based on consumer research from Civic Science polling U.S. adults in early March 2021. For the first time, a larger percent of Americans said they were better off financially since the start of the pandemic. This week, Civic Science shared their latest data on what they’re seeing beyond the coronavirus quarantine era to forecast trends that will shape a post-COVID America. Buoying peoples’ growing optimism was the expectation of the passage of the American Cares Act, which President Biden signed into effect yesterday. The HPA-CS Economic Sentiment Index

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Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

2021 is the 20th anniversary of the University of Michigan Center for Value-Based Insurance Design (V-BID). On March 10th, V-BID held its annual Summit, celebrating the Center’s 20 years of innovation and scholarship. The Center is led by Dr. Mark Fendrick, and has an active and innovative advisory board. [Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics].   Some of the most important areas of the Center’s impact include initiatives addressing low-value care, waste in U.S. health care, patient assistance programs, Medicare

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The Economics of the Pandemic Put Costs at the Top of Americans’ Health Reform Priorities

A major side-effect of the coronavirus pandemic in 2020 was its impact on the national U.S. economy, jobs, and peoples’ household finances — in particular, medical spending. In 2021, patients-as-health-consumers seek lower health care and prescription drug costs coupled with higher quality care, discovered by the patient advocacy coalition, Consumers for Quality Care. This broad-spanning patient coalition includes the AIMED Alliance, Autism Speaks, the Black AIDS Institute, Black Women’s Health Initiative, Center Forward, Consumer Action. Fair Foundation, First Focus, Global Liver Institute, Hydrocephalus Association, LULAC, MANA (a Latina advocacy organization), Myositis Association, National Consumers League, National Health IT Collaborative, National Hispanic

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Americans Lost Future Life-Years in 2020: How Much Life Was Lost Depends on the Color of One’s Skin

Some people remark about 2020 being a “lost year” in the wake of the coronavirus pandemic. That happens to be a true statement, sadly not in jest: in the U.S., life expectancy at birth fell by one full year over the first half of 2020 compared with 2019, to 77.8 years. In 2019, life expectancy at birth was 78.8  years, according to data shared by the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC). Life expectancy at birth declined for both females and males, shown in the first chart. The differences between

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The Social Determinants of Prescription Drugs – A View From CoverMyMeds

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

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Three in Four People Avoiding Health Care in the Pandemic Have Had Chronic Conditions

By the autumn of 2020, U.S. physicians grew concerned that patients who were avoiding visits to doctor’s offices were missing care for chronic conditions, discussed in in Delayed and Forgone Health Care for Nonelderly Adults during the COVID-19 Pandemic from the Urban Institute. More than three-fourths of people who delayed or forewent care had at least one chronic health condition. The pandemic may have led to excess deaths from diabetes, dementia, hypertension, heart disease, and stroke, as well as record drug overdoses in the 12 months ending in May 2020. In their JAMA editorial on these data, Dr. Bauchner and

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The Health Care Cost Curve is Bending Down – A New View from Deloitte

Over the next 20 years, health care spending in the U.S. will migrate toward well-being and the early detection of disease, away from the funding of America’s sick-care system, according to Breaking the cost curve, a forecast of U.S. health economics in the year 2040 from Deloitte. Current spending on health care in America is roughly $4 trillion (with a “t”) dollars, approaching 20% of the nation’s economy. By 2040, spending is projected to be $8.3 trillion based on future health trends — not historic workflows and delivery mechanisms which would consume an additional $3.5 trillion — close to what we

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Call It Deferring Services or Self-Rationing, U.S. Consumers Are Still Avoiding Medical Care

Patients in the U.S. have been self-rationing medical care for many years, well before any of us knew what “PPE” meant or how to spell “coronavirus.” Nearly a decade ago, I cited the Kaiser Family Foundation Health Security Watch of May 2012 here in Health Populi. The first chart here shows that one in four U.S. adults had problems paying medical bills, largely delaying care due to cost for a visit or for prescription drugs. Fast-forward to 2020, a few months into the pandemic in the U.S.: PwC found consumers were delaying treatment for chronic conditions. In October 2020, The American Cancer

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Dr. Burnout – The 2021 Medscape Physician Burnout & Suicide Report

