A blog covering the health/care ecosystem and people.

Rationing has long been seen as a common practice in national, single-payer health systems like the UK’s National Health Service and Canada’s national health insurance program (known as “Medicare”).  However, over half of U.S. physicians say they ration care to patients. In a peer-reviewed column in the Journal of General Internal Medicine published in July 2016, Dr. Robert Sheeler and colleagues at the Mayo Clinic, University of Iowa, and University of Michigan, found that 53% of physicians surveyed personally “refrained” in the past six months from using specific clinical services that would have provided the “best patient care” due to cost.

Personal fitness equipment is getting connected in the growing Internet of Things ecosystem (IoT), and fitness enthusiasts are getting more digitally connected well beyond their wristband tracking device. , a healthy living portal, looked into fitness consumers’ digital habits and found a health-engaged cohort that’s online in the Web 1.0 world — sharing workout tips in social media communities but not so much product information. Product information is still learned Old School-wise, via product websites, traditional magazines, from peers and word-of-mouth (offline), and trying new gear out at the gym in real time. This survey was conducted among HellaWella’s readers,

When consumers consider the many stakeholder organizations in healthcare, a majority trust pharmacists first, then doctors and dentists. Hospital and health insurance execs, and members of Congress? Hardly, according to a survey from Meyocks, a marketing consultancy. Meyocks conducted the survey via email among 1,170 US adults, 18 years of age and older. This survey correspondends well with the most recent Gallup Poll on most ethical professions, conducted in December 2015. In that study, pharmacists, nurses and doctors come out on top, with advertisers (“Mad Men”), car salespeople, and members of Congress at the bottom, as shown in the second

Millions of U.S. patients have more financial skin in the American health care game. But are they behaving like the “consumers” they are assumed to be as members in consumer-directed health plans? Not so much, yet, explained John Park, Chief Strategy Officer at Alegeus, during a discussion of his company’s 2016 Healthcare Consumerism Index. This research is based on an online survey of over 1,000 U.S. healthcare consumers in April 2016. Alegeus looks at healthcare consumerism across two main dimensions: healthcare spending and healthcare saving. As the chart summarizes, consumers show greater engagement and focus on buying a TV or car, choosing

“Gas ‘N’ Health Care” is one of my most-used cartoons these days as I talk with health/care ecosystem stakeholders about the growing and central role of consumers in health care. You may be surprised to learn that the brilliant cartoonist Michael Maslin created this image back in 1994. That’s 22 years ago. When I first started using this image in my meetings with health care folks, they’d all giggle and think, ‘isn’t that funny?’ Legacy health care players — hospitals, doctors, Pharma, and medical device companies — aren’t laughing at this anymore. At a Costco a 20 minutes’ drive from

There’s growing recognition of the role of food in health, on both the supply side of grocers, food growers and consumer marketers; and, among consumers who are, increasingly, shopping for food with health on their minds. 8 in 10 consumers in the U.S. enter a grocery store thinking about the health attributes of what they’re about to choose from the aisles that are stocked with more gluten-free, GMO-labelled, and organic products, according to the 2015 Deloitte Pantry Study. Our physicians have begun to “prescribe” food, especially as the collective BMI of Americans has reached medically catastrophic levels. See this forecast from

Cost ranks first among the factors of selecting health insurance for most Americans across the generations. As a result, most consumers are likely to shop around for both health providers and health plans, learned through a 2016 Xerox survey detailed in New Insights on Value-Based Care, Healthcare Attitudes 2016. The younger the consumer, the more important costs are, Xerox’s poll found, shown in the first chart. Thus, “shopping around” is more pronounced among younger health consumers — although a majority people who belong to Boomer and Greatest Generation cohorts do shop around for both health providers and health insurance plans —

“Health comes to your local store,” explains the recently-launched portal, GoHealthEvents. This site is a one-stop shop for health consumers who are seeking health screenings and consults in local retail channels like big box stores, club stores, drug stores, and grocery stores. Events covered include cholesterol, diabetes, heart health, nutrition, osteoporosis, senior health, vaccinations and immunizations. By simply submitting a zip code, a health consumer seeking these kinds of services can identify where and when a local retailer will provide it. I searched on my own zip code in suburban Philadelphia, and found the following opportunities taking place in the

