At a Campaign rally in 2008, Obama said that health care should not purchased with a tax increase (October 4, 2008).
Showing posts with label Should. Show all posts
Showing posts with label Should. Show all posts
Saturday, June 30, 2012
Tuesday, June 19, 2012
Should States Really Regulate Health Insurance?
(Photo credit: Wikipedia)Health insurance companies must make money to stay viable. To make money, the insurance company sets premium rates according to risk. If the insurance company covers mostly healthy people, there is good chance money will be left over at the end of the day.
Setting health insurance premiums is a complex science. Factors such as previous illness, occupation, gender, and where you live cause significant variation in how much you will use your insurance. If insurance companies had their ideal situation, they would cover only healthy, young male accountants and bankers. Fortunately, insurance companies are regulated by the states, so there are restrictions in what factors they can use in setting insurance rates. However, states vary widely in how well they protect their constituents in insurance matters.
It is good to remember that many state insurance regulators come from a previous life of being (drum roll here) – insurance industry executives. Or they work in regulation and may move to jobs in (another drum roll) – the insurance industry. This also happens on the federal level – a perfect example is Steve Larsen, the recent head of Center for Consumer Information and Insurance Oversight at CMS. He will be taking a job with for-profit United Health Care. Just as with FINRA’s attempt at oversight of independent financial advisors, are state insurance regulators another example of the fox watching the hen house?
I come from the standpoint we are all good people, and most of us want to do positive things. Frequently, we are blinded by the culture of our environment. The majority of people I have worked with in the insurance industry are wonderful souls, but the insurance culture has significant health issues (pun intended.) This causes great people to do not so great things, and as a result consumers get the short end in the insurance market.
Could the fact that insurance regulators are significantly intertwined with the insurance industry explain the lack of protection for consumers in many states? Texas is a great example. Here is an example from the Texas Department of Insurance web site:
“Insurance companies set their own premiums. TDI does not have the authority to regulate or approve health plan rates… In general, health plan rates are determined by…
Number of group plan participants. Group plans are usually less expensive than individual plans. As group size increases, administrative costs per plan member decline. Also, smaller groups and individuals tend to buy health coverage based on participants’ targeted needs, increasing the likelihood of claims. This type of custom tailoring is less likely as claims risk is distributed across a larger population.Claims experience. You can expect to pay more if you’ve filed claims in the past.Age. Older people can reasonably be expected to require more frequent, and more expensive, health care. Your premium will reflect your age or the ages of the members in your group plan.Gender. Young males typically incur lower medical costs than young females, particularly during childbearing years. This changes with age until medical costs for males begin to exceed those for females in the late 50s and early 60s. Plans with a large number of young females or older males generally have higher rates.Geography. Health costs vary by region due to differences in cost of living, medical practices, and the amount of medical competition in the area.Industry. If you are in an employer-sponsored plan, your rates may be affected by the nature of your profession. Industries with more dangerous jobs and a higher number of accidents will have higher medical claims costs than others. High employee turnover in some industries can also result in higher administrative costs for the insurance company.”This sort of “protection” is exactly why Texas has the highest rate of uninsured people in the country. This begs the question – Should insurance be regulated at a state or federal level? The Supreme Court is going to weigh in any day now. I don’t know the answer. I do know that unhealthy people, women, the elderly, and those with dangerous jobs should think twice about moving to Texas. If state regulation rules, then I will encourage Kaiser Family Foundation to start a consumer friendly section of their web site that rates state insurance regulators. (By the way, a big shout out to KFF – they are one of the best resources on health care information you can find anywhere. Their statehealthfacts.org site can help you pick apart where your state ranks in health care. I am applying for a job there – kidding!)
The good news – if the Affordable Care Act stands, insurance prices will be based on just four things.
Premium rating area – if you live in a high cost health area such as Boston, New York, or Miami, you will pay more for health insurance.Number of people covered – if there are three people in your family, your insurance will cost more than if only two people are covered. Duh.Age – older people will not pay more than three times what younger people pay.Tobacco use – tobacco users will pay up to 1.5 times the rate of non-tobacco users. This makes absolute sense. I wish they would have included obesity as a lifestyle factor, but that lobby was too large to get the law passed.This simplification will help consumers, improve transparency in pricing, and allow us to move to Texas without fear. It really is a great state in many ways.
Questions, comments, suggestions? Post here, or reach me on Twitter @CarolynMcC or at Carolyn.mcclanahan@gmail.com.