Physicians in the U.S. are experiencing “death by 1,000 cuts,” according to the 2021 Medscape Physician Burnout & Suicide Report. Medscape polled 12,339 physicians representing over 29 specialties between late August and early November 2020 to gauge their feelings about work and life in the midst of the coronavirus pandemic. Medscape researched its first Physician Lifestyle Report in 2012. That research focused on physician “happiness” and work-life satisfaction. In 2013, the issue of burnout was called out on the cover of the report, shown here with the question, “does burnout affect lifestyle?” In 2015, the Physician Lifestyle Report was titled,

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Food Trends and Hunger in the Pandemic – the Importance of Food Security in Health and Economic Security

In 2020, the COVID-19 pandemic changed all kinds of aspects of our daily lives, not the least of which were our food habits — how we shopped for food, how we bought food, how we cooked and baked from scratch, and how our tastes and nutritional choices changed with our #StayHome and #WorkFromHome lifestyles. People who could keep their jobs and work from home connected by broadband learned how to build up pandemic pantries, shop online, and stay well-fed. But for people in the U.S. who lost employment, had hours cut, or were compelled to stay home to teach kids

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The Digital Consumer, Increasingly Connected to Health Devices; Parks Associates Kicking Off #CES2021

In 2020, the COVID-19 pandemic drove U.S. consumers to increase spending on electronics, notably laptops, smartphones, and desktop computers. But the coronavirus era also saw broadband households spending more on connecting health devices, with 42% of U.S. consumers owning digital health tech compared with 33% in 2015, according to research discussed in Supporting Today’s Connected Consumer from Parks Associates. developed for Sutherland, the digital transformation company. Consumer electronics purchase growth was, “likely driven by new social distancing guidelines brought on by COVID-19, which requires many individuals to work and attend school from home. Among the 26% of US broadband households

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“The virus is the boss” — U.S. lives and livelihoods at the beginning of 2021

“The virus is the boss,” Austan Goolsbee, former Chair of the Council of Economic Advisers under President Obama, told Stephanie Ruhle this morning on MSNBC. Goolsbee and Jason Furman, former Chair of Obama’s Council of Economic Advisers, tag-teamed the U.S. economic outlook following today’s news that the U.S. economy lost 140,000 jobs — the greatest job loss since April 2020 in the second month of the pandemic. The 2020-21 economic recession is the first time in U.S. history that a downturn had nothing to do with the economy per se. As Uwe Reinhardt, health economist guru, is whispering in my

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The 2021 Shkreli Awards: Lown Institute Counts Down the Top 10 Healthcare Industry Abuses in the Coronavirus Pandemic

The first year of the coronavirus pandemic in America was a kind of stress test on the U.S. health care system, revealing weak links and opportunities for bad behavior. “These are not just about individual instances or bad apples,” Dr. Vikas Saini, President of The Lown Institute, explained, referring to them as “cautionary tales” of the current state of U.S. health care. Dr. Saini and his colleague Shannon Brownlee released the annual Lown Institute 2020 Shkreli Awards this week, highlighting their ten most egregious examples of the worst events in U.S. health care that happened in the past year —

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Nurses, doctors, pharmacists join with teachers in Gallup’s 2021 honest and ethics poll

Each year, Americans rank nurses as the most honest and ethical professionals along, generally followed by doctors and pharmacists. In the middle of the coronavirus pandemic in the U.S., grade school teachers join the three medical professions in the annual Gallup Poll on the top-ranked professions for honest and ethical behavior in America as we enter 2021 with many U.S. hospitals’ intensive care units at full capacity….and schools largely emptied of students. The three health care professions scored their highest marks ever achieved in this Gallup Poll, which has been assessing honesty and ethics in America since 1999. Nurses are

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The 2021 Health Populi TrendCast – Health Care, Self-Care, and the Rebirth of Love in Public Health

In numerology, the symbolic meaning behind the number “21” is death and re-birth. In tarot cards, 21 is a promise of fulfillment, triumph, and victory. How apropos that feels right now as we say goodbye and good riddance to 2020 and turn the page for a kinder, gentler, healthier New Year. It would be sinful to enter a New Year as challenging as 2021 promises to be without taking the many lessons of our 2020 pandemic life and pain into account. For health care in America, it is a time to re-build and re-imagine a better, more equitable landscape for

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Consumers Demand Digital Transformation Across Their Health Care Experiences