American workers are feeling financial stress and uncertainty, struggling with health care costs, and seeking support for managing finances. 75% of employees feel financially insecure, with 60% feeling stressed about their financial situation, according to the 2016 Workplace Benefits Report, based on consumer research conducted by Bank of America Merrill Lynch. The overall feeling of financial wellness fell between 2013 and 2015. 75% of U.S. workers don’t feel secure (34% “not very secure” and 41% “not at all secure”), with the proportion of workers identifying as “not at all secure” growing from 31% to 41%. Financial wellness was defined for this

As patients continue to grow health consumer muscles, their ability to vote with their feet for health care services and products grows. That’s why it’s crucial for health care providers to understand how patients perceive their quality and service levels, explained in Patient Experience: It’s Time to Rethink the Consumer Healthcare Journey, a survey report from GE Healthcare Camden Group and Prophet, a brand and marketing consultancy. 3 in 4 frequent healthcare consumers say they are frustrated with their services. One-half of less-frequent patients are frustrated. Patients and physicians are on different pages when it comes to evaluating the health care

9 in 10 people in the U.S. use some form of digital technology or electronic tools for health management, Accenture found in the company’s 2016 Consumer Survey on Patient Engagement. Younger people (18-34) tend to favor wearable technology, apps and social media for health. More older people (age 65-74) mine electronic health records (EHRs) for personal health data and more likely use tech for remote consultations with care providers. Overall, the percent of U.S. consumers accessing their EHR data grew by over 50% between 2014 and 2016, from 27% to 45% of people doing so, with older people indexing higher

When I say “Fitbit,” you may think, “digital health.” When I mention “Gatorade,” “Nestle,” and “Dannon,” you might think, “drink,” “chocolate,” and “yogurt.” But soon, the phrase “digital health” will come to mind. That’s because a growing list of food manufacturers is looking to digital technologies to bake (or cook, blend, or mix) health into their value propositions. “Gatorade Taps Into Tech-Thirsty Consumers” is an article published in today’s Wall Street Journal, page B1 in the Business & Tech section of the newspaper. Mike Estrel writes that Gatorade is going high tech, working on a “smart cap” bottle with a microchip

As HIMSS 2016, the annual conference of health information technology community, convenes in Vegas, an underlying market driver is fast-reshaping consumers’ needs that go beyond personal health records: that’s personal health-financial information and tools to help people manage their growing burden of healthcare financial management. There’s a financial risk-shift happening in American health care, from payers and health insurance plan sponsors (namely, employers and government agencies) to patients – pushing them further into their role as health care consumers. The burden of health care costs weighs heavier on younger U.S. health citizens, based on a survey from the Xerox Healthcare

Italians get the food=health connection as a natural everyday behavior. So it’s no surprise that one of the fast-selling books in Italy’s librerias is about Slow Food – a movement that’s celebrating its 30th anniversary in that hot book by Carlo Petrini, a father of the Slow Food organization. I took the photograph this evening peering into a shop window during our post-dinner walk along the Via Gucciardini past the Giunti al Punto bookstore. [In full transparency, I’ve been a long-time member of this organization, represented by the little red snail icon.] The book has a three-word title: Buono, Pulito, Giusto. This

La salute prima de tutto! Health is first of all!  I am on holiday with my favorite person in the world, my husband, and we are Italophiles. He comes by that bias genetically, and I through loving him and sharing so many joyful, enchanting experiences in la Bella Italia over our many years of marriage. The day before flying to Italy, Dr. Michael Painter, Senior Program Officer of the Robert Wood Johnson Foundation, posted a link on his Facebook page to this wonderful explanation of why Italy ranks as the second-healthiest country in the world, just after Singapore. The rankings

The so-called legacy healthcare system are the incumbents in American health care — hospitals, physician practices, pharma, health plans, and other organizations that have long-served and been reimbursed by traditional volume-based payment. Patients, now morphing in to health consumers, look to these stakeholders to provide new levels of service, accessibility, convenience, transparency and value — the likes of which people find in their daily life in other market sectors. Those consumer demands are pressuring the health system as we know it in many new ways, which I discussed with Unity Stoakes, Co-Founder of Startup Health, at the Health 2.0 Conference in

