A blog covering the health/care ecosystem and people.

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

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

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

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

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

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

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

“We knew millions of people weren’t getting the care they needed — they were either too embarrassed to seek help or felt stuck in a system that was confusing and intimidating. Digital health has the potential to radically change the way people approach their wellness and, since launching in 2017, we’ve outpaced even our own expectations, delivering more than 1 million Hims & Hers products to our customers. In collaboration with highly-qualified doctors and healthcare providers, we’ve built a digital health platform that is changing the way people talk about and receive the care they need.” That’s  a verbatim paragraph

        Here’s the latest arithmetic on American workers’ financial trade-off of wages for health care insurance coverage: in the ten years since 2009, family premiums have risen 54% and workers’ contribution to health care spending grew 71%. Wages? They rose 26%, and general price inflation by 20%, according to the Kaiser Family Foundation survey on employer-sponsored benefits for 2019 released yesterday. Survey details for this 21st annual encyclopedia on employer-sponsored health care are published in Health Affairs October 2019 issue in a paper titled, Health Benefits in 2019: Premiums Inch Higher, Employers Respond to Federal Policy. Because this

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

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

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

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

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

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

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

Today, I am speaking with marketing leaders who are members of CHPA, the Consumer Healthcare Products Association on this very topic. This is CHPA’s 2019 Marketing Conference being held at the lovely historic Hotel du Pont in Wilmington, DE. The gist of my remarks will be to focus on the evolving retail health ecosystem, with my HealthConsuming lens on health/care, everywhere. And timing is everything, because today is International Self-Care Day to promote peoples’ health engagement. The plotline begins with a tale of two companies — CVS/health and Best Buy — discussing these two organizations’ approach to acquiring companies to expand

Today is July 15, and my email in-box is flooded with all flavors of Amazon Prime’d stories in newsletters and product info from ecommerce sites — even those outside of Amazon from beauty retailers, electronics channels, and grocery stores. So I ask on what will probably be among the top ecommerce revenue generating days of all time: “What could health care look like when Amazon Prime’d?” I ask and answer this in my book, HealthConsuming, as chapter 3. For context, this chapter follows two that explain how patients in the U.S. have been morphing into health consumers based on how health

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

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

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

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

Food insecurity ranks high on Americans’ greatest social health risks. In local communities, grocery stores are playing key roles in bolstering neighborhood wellness. Publix and other food chains, collaborating with the Produce for Kids program, are walking the talk on nutrition for local health citizens. Produce for Kids is associated with Feeding America, which works with local food banks and non-profits to help channel healthy food to children and families. Feeding America is a national network of over 200 food banks fighting hunger in America, serving over 46 million people and 60,000 food pantries, and advocating for legislation that addresses

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

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

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

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

There’s no denying the growth of telehealth, virtual visits, remote health monitoring and mHealth apps in the healthcare landscape. But these growing technologies don’t replace the role of real estate in health, wellness and medical care. Health care is a growing force in retail real estate, according to the ICSC, the acronym for the International Council of Shopping Centers, which has been spending time analyzing, in their words, “what landlords should know in eyeing tenants from a $3.5 trillion industry.” Beyond the obvious retail clinic segment, the ICSC points out a key driving growth lever for its stakeholders, recognizing that,

As patients now assume the role of health consumer, they rationally expect retail-level experiences with greater first-dollar payment for health insurance, health care services and medical products like prescription drugs. Consumers know what good retail looks and feels like, and are focusing that experiential lens on health care, Aflac found when their Workforces Survey polled Americans on their desirable health insurance shopping experience. One in two people said it should feel, “like Amazon,” and another 20% of folks said, “like retail.” Chapter 3 of HealthConsuming is titled, “How Amazon Has Primed Health Consumers,” and explains this re-shaping of patient expectations.