From appointment scheduling to checking in, payment and clinical encounter follow-up, patients now expect digital experiences across the health care continuum….and really great ones, like they get from Amazon and other platforms that earn high net promoter scores. That is the big message from the 2020 Healthcare Consumer Experience Study published by Cedar, based on the input of 1,502 U.S. adults who paid a medical bill between October 2019 and October 2020. The timing of this study coincided with the start of the COVID-19 pandemic in the U.S. through at least seven months of American patients’ experiences in 2020. Two-thirds

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The Fastest-Growing Brands of 2020 Are All About the Pandemic and Health

Staying home, being clean, staying entertained, eating well, and self-caring for healthcare….these are the major factors underpinning the twenty fastest-growing brands of 2020, based on Morning Consult’s annual look at the topic. Let’s look into these categories by brand, and connect the dots for health, medical care, and well-being… Connectivity as a social determinant of health. Zoom was the fastest-growing brand of the year, with 26% of U.S. consumers saying they would consider purchasing the service in November compared with 11% in January. Zoom morphed from a business meeting platform to a consumer and family-connecting service spiking on holidays like

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U.S. Health Consumers’ Growing Financial Pressures, From COVID to Cancer

Before the coronavirus pandemic, patients had been transforming into health care payors, bearing high deductibles, greater out of pocket costs, and financial risk shifting to them for medical spending. In the wake of COVID-19, we see health consumers-as-payors impacted by the pandemic, as well as for existing diagnoses and chronic care management. There is weakening in U.S. consumers’ overall household finances, the latest report from the U.S. Bureau of Economic Analysis (BEA) asserted (published 25 November 2020). In John Leer’s look into the BEA report in Morning Consult, he wrote, “Decreases in income, the expiration of unemployment benefits and increased

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How Nurx Is Empowering Women’s Health and Self-Care in the Pandemic Era

In the wake of the coronavirus pandemic, women have experienced more than the direct physical, clinical impact of COVID-19: beyond “lives,” women’s livelihoods, financial health and emotional well-being have been hard-hit. This is true on both a global basis as well as in the United States. In that context, last week I engaged in a fascinating conversation with Varsha Rao, CEO of Nurx, to discuss the current state of women and health/care in America, and some thoughts about the future. If you’ve had the TV on sometime since March 2020, one of many millions of people in the U.S. spending

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Consumers Seek Health Features in Homes: How COVID Is Changing Residential Real Estate

The coronavirus pandemic has shifted everything that could “come home,” home. THINK: tele-work, home schooling for both under-18s and college students, home cooking, entertainment, working out, and even prayer. All of this DIY-from-home stuff has been motivated by both mandates to #StayHome and #WorkFromHome by government leaders, as well as consumers seeking refuge from contracting COVID-19. This risk-shift to our homes has led consumers to re-orient their demands for home purchase features. Today, home is ideally defined as a safe place, offering comfort and refuge for families, discovered in the America at Home Study. The Study is a joint project of

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The COVID Healthcare Consumer – 5 Trends Via The Medecision Liberation Blog

The first six months into the coronavirus pandemic shocked the collective system of U.S. consumers for living, learning, laboring, and loving. I absorbed all kinds of data about consumers in the wake of COVID-19 between March and mid-August 2020, culminating in my book, Health Citizenship: How a virus opened hearts and minds, published in September on Kindle and in print in October. In this little primer, I covered the five trends I woven based on all that data-immersion, following up the question I asked at the end of my previous book, HealthConsuming: when and how would Americans claim their health

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The Pandemic, Amazon, Pharmacy, and the Digital Transformation of Health Consumers

As the COVID-19 pandemic emerged in the U.S., Americans were already Primed for ecommerce — even in health care. The coronavirus accelerated the digital transformation on people as consumers — and consumers as health consumers. Today, Amazon announced the company’s launch of Amazon Pharmacy. Watch for earth-shaking (negative) impacts on the incumbent pharmacies like CVS, Rite-Aid, Walgreens, as well as discount and ecommerce players such as GoodRx. [Sidebar: as of 10 am this morning, the announcement “sunk” the retail pharmacy stocks, according to TheStreet.com]. Some context: this announcement builds on Amazon’s previous major move into pharmacy with its acquisition of

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The Pandemic Has Been a Shock to Our System – Learning from Known