The rising cost of health care for Americans continues to contribute to self-rationing care in the forms of not filling prescriptions, postponing necessary services and tests, and avoiding needed visits to doctors. Furthermore, health care costs are threatening the livelihood of most American families, according to the Pioneer Institute. “What Will U.S. Households Pay for Health Care in the Future?” asks the title of a study by the Institute, noting that health care costs for an American family of average income could increase annually to $13,213 by 2025 — and as high as $18,251. Pioneer calculates that this forecasted spend will

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

Among TIME magazine’s 25 best inventions of 2015, most relate directly or adjacently to health and health care. Among the 25 are: The EKO Stethoscope A gluten-sniffing sensor, the 6SensorLabs Nima The Sproutling baby monitor Nike Flyease 8 shoes, that you can tie with one hand Cogni-Toys Dino, the toy that talks back A smart refrigerator that can fix you a glass of nutrient-enriched water The TZOA environmental tracker for personal pollution sensing, measuring atmosphere in a specific area (e.g., temperature, particulates such as dust, pollen, mold, and car exhaust), and UV ­exposure Doppler Labs Here Active Listening earbuds The

Food + Drink, Beauty, Tech + Innovation, Retail, Lifestyle…JWT pulls out their crystal ball for 2016, and I see health, everywhere. The Future 100 – Trends and Change to Watch in 2016 is J. Walter Thompson Intelligence Innovation Group’s annual trend forecast, which I highly value and mine each year to help THINK-Health continue to hone our own environmental analyses for health and healthcare. [Here’s what I wrote one year ago about JWT’s 2015 forecast]. Health is baked into JWT’s 2016 trendscape, well beyond their “Health” chapter. Even the report’s introduction is health-flavored: “As forecasters, we’re watching the rapid metabolism

U.S. spending on medicines will approach $590 billion in 2020, increasing 34% over 2015, IMS Institute for Healthcare Informatics projects in its forecast, Global Medicines Use in 2020. Growth in spending will be attributable to innovation (new products), price increases and some patent losses of exclusivity (e.g., branded drugs going generic). The U.S. will cover the bulk of drugs spending in 2020 at 41% of the world medicines market, shown in the first pie in the first chart. U.S. medicines spending dwarfs any other country or region in the world, including China which is expected to account for 11% of

The average price for a specialty drug was $53,384 in 2013; the average household income was $52,250. Thus, even allocating 100% of a family’s annual earnings to pay for a drug wouldn’t stretch far enough to cover it in 2013, nor would it do so today in 2015. This sober health economic artifact comes from the latest Rx Price Watch Report from the AARP, detailing cost trends for prescription drugs across all segments — generics, brands and specialty drugs.  Contrast, as well, the $53K for the average specialty drug with the median 2013 Social Security benefit payout of $15,526 and median Medicare

The Old School retail clinic is going beyond checking your child’s ear infection and sore throat, giving immunizations and filling out back-to-school forms just-in-time over LaborDay  weekend. The new-new retail clinic is supporting patients’ chronic disease management, partnering with academic medical centers, and bolstering medication management. Accenture’s bullish forecast is titled “US Retail Health Clinics Expected to Surge by 2017,” making the case that these brick-and-mortar providers are shifting from a relatively limited retail scope to a broader and deeper clinical focus. The so-called surge in the number of retail clinics is projected to be nearly 50% growth between 2014 and 2017,

Two-thirds of all internet users, and 65% of all adults over 18 years of age, use social networking sites. Social Media Usage: 2005-2015, the latest report from the Pew Research Center, finds social networking is the new normal for people up to 65 years of age. One-third of people over 65 use social networking sites. Peoples’ use of social media impacts every aspect of daily living beyond sharing social updates, from home keeping and political discussions to work, parenting, and managing stress, the Pew research found. Key findings in the report are that: Seniors’ use of social networks rose from