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

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

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

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

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

The vision/optical industry is one piece of the health/care ecosystem, but the segment has not been as directly impacted by patients’ new consumer muscles until just about now. It feels like the vision industry is at an inflection point at this moment, I intuited during yesterday’s convening of Decoding the Consumer: The new science of customer behavior, the theme of the 13th annual global leadership summit hosted by Vision Monday, a program of Jobson Medical Information which is part of the WebMD family. I was grateful to have an opportunity to share my views with attendees on the vision patient as

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

“The Fourth Industrial Age,” Dr. Abraham Verghese writes, “has great potential to help, but also to harm, to exaggerate the profound gap that already exists between those who have much and those who have less each passing year.” Dr. Verghese asserts this in his forward to Deep Medicine, Dr. Eric Topol’s latest work which explores the promise of artificial intelligence (AI), Big Data, and robotics — three legs of the Fourth Industrial Age stool. [If you don’t know the work of Dr. Verghese, and since you’re reading the Health Populi blog, you must get to know Dr. V now. Your

CVS + Aetna have merged to evolve a new business model for health and medical care. Walgreen’s continues to add new services beyond the core pharmacy business, and Walmart is expanding telehealth and healthier food aisles in the grocery. More grocery stores  added dietitians to their operations in 2018, as well. As people take on more self-care for health care, they are looking to access products and services in retail bricks-and-mortar and ecommerce channels in the same places they buy food and other products. ACSI’s latest customer satisfaction benchmark study into retailers provides insights into the trusted channels for retail health

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

Ten years ago, two brothers, physicians both, started up a telemedicine company called American Well. They launched their service first in Hawaii, where long distances and remote island living challenged the supply and demand sides of health care providers and patients alike. A decade later, I sat down for a “what’s new?” chat with Roy Schoenberg, American Well President and CEO. In full  transparency,  I enjoy and appreciate the opportunity to meet with Roy (or very occasionally Ido, the co-founding brother-other-half) every year at HIMSS and sometimes at CES. In our face-to-face brainstorm this week, we covered a wide range

Talk to me, patients are demanding in unison. Most health consumers expect providers to communicate about routine health care and prevention; this is especially true among those patients trying to manage chronic conditions we learn from 10 Ways to Fulfill Patients’ Communication Wish List, a report based on a consumer survey from West, the communications and network infrastructure company. Four in five patients say that talking to “me” means they want personalized recommendations to their unique needs – but only one-third of patients say they’re getting that level of service from their healthcare providers. Most health consumers expect providers to communicate about

Most consumers would be willing to try an FDA-approved app or online to treat a medical condition, as well as receiving hospital care at home if would be less costly. We’ve reached an inflection point on the demand side among consumers for digital health options, PwC suggests in their report on the New Health Economy coming of age. The report outlines health/care industry issues for 2019, with a strong focus on digital health. Whether a menu of care options including virtual health to access specialists across the U.S., post-hospital virtual visits, or hospital care at-home, a majority of Americans supports

Most Americans like the idea of universal health care as a guaranteed right, Kaiser Family Foundation learned in this month’s Health Tracking Poll. This finding reinforces the voter turnout for the 2018 mid-term elections which was largely driven by peoples’ concerns for losing health access for pre-existing conditions. The first chart notes important nuances under the majority support for a national health plan which, in this case, asked whether people favored a plan “sometimes called ‘Medicare for all.'” I note that note all national health plan designs would need to be tied to Medicare. There are many ways to deliver

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

According to the Cambridge Dictionary, a “caveat” is, “a warning to consider something before doing anything more.” It is fitting that CES is held in Las Vegas, land of high risk and, with a lot of luck, reward. With that theme in mind, I depart LAS airport tonight on an aptly-named red-eye flight back home after spending an entire week here. I’m pondering not what I saw — some of which I covered daily over the past week — but what I didn’t see. Consider these the caveats for health/care at #CES2019. In no particular order… Where was the Chairman of

Self-care is the new health care as patients, now consumers at greater financial risk for medical spending, are learning. At #CES2019, I’m on the lookout for digital technologies that can help people adopt and sustain healthy behaviors that can help consumers save money on medical care and enhance quality of life-years. This week’s heart-and-food tech announcements at #CES2019 coincide with an FDA recall on a popular drug prescribed to treat hypertension (high blood pressure). Using food and tech as medicine can help people avoid going on medications like statins and others for heart health. An important example of this self-care

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

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

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