The coronavirus pandemic has been a shock to people across all aspects of everyday living, for older and younger people, for work and school, for entertainment and travel — all impacting our hearts, minds, and wallets. “As the bedrock of daily life was shaken, uncertainty predictably emerged as the prevailing emotion of our time but this universal problem was eliciting a highly differentiated reaction in different people,” Kern Schireson, CEO of Known, observed. His company has conducted a large quantitative and qualitative research program culminating in a first report, The Human Condition 2020: A Shock To The System. Known’s team of

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Rebuilding Resilience, Trust, and Health – Deloitte’s Latest on Health Care and Sustainability

The COVID-19 pandemic has accelerated health care providers’ and plans’ investment in digital technologies while reducing capital spending on new physical assets, we learn in Building resilience during the COVID-19 pandemic and beyond from the Deloitte Center for Health Solutions. What must be built (or truly re-built), health care leaders believe, is first and foremost trust, followed by financial viability to ensure long-term resilience and sustainability — for the workforce, the organization, the community, and leaders themselves. For this report, Deloitte interviewed 60 health care chief financial officers to gauge their perspectives during the pandemic looking at the future of

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How Grocery Stores Are Part of the Health/Care Ecosystem – the Case of ALDI and Instacart

As humans in the Age of the Coronavirus focus on physiological needs, people have intensely focused on hunting-and-gathering food and hygiene products. We will remember memes about toilet tissue stockpiling and re-visiting canned and shelf-stable comfort foods from childhood long after the pandemic. Some people, though, haven’t had easy access to nutritious food in their communities or the ability to engage with ecommerce platforms to order food for delivery. An alliance between ALDI, the value-priced grocer, and Instacart, was forged to address that gap as a key social determinant of health. Food-is-medicine when it comes to managing chronic conditions like

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Healthcare Costs, Access to Data, and Partnering With Providers: Patients’ Top User Experience Factors

As patients returned to in-person, brick-and-mortar health care settings after the first wave of COVID-19 pandemic, they re-enter the health care system with heightened consumer expectations, according to the Beryl Institute – Ipsos Px Pulse report, Consumer Perspectives on Patient Experience in the U.S. Ipsos conducted the survey research among 1,028 U.S. adults between 23 September and 5 October 2020 — giving consumers many months of living in the context of the coronavirus. This report is a must-read for people involved with patient and consumer health engagement in the U.S. and covers a range of issues. My focus in this

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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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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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Our Home Is Our Health Hub: CTA and CHI Align to Address Digital and Health Equity

In the pandemic, I’ve been weaving together data to better understand how people as consumers are being re-shaped in daily life across their Maslow Hierarchies of Needs. One of those basic needs has been digital connectivity. People of color have faced many disparities in the wake of the pandemic: the virus itself, exacting greater rates of mortality and morbidity being the most obvious, dramatic inequity. Another has been digital inequity. Black people have had a more difficult time paying for phone and Internet connections during the COVID-19 crisis, we learned in a Morning Consult poll fielded in June 2020. In

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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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50 Days Before the U.S. Elections, Voters Say Health Care Costs and Access Top Their Health Concerns — More than COVID-19

The coronavirus pandemic has revealed deep cracks and inequities in U.S. health care in terms of exposure to COVID-19 and subsequent outcomes, with access to medical care and mortality rates negatively impacting people of color to a greater extent than White Americans. The pandemic has also led to economic decline that, seven weeks before the 2020 elections in America, is top-of-mind for health citizens with the virus-crisis itself receding to second place, according to the Kaiser Family Foundation September 2020 Health Tracking Poll. KFF polled 1,199 U.S. adults 18 years of age and older between August 28 and September 3,

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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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Behavioral Health Side-Effects in the COVID Era

“This surge of people experiencing acute behavioral health problems…has the potential to further impact the healthcare system for years to come,” a report from McKinsey expects looking at the hidden costs of COVID-19’s impact on U.S. health care. The coronavirus pandemic has taken a toll on Americans’ mental health, with anxiety and depression growing as a side-effect to worries about the virus itself, the long Great Lockdown in much of the country, and the economic recession that has particularly impacted women and people of color. I covered depression impacts due to COVID-19 here in Health Populi yesterday, and wanted to

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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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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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My ABCovid-19 Journal – Day 4 of 5, Letters “P” through “T”