By 2018, 90% of health care delivered to people enrolled in Medicare will be paid-for on the basis of quality, not on the amount of services delivered (that is, volume). But as providers must up their game in that new value-oriented health payment world, they are bound up in work flows and organizational structures built for fee-for-service reimbursement. This changing future is discussed in Healthcare’s alternative payment landscape, PwC’s Healthcare Research Institute report on the volume-to-value shift. PwC notes that health care providers’ ability to adapt to changing payment regimes vary and fall into four categories: traditional, lagging, vanguard and

Direct-to-consumer retail health options are fast-growing in the U.S. health ecosystem. CVS Health brought three telemedicine vendors to its pharmacy brick-and-mortar stores. CVS also acquired Target’s pharmacies, expanding its retail health footprint. Rite Aid has added HealthSpot kiosks to its pharmacies, while Walgreens expanded its relationship with MDLive. And, Cox Cable acquired Trapollo to bring remote health monitoring into subscribers’ homes, along with the cable company’s venture with Cleveland Clinic, Vivre Health. Coupled with the growing supply side of telemedicine vendors, the latest National Business Group on Health survey found that most large employers plan to expand the telemedicine services they

CVS quit selling cigarettes and tobacco products in 2014, made $139 bn, and saved 65,000 lives. That’s the best kind of retail health there is. It’s been a year since CVS quit selling cigarettes, I’m reminded by a one-page ad in today’s Wall Street Journal on page B5. This is a big investment in an ad for a business strategy that’s had a huge return-on-investment. The ad reads: “One year ago, we took a deep breath and quit selling cigarettes in our pharmacies. Now we’re working to create a tobacco-free world. We just want to help everyone, everywhere, breathe easier,”

I switched from being a devoted coffee drinker to green tea several years ago, but once in a while I still love an excellent cup of coffee (especially when I’m in Italy – stay tuned for late October posts from the 2015 Milan Expo where I’ll be all-food-and-health, all-the-time). One of my long-time favorite coffee brands is Lavazza, based in Italy. The company hadn’t allocated much resource to advertising in the U.S. But they are launching a new multimedia campaign in America; here’s a look at their initial video promotion… [youtube http://www.youtube.com/watch?v=Jfx2yL6guhk?rel=0] This ad covers many features that are relevant

Think of the word “pharmacy,” and what names come to your mind? CVS Health, Walgreens, Rite-Aid, perhaps. But it’s Wegmans who’s #1 across all pharmacy brands and types, according to the 2015 J.D. Power Pharmacy Study. The big improvement in pharmacy satisfaction in 2015 has been among supermarket drug stores, up to an index score of 851 (of 1,000), the highest consumer score. The satisfaction score for chain pharmacies increased a small 2 points, whereas satisfaction for two other channels for pharmacies — mass merchandisers and mail order — both fell from 2014. It may come as no surprise to Health

In the growing value-based era of health care, patients are looking for real consumer experiences: being treated well, with respect, and with a high level of service people find in other industries. PwC polled about 2,300 U.S. adults online in June 2014, resulting in the paper, Personal health management: The rise of the empowered consumer, part of PwC’s research into The New Health Economy. In that New Health Economy, more consumers want to take control of their health, PwC discovered through the survey. The three key parameters for this empowered health consumer are personal, proactive health management, service, and value,

Sales of computers and tablets and LCD TVs won’t be hot on peoples’ holiday shopping lists in 2015. But smartwatches, health and fitness tech, and 4K Ultra HD TVs will be in peoples’ gift wish-lists and under homes’ holiday trees. The Consumer Electronics Association (CEA) published its 2015 U.S. Consumer Electronics Sales and Forecasts report, and it shows a shifting retail picture where traditional consumer electronics categories — notably computers and mainstream TVs — are declining in demand. But new-new categories are expected to buoy 2015 retail sales. The new categories of consumer electronics will generate about $10 bn (wholesale

Now that the Affordable Care Act is settled, in the eyes of the U.S. Supreme Court, what does the 6-3 ruling mean for health/care consumers living in America? I wrote the response to that question on the site of Intuit’s American Tax & Financial Center here. The top-line is that people living in Michigan, where the Federal government is running the health insurance exchange for Michiganders, and people living in New York, where the state is running the exchange, are considered equal under the ACA’s health insurance premium subsidies: health plan shoppers, whether resident New Yorkers or Michiganders, can qualify for