Wednesday, May 16, 2012
Self-management support should be routine part of primary health care delivery
Health Council of Canada releases report on self-management support for Canadians with chronic conditions
TORONTO, May 15, 2012 /CNW/ - Today the Health Council of Canada released Self-management support for Canadians with chronic health conditions: A focus for primary health care. The report explores how self-management support can improve patient outcomes and calls for health systems across Canada to provide self-management supports in a more systematic way. It profiles a range of practices and recommends targeted investments in self-management support strategies.Chronic disease in Canada costs more than $90 billion a year in lost productivity and health care costs. And with half of Canadians reporting at least one chronic condition, these costs will continue to rise. Successful self-management can help save health resources and keep patients out of hospital for preventable incidences.
Self-management refers to the things a patient does to live well with chronic conditions, like monitoring symptoms, taking medication as prescribed, and recognizing what health-related behaviours will help manage their conditions. New research shows that patients who successfully self-manage tend to have reduced disease-related effects and may make better use of health services because they monitor symptoms effectively and can prevent or respond to problems before they become a crisis.
Self-management support includes education and health coaching and is key to ensuring patients manage their health successfully. In Canada, 95% of adults with multiple chronic conditions have a regular primary care provider - making this a clear area in which to anchor self-management support. Primary health care providers should be an ongoing source of self-management support to follow up with patients and link them to community services and specialists. The problem is that this support role is not yet a routine part of care in Canada.
The report discusses how primary health care providers can better assume this support role for patients with chronic conditions. Self-management support can start at routine primary care visits where providers can empower patients to confidently ask questions and get involved in making decisions about their health. The provider can assist with self-management education and technical skills, and can support personal goal-setting with the patient. Another important role for providers is to link patients to community-based programs. There are many promising programs that exist to support self-management, but patients may need their provider to point them in the right direction and follow up with them on their progress. Providers can also improve aspects of their practice environment in order to better serve patients with chronic conditions. Making better use of all members of a health care team can ease time pressures on physicians and provide patients with the expertise and coaching they need. Health care professionals like nurses, social workers and pharmacists can play a role (especially when many family doctors only have 15 minutes, on average, to devote to patient visits). Offering group visits and integrating self-management support programs directly into primary care settings can also yield positive outcomes.
Given their access to Canadians with chronic-disease, primary health care providers need to be enabled to deliver self-management support. We must invest in ongoing education for providers in self-management support, and encourage the expansion of primary health care teams which can use a variety of health care providers to deliver self-management support. Supporting and creating better links between primary care providers and community-based self management programs will help increase participation and engagement by patients in their own care.
"Self-management has great potential for patients, providers and Canadians," said John G. Abbott, CEO, Health Council of Canada. "Patients and their families will enjoy better quality of life. Primary care providers will have the tools to help their patients succeed."
Investing in ongoing, long-term support for self-management support needs to be a key priority for governments. Collaboration among governments, health care providers and chronic disease organizations can help fill gaps in service and create an integrated, system-wide approach to self-management support. Further recommendations to enable self-management support in a more systematic way can be found in the report.
About the Health Council of CanadaCreated by the 2003 First Ministers' Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on leading practices and innovation across the country. The Councillors are appointed by the participating provincial and territorial governments and the Government of Canada.
Image with caption: "Self-management support for Canadians with chronic health conditions: A focus for primary health care (CNW Group/Health Council of Canada)". Image available at: http://photos.newswire.ca/images/download/20120515_C7467_PHOTO_EN_13697.jpg
Audio with caption: "Podcast with Kelly McQuillen, Director, Acting Executive Director, B.C. Ministry of Health, and Connie Davis, a nurse practitioner and consultant on health care design". Audio available at: http://stream1.newswire.ca/media/2012/05/15/20120515_C7467_AUDIO_EN_13701.mp3
Monday, April 2, 2012
Should You Pay for Credit Repair?
There are businesses out there that promise to improve your credit score for a price. But are they doing anything for you that you can't do yourself?
Tuesday, February 28, 2012
Health insurance hikes - should you stick or switch?
The Irish Times - Tuesday, February 28, 2012
The health insurance industry has become a minefield to navigate in recent years – soaring premiums, losses of cover, product proliferation – but there are ways for canny customers to save, writes CONOR POPE.
THESE ARE TOUGH times for more than two million people who have health insurance in Ireland. Prices are climbing, cover is falling, people who can’t afford premiums anymore are being hit with massive termination fees while the sick and vulnerable are being asked by some providers who seem to be haemorrhaging money to jump through hoops to get access to treatments.