While I’m on holiday this week, restoring and re-setting, I’ve been sharing pages from my ABCovid-19 Journal with readers of Health Populi. I created this journal during the early phase of the pandemic in the U.S., as a form of art therapy, creative outlet, and learning. Today is Day 4 of sharing: we consider the letters “P” through “T,” and what I saw in the early coronavirus era. P is for pandemic This “P” was self-evidence in our collective early COVID-19 lexicon. The “P” word was uttered by the Secretary General of the World Health Organization on March 11, confirming

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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 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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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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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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From Dr. Fauci to Peloton, Healthcare and Wellness Baked Into Ad Age’s Top 20 Brands for 2020

Advertising Age announced their list of the top 20 brands in 2020 this week. Ad Age’s lens on these was heavily tinted by consumers’ lives coping with the coronavirus pandemic: “The coronavirus has brought new attention to typically boring, decades-old consumer staples, while hastening the rise of digital newcomers that were only just beginning to gain traction pre-pandemic,” Ad Age explains in the introduction to the list of the selected brands. As the editors of the MadMen-and-Women’s most influential industry publication, they explain, “Ad Age chronicles 20 brands that are having a moment.” This moment to them as well as

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How Can Healthcare Bring Patients Back? A Preview of Our ATA Session, “Onward Together” in the COVID Era

Today kicks off the first all-virtual conference of the ATA, the American Telemedicine Association. ATA’s CEO Ann Mond Johnson and team turned on a dime over the past few months, migrating the already-planned live conference scheduled in early May to this week, all online. I’ll be midwifing a panel this afternoon at 440 pm Eastern time, initially focused on how health care can garner patient loyalty. That theme was given to us in the fourth quarter of 2019, when initial planning for ATA 2020 had begun. What a difference a few months make. Not only has ATA pivoted to an

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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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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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The Hair Economy in the COVID-19 Pandemic: Control, Wellness, and Self-Care

The barbershop and beauty salon are important community touch points for health, wellness, and social connection in so many peoples’ lives. In my book, HealthConsuming: From Health Consumer to Health Citizen, I feature the black barbershop to introduce a chapter on “The New Retail Health.” In the COVID-19 pandemic, how we’re dealing with hair is a metaphor for personal control, for political statements, for mental health, and for overall well-being. Check out Geoff Coates’ (known as Sadochicken, from Vancouver) take on “how quarantine hairdos are lookin’,” here. Can you see yourself? I can (it’s the “Corona Bangs” style for me,

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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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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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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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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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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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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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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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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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Outpatient is the New Inpatient – The Future of Hospitals in America

Outpatient revenue is crossing the curve of inpatient income. This is the new reality for U.S. hospitals and why I’ve titled this post, “outpatient is the new inpatient,” a future paradigm for U.S. hospitals This realization is informed by data in a new report from Deloitte, Where have the many hospital inpatient gone? The line chart illustrates Deloitte’s top and bottom line: “The shift toward outpatient is happening and will likely have a tremendous impact on operations, business models, staffing, and capital. Health systems should prepare for the future today and start thinking not only about how to manage their

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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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Most Workers and their Employers Want to Receive Digital Healthcare On-Demand

Most employers and their workers see the benefits of digital health in helping make health care more accessible and lower-cost, according to survey research published in Health on Demand from Mercer Marsh Benefits. Interestingly, more workers living in developing countries are keener on going digital for health than people working in wealthier nations. Mercer’s study was global, analyzing companies and their employees in both mature and growth economies around the world. In total, Mercer interviewed 16,564 workers and 1,300 senior decision makers in companies. The U.S. sample size was 2,051 employees and 100 decision makers. There’s a treasure trove of insights

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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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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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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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Living in Digital Healthcare Times – Kicking off #DigitalHealthCES & #CES2020

Today is Day 1 of two Media Days at #CES2020 in Las Vegas, kicking off this manic week of the Consumer Electronics Show at the Mandalay Bay convention center. For several years, I’ve convened with journalists and industry analysts from around the world for these two days before the “official” opening of CES to hear the latest news from some of the largest tech-focused companies on Earth. Announcements come from across industry sector — from automotive and transportation, telecoms, consumer goods, entertainment, social media, travel, and retail…with platform technologies playing a role including but not limited to AI, AR/VR/XR (the

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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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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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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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