Two forces are converging to shape a new era of “living services,” Accenture posits: the digitization of “everything” and consumers’ “liquid” expectations — which are demands for personalized, engaging and adaptable experiences. Accenture’s report on this phenomenon, The Era of Living Services, spans the broad range of consumers’ daily lives where these services will impact: homes, families, transportation, shopping, leisure time, jobs, finances, education, cities, and above all for Health Populi readers, “our bodies.” Living services are physically close to us, as Accenture sees them, “wrapping themselves around the everyday things we do.” They are digital services that are aware

Three-quarters of U.S. adults say the cost of prescription drugs are unreasonable, and blame high medication prices set by profitable pharmaceutical companies according to the Kaiser Family Foundation Health Tracking Poll for June 2015. Profits made by drug companies are the #1 reason Americans cite among major factors that contribute to the price of prescription drugs (among 77% of people), followed by the cost of medical research (64%), the cost of marketing and advertising (54%), and the cost of lawsuits (49%). Regardless of the cost, 71% of people say that health insurance should “always” pay for high-cost drugs. At the same

In the past couple of weeks, a grocery store launched a telemedicine pilot, a pharmacy chain expanded telehealth to patients in 25 states, and several new virtual healthcare entrants received $millions in investments. On a parallel track, the AMA postponed dealing with medical ethics issues regarding telemedicine, the Texas Medical Association got stopped in its tracks in a case versus Teladoc, and the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the Medicare Shared Savings Program that falls short of allowing Accountable Care Organizations (ACOs) to take full advantage of telehealth services. These events beg the

People in the U.S. spend over five-and-a-half hours a day with digital media in 2015, with time on mobile devices exceeding use of laptop and desktop computers. The growth of mobile means people are using and seeking more just-in-time services in daily living, and this has big implications for health/care, based on the annual mega-report on Internet Trends from Mary Meeker, KPCB’s internet analyst. “People” in health/care are patients, consumers and caregivers; people in health/care are also health plan administrators, employer benefits managers, doctors, nurses, allied health professionals, financial managers in hospitals, pharmacists, and the entire range of humans who

The cost of a PPO for a family of four in America hits $24,671 in 2015, growing 6.3% over 2014’s cost. The growth in health care costs will be driven by high specialty prescription drug costs. The 6.3% growth rate in health costs is a stark increase compared with the twelve month April 2014-March 2015 decline in the Consumer Price Index of -0.1%. Welcome to the 2015 Milliman Medical Index, subtitled “Will the typical American family of four be driving a ‘Cadillac plan’ by 2018?” The MMI gauges the average cost of an employer-sponsored preferred provider organization (PPO) health plan and includes all

Call it a Silver Million Anniversary, if you will: The MinuteClinic just saw its 25 millionth patient. This is a milestone in the evolution and growth of retail health in America, a trend-marker in this growing health industry segment that will become increasingly used by consumers, patients, parents, and caregivers. CVS bought the MinuteClinic in 2006, when the organization treated seven illnesses. Today, MinuteClinic offers 65 services and vaccinations in nearly 1,000 clinics located in 31 states and Washington, DC. In addition, MinuteClinic will grow the number of clinic locations in both existing and new markets. The company will open

The costs of healthcare in the U.S. have trended upward since 2000, with a slowdown in cost growth between 2009 to 2013 due to the impact of the Great Recession. That’s no surprise. What stands out in the new U.S. News & World Report Health Care Index is that people covered by private health insurance through employers are bearing more health care costs while publicly-covered insureds (in Medicare and Medicaid) are not. Blame it on the fast-growth of high-deductible health plans, the Index finds, resulting in what U.S. News coins as a “massive increase in consumer cost.” U.S. News &

TD Bank gifted free Fitbit activity trackers to new customers signing up for savings accounts in the 2015 New Year. John Hancock is discounting life insurance premiums for clients who track steps and take on preventive care strategies. And Banco Sabadell in Spain, along with Westpac in New Zealand and Standard Chartered in the United Kingdom are all piloting wearable technology for consumer financial management. Financial wellness is an integral part of peoples’ overall health, so financial services companies are putting their collective corporate feet into the health/care market. Banks and consumer investment companies are new entrants in health/care as