The price increases in particular are taking their toll. The cost of some premiums sold by the VHI, the largest player in the market with more than 1.3m subscribers, increased by more than 60 per cent last year alone. The hikes forced 65,000 people to abandon their health insurance in 2011, a 100 per cent increase on the numbers who cancelled subscriptions the previous year, according to figures released today by the Heath Insurance Authority (HIA).
And the problem is getting worse. A recent survey carried out by the Irish League of Credit Unions found that nearly one in 10 adults with health insurance would abandon policies this year because they could no longer afford them, while 31 per cent claimed that if prices increased again this year – as seems likely – they will follow suit.
The VHI, as the largest provider in the State, gets the most flack. Looking at some of the moves it has made over the past 18 months, it probably deserves it.
It is the only insurer in the market to impose punitive charges on people looking to cancel policies, and while it does cut people slack if they are cancelling following a bereavement, the loss of a job or emigration, everyone else has to pay a €50 administrative fee and percentage of the health insurance levy – how much depends on how long the person is into a 12-month contract.
This rule saw one family who contacted this newspaper hit with a cancellation fee of €700. The company stoutly defends the charge, which it started imposing in the middle of last year, and says it refers to the consequence of early cancellation by a customer and to terms and conditions in its contract renewal letters.
SITTING IN HIS office overlooking the Grand Canal, Liam Sloyan, chief executive of the Health Insurance Authority (HIA), is surprisingly upbeat about the state of the market, although he is not oblivious to the problems which policy holders are being forced to confront.
Even in the current climate, he points out, the vast majority of consumers with health insurance are hanging on to their cover, and while thousands are leaving the market each month, in percentage terms, he says, the impact is still relatively small with just 2 per cent of the total market cancelling their policies last year.
Sloyan has one simple message which he repeats over and over again. He wants people to know that when it comes to health insurance, they have choices, and if they choose wisely they will save money. He says the most important thing consumers should do to shop around and not be afraid to switch.
During the boom years, many Irish people couldn’t be bothered looking for better value elsewhere. There was a huge level of inertia in the health insurance market, with just 1 per cent of the market switching provider each year, despite the fact that prices were regularly going up by three or four times the rate of inflation.
Now it is a different story. As the economic downturn worsened the numbers taking their business from A to B to C spiked. Today, almost 25 per cent of the market has switched provider at least once and, according to Sloyan, most have been motivated to do so because of money.
“There was a lot of inertia, but when the economic conditions changed, all our priorities changed,” he says. “People can save hundreds of euro and still have a similar level of benefits. Maybe there is an excess, but that excess might be €100 per hospital visit and they might be saving hundreds of euro each year,” he says.
Sloyan is perhaps stating the obvious when he says that “health insurance can be confusing in a number of ways”. He also says that too many people are unaware of their rights as consumers and are afraid to tinker with policies in case they find themselves cut adrift when the get sick. But Sloyan says people can switch “even if you are older or you are sick. Consumers who have the information can save themselves a lot of money.”
While the growing numbers switching represent “a very big change”, Sloyan says, it is “only part of the story”. He points to even greater numbers who have chosen to stick with the same insurance company but have modified their policies in order to get better value. The biggest shift has been towards corporate policies. According to the latest figures, one in three people with private health insurance now has a corporate plan. It is such an easy way to save money, it is a wonder more people aren’t doing it.
Over the past three years, the health insurance providers have all started offering discounted plans aimed at businesses. These are cheaper than regular policies, but the companies rarely advertise their existence far and wide.
But it is worth looking – a family policy for two adults and two children bought under a corporate scheme can cost more than €1,000 a year less than an identical policy sold primarily in the mainstream market. The HIA has details of all of the products available on its website hia.ie, but the easiest thing you can do is contact your insurer directly and ask for an equivalent company plan.
A more proactive approach being taken by consumers has gone some way to offsetting the premium increases that have been imposed on the market by all three companies, Sloyan says. While premiums have increase by more than 10 per cent across the board in the past 12 months alone, the average price of premium per person has increased by just 6 per cent. He accepts that this average “hides a lot and says that the reality is that some people are paying much larger increases.
For “some people”, you could read older people. The manner in which the price hikes have been targeted at older, less profitable customers, with almost surgical precision is a concern for the HIA.
IN JANUARY 2011 the cost of the Plan B Options policy, now known as HealthPlus Extra, stood at €986 for an adult. The VHI announced a 45 per cent increase that month, taking the cost to €1,429. It rolled out a further 2 per cent increase in November 2011, which saw the price rise to €1,461. And the cost of the plan is set to climb a further
12.5 per cent from St Patrick’s Day, March 17th, seeing the price climb to €1,644, a whopping 65 per cent higher than it was at the beginning of last year
“We have a community-rated market, which means all adults have to be charged the same for a specific product – but some adults cost at lot more than others,” Sloyan says.
The average cost of a claim for someone in their 60s and beyond is around €3,500 per year, while the cost for someone in their 20s or 30s is closer to €500.
This discrepancy gives the companies a huge incentive to target the younger people and absolutely no incentive to sell to older people, and it also explains why there has been a dramatic segmentation of the market in recent years – there are now more than 200 different policies available.
“The public policy objective is to have a community-rated market, but unless you align the commercial incentives with the public policy objective, commercial companies will find ways in which to meet their own objectives – which is to make money. What we have to do is align public policy objectives with commercial incentives. The way you do that is, if you want the same premium to be charged to everyone, then everyone has to cost the insurer same amount.”
Sloyan points out that the only solution is a risk-equalisation scheme, which is to be introduced next year.
And it is not just prices but cover that concerns the HIA. Last year, the VHI substantially reduced the cover it offers for certain procedures under some popular schemes. Under the changes, cover for certain orthopaedic and ophthalmic treatments was reduced to 80 per cent of the total cost if performed in a private hospital. This changes could leave people facing shortfalls of at least €4,000 on certain operations.
When challenged on the move by this newspaper last year, the company said the changes were outlined in renewal letters sent to consumers, but critics said it was buried in the terms and conditions and easy to miss. Sloyan describes the reductions in orthopaedic and ophthalmic benefits as part of the segmentation. “Consumer information is a matter for the financial regulator and the NCA [National Consumer Agency]. We would say that it is important that consumers get full information in order to help them make the right decision.”
“The contract between an insurance company and the insurer is a very important document, and people should refer to it. But we would like to see significant changes, and particularly reductions in benefits highlighted. We don’t have a role in enforcing that, but I think it is sensible and important thing.”
Sloyan returns to the topic of prices. “People should pay as little as they can for the benefits they want, and the place to find that information is our website. It is up to the market, if organised properly, to have the incentives to reduce prices to win custom and to control their own costs to keep the prices lower.
“Prices for health insurance have increased for many years, but I don’t think that is something we should just accept. Prices increased in other areas for many years and have started to reduce. Claims costs increased very much in the late 2000s, and since then, insurers have got a better handle of them and that goes to show things can change. We should not necessarily accept that prices will rise inevitably.”
Saturday, February 18, 2012
Health Start-Ups Like ZocDoc Should Dial Back The Hype
I like health Web sites and tech start-ups. I think the democratization of medical information is a beautiful thing. It’s a cliche that you can find out more about a hotel than a doctor with a few Google searches. I love how that’s starting to change. I also think that electronic medical records will improve health care over the long haul.
But I am also cynical about the idea that technology is some sort of panacea all that ails the sector. I read Michael Lewis’s book The New New Thing when it came out in 1999. There’s a great anecdote in it about Netscape founder Jim Clark. He was looking for another big challenge and decided–this was 1996–that all that was missing from health care was good software. So he started Healtheon. To Clark it was just a matter of writing some really good code and all the inefficiencies and paperwork that bedeviled the industry would go away. His business plan was a flow chart showing how software cuts out paperwork. It was simple.
Flash forward and Healtheon is buried somewhere deep inside WebMD. There’s still a lot of waste and paperwork that hasn’t gone away.
Since Clark there has been a parade of other ambitious health-tech entrepreneurs. Do you remember the search engine Wondir? Or the comparison-shopping site Vimo? Or Carol.com? How about Steve Case‘s modestly named Revolution Health? What about Subimo?
Just like Healtheon they all failed to catch on, much less “fix health care.” Castlight is a more recently hyped entry in the field. Another is John Doerr‘s company Essence Healthcare. HealthTap is another one that’s gotten buzz.
Though people keep trying, the track record of trying to “solve” health care the Silicon Valley way is fairly uninspiring.
That’s why I cringed this week when I saw another company–and another reporter–fall into the “if we Webify health care we can fix it” trap. The Times profiled ZocDoc, a New York start-up that has raised over $90 million from big names like Amazon’s Jeff Bezos. Its business is an interesting one. It’s like OpenTable, but instead of helping you get a restaurant reservation, you use it to get an appointment with a doctor.