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

As much as the Affordable Care Act is bolstering health insurance rolls for the uninsured, people who have enjoyed health insurance at work continue to highly value that benefit, according to a survey from Benz Communications and Quantum Workplace published April 2015. Based on a national sample of over 2,000 employees surveyed in October 2014 about workplace benefits. The research re-confirms the long-term reality of workers working in America for the health benefit. Benz/Quantum note that 89% of workers say health benefits play a part in remaining on-the-job, and half say the health benefit is a “major” part of remaining

Financial wellness is integral to overall health. And the proliferation of high-deductible health plans for people covered by both public insurance exchanges as well as employer-sponsored commercial (private sector) plans, personal financial angst is a growing fact-of-life, -health, and -healthcare. Ask any hospital Chief Financial Officer or physician practice manager, and s/he will tell you that “revenue cycle management” and patient financial medical literacy are top challenges to the business. For pharma and biotech companies launching new-new specialty drugs (read: “high-cost”), communicating the value of those products to users — clinician prescribers and patients — is Job #1 (or #2,

While I am all health, all-the-time when I’m at the annual South-by-Southwest meet-up in Austin, I had the opportunity to attend the premiere of the documentary, Mavis! (exclamation point included and appropriate, given the energy and joy in the title’s subject). “Mavis” is Mavis Staples, who you should know for her music, as singer with her family’s group, The Staple Singers; and, for as a positive force for good. In fact, she’s a lesson in whole health, which is why I’m writing about here on Health Populi which is dedicated to health where we live, work, play, pray…and sing. For

More employers are recognizing the link between workers who may be overweight or obese on one hand, and health care costs, employee engagement and productivity on the other. As a result, some companies are adopting wellness programs that focus on weight loss as part of an overall culture of health at the workplace. Humana and Weight Watchers are the latest example of two health brands coming together to address what is one of the toughest behavior changes known to humans: losing weight. Humana will extend access to Weight Watchers for the health plan’s enrollees in an integrated wellness program. The program

In our ADHD-addled, over-messaged and noisy world, it’s hard to break through the media clutter and binge-watching to get a health message out. Here’s the way it’s done: an engaging, humorous, impactful and crisp campaign focusing on making smoking so un-sexy and un-cool, you swipe the prospective date off of your Tinder app. Watch and learn, from The Truth. You can follow the campaign on Twitter using the hashtag #LeftSwipeDat. Kudos to the truth® anti-smoking campaign and the creative team who got this blend of message and medium so right. truth® is part of the Legacy project which is funded by the

Long an advocate for consumer-directed health in his company, John Mackey, co-CEO and co-Founder of Whole Foods Market, is talking about expanding the food chain’s footprint in retail health. “Americans are sick of being sick,” Mackey is quoted in “Whole Foods, Half Off,” a story published in Bloomberg on January 29, 2015. Mackey talks about being inspired by Harris Rosen, a CEO in Florida, who has developed a workplace clinic for employees’ health care that drives high quality, good outcomes, and lower costs. Mackey imagines how Whole Foods could do the same, beginning in its hometown in Austin, TX. He

Evidence of the rise of retail health grows, with the data point that on-demand health care is in-demand by 2 in 3 U.S. adults. American Well released the Telehealth Index: 2015 Consumer Survey, revealing an American health public keen on video visits with doctors as a viable alternative to visiting the emergency room. Virtual visits are especially attractive to people who have children living at home. [For context, this survey defines “telehealth” as a remote consultation between doctor and patient]. Convenience drives most peoples’ interest in telehealth: saving time and money, not leaving home if feeling unwell, and “avoiding germs

What is the nature of disability? What is the nature of beauty? What is perfection? Who among us is perfect? These questions are at the heart (literally and figuratively) of a project undertaken by Pro Infirmis, a Switzerland-based advocacy organization raising awareness of people with disabilities, promoting the International Day of Persons with Disabilities in December 2013. Mannequins in fashionable shops on Zurich’s tony street the Bahnhofstrasse were replaced by new ones, artfully, painstakingly and lovingly created, as shown in the video. Pro Infirmis’s website tells us “who” we are looking at in human and 3-D life-size mannequin form: Miss Handicap 2010,