But here’s the money quote from the article that made me shake my head:
“We’re one of the companies that can help fix the health care system,” said Dr. Kharraz, a physician and ZocDoc’s chief operating officer. “We’re making doctors more efficient and helping patients find the hidden supply of health care.”
Uh oh. Why go there?
ZocDoc has a cool service that’s attracting doctors. It will hopefully make some money for its investors. But why does it also have to “fix the health care system?”
There are lots of interesting debates about whether our health system is broken, if so why, and how to make it higher quality, lower cost, less wasteful, and so on. But I promise you that nobody having these debates has pinpointed the inability to get a doctor’s appointment as part of the problem.
So why do start-ups fall into this trap of promising to fix health care? I have a couple theories.
The Apple Effect There’s an unofficial requirement that tech companies can’t just build a great product. They also have to make the world a better place. Remember how Steve Jobs recruited John Sculley from Pepsi by asking if he wanted to spend his life “selling sugared water? Or did he want to come with me and change the world?” The punch line, of course, is that Apple has changed the world. But that kind swagger has also raised the bar. Every other tech company must act like it’s doing something more than just engineering a cool product.
Everybody In The Industry Must Be A Reformer When you’re in health care, changing the world means “fixing it.” I’m someone who thinks that our country’s health care system works better than any other and that the crisis has been vastly overstated. But I’m in the minority. We wouldn’t have just passed a $1 trillion health reform bill. So if you are an entrepreneur it’s tempting not just to “change the world” by making doctors offices run a bit better. You shoot higher. You will fix the world! Apply the same rhetoric to OpenTable and the food business and it sounds kind of silly.
Overzealous Tech Reporters Usually technology reporters, not health care reporters, write these hyped up stories. They need a hook for why the company will be the next Facebook or Google. Health reform is staring right at them. They may get the quote simply by asking over and over again the “fixing health care” question. And for whatever reason, there’s little effort to hold previous companies accountable that had the same ambition.
Health Care Is Analogue Medicine is easy to diss for being a Luddite field. Doctors don’t use email like other professionals. The paperwork is out of control. Hospitals are big, messy service businesses. There’s a feeling that any service can be better with technology.
This diagnosis is true. But the cure is not necessarily as simple as adding software. (Although that is happening with the widespread implementation of electronic medical records.) What’s harder to grasp is that health care is not just a service. It’s an experience. And while many services can be replicated online, human experiences can not. There’s no real electronic replacement for being seen by your doctor. When you take a pill you can’t do it over the Internet. You obviously can’t get virtual surgery.
So it’s true that you can point a finger at health care and say it lacks tech. But it’s not because the technology doesn’t exist. It may be that technology doesn’t really fit. To make a comparison to another “experience sector”: the Web also can’t replace a vacation. It can enhance it, perhaps. But it’s a human experience existing in three-dimensional space.
Going After Bricks & Mortar Many of these health-tech start-ups have looked at a big hospital, or a doctor’s office, the same way Amazon.com once looked at Barnes & Noble. Make the industry faster, chaper, more transparent and disaggregate the market–and you’ll win. (I’m in favor of all those things, by the way.) But in health care it hasn’t been an easy road. Just ask Google, which had to shut down its Google Health product last year after nobody found much utility in storing their health information online. Microsoft HealthVault may be next.
If I were working at one of these health start-ups I’d be careful not to over-hype what I’m doing. (And not just because I’m a superstitious, jinx-minded guy.) I think health care needs more entrepreneurs. But a team of engineers coding all night, no matter how smart they are, how well they’re funded, how much publicity they get from the tech press, or how high their ambitions–is not going to “fix” health care anytime soon.
Matthew Holt, who hosts the Health 2.0 conference and has followed this space more comprehensively and for much longer than I have, makes a similar point in an article he wrote this week on The Health Care Blog.
He was taken aback recently by the hype surrounding a start-up called CareZone. It appears to be a private Facebook for people taking care of sick loved ones to store information. It also has a certain hubris and a big-name founder from the software industry. It might turn out to be great. But as Holt writes convincingly: don’t act like this kind of thing hasn’t been tried before.
Follow @WhelanHealth on Twitter
Friday, February 17, 2012
Health Start-Ups Like ZocDoc Should Dial Back The Hype
I like health Web sites and tech start-ups. I think the democratization of medical information is a beautiful thing. It’s a cliche that you can find out more about a hotel than a doctor with a few Google searches. I love how that’s starting to change. I also think that electronic medical records will improve health care over the long haul.
But I am also cynical about the idea that technology is some sort of panacea for all that ails the sector. I read Michael Lewis’s book The New New Thing when it came out in 1999. There’s a great anecdote in it about Netscape founder Jim Clark. He was looking for another big challenge and decided–this was 1996–that all that was missing from health care was good software. So he started Healtheon. To Clark it was just a matter of writing some really good code and all the inefficiencies and paperwork that bedevil the industry would go away. His business plan was a flow chart showing how software cuts out paperwork. It was simple.
Flash forward and Healtheon is buried somewhere deep inside WebMD. Certainly there’s still a lot of waste and paperwork that hasn’t gone away.
Since Clark there has been a parade of similarly ambitious health-tech entrepreneurs. Do you remember the search engine Wondir? Or the comparison-shopping site Vimo? Or Carol.com? How about Steve Case‘s modestly named Revolution Health? What about Subimo?
Just like Healtheon they all failed to catch on in a big way, much less “fix health care.” Castlight, a well-funded start-up, is a more recently hyped entry in the field. Another is John Doerr‘s company Essence Healthcare. HealthTap is another one that’s gotten buzz.
Though people keep trying, the track record of trying to “solve” health care the Silicon Valley way is fairly uninspiring.
That’s why I cringed this week when I saw another company–and another reporter–fall into the “if we Webify health care we can fix it” trap. The Times profiled ZocDoc, a New York start-up that has raised over $90 million from big names like Amazon’s Jeff Bezos. It’s business is actually an interesting one. It’s like OpenTable, but instead of helping you get a restaurant reservation, you use it to get an appointment with a doctor.
But here’s the money quote from the article that made me shake my head:
“We’re one of the companies that can help fix the health care system,” said Dr. Kharraz, a physician and ZocDoc’s chief operating officer. “We’re making doctors more efficient and helping patients find the hidden supply of health care.”
Uh oh. Why go there?
ZocDoc has a cool service, is signing up doctors, and will hopefully make some money for its investors. But why does it also have to “fix the health care system?”
There are lots of interesting debates about whether our health system is broken, if so why, and how to make it higher quality, lower cost, less wasteful, and so on. But I promise you that nobody having these debates has pinpointed the inability to get a doctor’s appointment as part of the problem.
So why do start-ups fall into this trap of promising to fix health care? I have a couple theories.
The Apple Effect There’s an unofficial requirement that tech companies can’t just build a great product. They also have to make the world a better place. Remember how Steve Jobs recruited John Sculley from Pepsi by asking if he wanted to spend his life “selling sugared water? Or did he want to come with me and change the world?” The punch line, of course, is that Apple has changed the world. But that kind swagger has also raised the bar. Every other tech company must act like it’s doing something more than just engineering a cool product.
Everybody In The Industry Must Be A Reformer When you’re in health care, changing the world means “fixing it.” I’m one of those people who thinks that our country’s health care system works better than any other and that the crisis has been vastly overstated. But I’m in the minority. We wouldn’t have just passed a $1 trillion health reform bill if there weren’t a lot of people who think that we have a big problem that needs fixing. So if you are an entrepreneur it’s tempting not just to “change the world” by making doctors offices run a bit better. You shoot higher. You will fix the world! Apply the same rhetoric to OpenTable and the food business and it sounds kind of silly.
Overzealous Tech Reporters Usually technology reporters, not health care reporters, write these hyped up stories. They need a hook for why the company will be the next Facebook or Google. Health reform is staring right at them. They may get the quote simply by asking over an over again the “fixing health care” question. And for whatever reason, there’s little effort to hold previous companies accountable that had the same ambition.
Health Care Is Analogue Medicine is easy to diss for being a bit of a Luddite field. Doctors don’t use email like other professionals do. The paperwork is out of control. Hospitals are big, messy service businesses. There’s a feeling that any service business can be better with technology.
This diagnosis is true. But the cure is not necessarily so simple as adding a bit of software. (Although that is happening with the widespread implementation of electronic medical records.) What’s harder to grasp is that health care is not just a service. It’s an experience. And while many services can be replicated online, human experiences can not. There’s no real electronic replacement for being seen by your doctor. When you take a pill you can’t do it over the Internet. You obviously can’t get virtual surgery.
So it’s true that you can point a finger at health care and say it lacks tech. But it’s not because the technology doesn’t exist. It may be that technology doesn’t really fit. To make a comparison to another “experience sector” as opposed to a service sector: The Web also can’t replace a vacation. It can enhance it, perhaps. But it’s a human experience existing in three-dimensional space.
Going After Bricks & Mortar One reason why so many of these health-tech start-ups have come and gone is that they look at a big hospital, or a doctor’s office, the same way Amazon.com once looked at Barnes & Noble. Make the industry faster, chaper, more transparent and disaggregate the market–and you’ll win. (I’m in favor of all those things, by the way.) But in health care it hasn’t been an easy road. Just ask Google, which had to shut down its Google Health product last year after nobody found much utility in storing their health information online. Microsoft HealthVault may be next.
If I were working at one of these health start-ups I’d be careful not to over-hype what I’m doing. (And not just because I’m a superstitious jinx-minded guy.) I think health care needs more entrepreneurs. But a team of engineers coding all night, no matter how smart they are, how well they’re funded, how much publicity they get from the tech press, or how high their ambitions–is not going to “fix” health care anytime soon.
Matthew Holt, who hosts the Health 2.0 conference and has followed the health start-up world more comprehensively and for much longer than I have, makes a similar point in an article he wrote this week on The Health Care Blog. He was taken aback recently by the hype surrounding a start-up called CareZone. It appears to be a private Facebook for people taking care of sick loved ones to store information. It also has a certain hubris and a big-name founder from the software industry. It might turn out to be great. But as Holt writes convincingly: don’t act like this kind of thing hasn’t been tried before.
Follow @WhelanHealth on Twitter
Monday, February 6, 2012
Some Say New York City Health Ads Should Inspire, Not Scare
The ads are the latest installment in a campaign by the Bloomberg administration to jolt New Yorkers out of bad health habits; other ads, which have run in the transit system and on local broadcast outlets and the Internet, have depicted smokers who lost fingertips or their ability to speak normally. The city’s approach — in one recent ad it sharpened its message by editing off a model’s leg — has drawn some criticism for its negativity. But it is not the health department’s first brush with controversy: In 2009, it ran an ad that suggested drinking a can of soda a day could add 10 pounds of fat a year. Internal e-mails exposed dissent about that claim among officials of the department. On a lighter note, the department has been running an ad that claims a person would have to walk the three miles from Union Square in Manhattan to Brooklyn to burn off the calories in a 20-ounce soda. The department explained its approach on Sunday in a statement: “When science tells us that smoking does not cause lung cancer or that obesity is not driving an epidemic of Type 2 diabetes, we will stop depicting those facts in ads. Until then we are going to accurately convey the facts in our advertising — advertising that has helped to successfully reduce smoking in New York City to a historic low of 14 percent, saving thousands of lives.” The ads are far from the first to try to frighten people away from risky behavior. Startling and disgusting imagery has been a staple of prevention ads for decades, even before an egg sizzling in a frying pan represented “your brain on drugs.” That ad, which had its debut in 1987 and has been copied and parodied ever since, was a vivid counterpoint to the “Just say no” campaign led by Nancy Reagan, the first lady. It was an experiment that sparked a variety of arresting messages, said Steve Pasierb, president of the Partnership at Drugfree.org, then known as the Partnership for a Drug-Free America. Still, Mr. Pasierb said, scare tactics do not always have the desired effect. As an example, he cited efforts to reduce cigarette smoking among teenagers by running ads that depicted diseased lungs and other potential long-term effects. Focus groups and other studies of effectiveness showed that teenagers were undeterred and continued to take up smoking, he said. “Folks tell us all the time: ‘You need to tell kids that doing drugs is going to kill them,’ ” Mr. Pasierb said. But because “14-year-olds think they’re bulletproof,” he said, scare tactics like that rarely work. “The definition of a scare tactic is a non-credible risk message,” Mr. Pasierb said. Beth Anne Sacks, a Manhattan actress and singer who posed for one of the ads the city health department started running last month, said she herself was not scared by the ads, especially the one showing her trudging up the stairs of a subway station. Despite having been paid $300 for her appearance, Ms. Sacks said the ads would not be effective with obese people like her and suggested that the health department instead try to inspire overweight people to eat fresh fruit and vegetables and get more exercise. In Miami and some other cities, local health departments are doing just that: In a campaign called Make Healthy Happen, residents of South Florida are being encouraged to walk more and to make wiser choices at vending machines. “We wanted to be more positive with how we dealt with it,” said Ann-Karen Weller, who is overseeing the campaign, which was financed by a $14.7 million grant of federal stimulus money in 2010. Ms. Weller said the department would not know how effective the campaign had been until its results were measured later this year. In Grand Rapids, Mich., a three-year campaign called Project Fit wrapped up at the end of December. Dr. Hye-Jin Paek, who researches health-related communications, said the positive message used there was less likely to have the unintended consequences of victimizing obese people. Dr. Paek, who recently left the faculty of Michigan State University to return to South Korea, said her research on anti-smoking ads concluded that “fear appeals could work, but most of the time could backfire.” She said “a wealth of literature” showed that appealing to people’s fears was not effective in reducing tobacco or marijuana smoking. It may be more useful in preventing the use of highly addictive substances like methamphetamine, she said. Mr. Pasierb cited shocking ads aimed at cutting methamphetamine use in Montana as the sort of scare tactic that may sometimes be necessary. But he cautioned that with cigarette smoking and teenagers, a message of empowerment was significantly more effective. He cited the Truth campaign of the American Legacy Foundation, whose ads depicted young people sounding off to tobacco companies. In one, antismoking campaigners pile 1,200 body bags outside the Manhattan offices of one company to illustrate what they said was the daily death toll from smoking. “You need a multitude of approaches,” Mr. Pasierb said. “No one ad is right for all people.”
Monday, December 26, 2011
Very Low Calorie <b>Diets</b> � What You Should Know About Them <b>...</b>
Simply because our career requires, getting into the medical industry as an ultrasound tech, we’re showed back in ultrasound technician schools this kind of knowledge in relation to clinical and healthcare needs. And a single way of getting an improved general health is always to prepare a healthy diet and sticking to it. Though I can use my ultrasound tech salary with everything I’d like, it simply brings more inches to my waistline since I can easily just swipe or buy junk foods, doing market and doing a lot more food trip. It only makes sense that a diet where you eat very little calories would be the answer to weight loss, but it is a good idea to do a little research before you begin. When choosing one of these diets, you should be cautious and if possible have a doctor monitor your progress; they may not be a healthy weight loss option. In this piece, we intend on pointing out the helpful and the harmful aspects of intensive weight loss diets. Having a truly good ultrasound technician salary can provide me various things, it can certainly cause me to feel happier or very successful on the other hand, it also can cause me to feel even get plump and even fatter. This may cause me think that I ought to start eating balanced and healthy diet to be able to reduce risk of obesity and other possibly detrimental factors in our health. Furthermore, one of many standards for being an ultrasound technician so you might be able to be productive is that you need to be healthy and stay healthy.
Very low calorie diets are deemed to be unhealthy by some experts, but there’s another opinion out there and some people reckon they’re the key to a long life. One theory, that’s got research based primarily on animals, says that by drastically cutting your intake of calories you can help disease prevention and make the process of aging slower. Because they believe that they will live longer, people who believe this view will go on a very low calorie diet regardless of whether they’re overweight or not. There’s even an organization dedicated to this practice, the Calorie Restriction Society. This theory hasn’t been either proven or disproved with humans, but it’s certainly something that could be studied further. A diet plan, by the name of Medifast, is rather well known and it has helped a lot of people lose weight. To ensure that the users of this program don’t go over the calorie restrictions put in place, they are supplied with meal replacement products. Variety is given to you in the form of lean meats, eggs, vegetables and even desserts like puddings, even though you have to eat the meals given by Medifast whilst you’re on the diet. With the Medifast diet you can consume between 800 and 1000 calories every day, which is slightly over the typical very low calorie diet calorie intake, so technically it’s not a strict very low calorie diet. One advantage Medifast has over doing things yourself is that you will not be deficient in any crucial vitamins, minerals and nutrients as they’re all calculated beforehand.
When it comes to very low calorie diets there are drawbacks for your overall health. You will lose muscle as well as fat because you are restricting calories which can be unhealthy for a few reasons. With this diet for woman there is a risk of osteoporosis because of the lack of dairy and other calcium sources. Of course, working out with weights or other resistance training can help to maintain muscle mass, but very often people who are on very low calorie diets lack energy. Anemia is another risk to be aware of. So, while a very low calorie diet may be appropriate if you’re obese or your excess weight presents a serious health risk, it may not be the best idea for the average person.
The long term benefits of a very low calorie diet can be questionable, however they’re useful for short term weight loss. Such diets may be suitable for obese people under the supervision of a doctor. However for other people it’s important that they get the right amount of nutrients for their body. After all, you don’t just want to lose weight, you want to stay healthy too.
Thursday, December 22, 2011
Should you Drink Caffeine Free Green Tea
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