A blog covering the health/care ecosystem and people.

Our homes should nurture our health. In addition to nutrition and good food, positive relationships, clean air and water, and the basic needs that bolster whole health, technology is playing a growing role to help us manage health at home. At CES 2019, I spent time with Roy Jakobs, Chief Business Leader of Personal Health with Philips, to discuss the company’s evolving portfolio of products that help fulfill the mission to support people across their own continuum of health. Following CES, I wanted to further dive into one part of the portfolio very important to family health at home: the

For the past two holiday shopping seasons in 2017 and 2018, I’d noticed pre-print ads in my local Sunday newspaper from Kohl’s, the value-priced retailer, featuring wearable technology for health. There were devices branded Fitbit on the front page of Black Friday’s 2018 ad, shown here, with other tech brands promoted inside the pages. These ads were bundled in my newspaper along with ones from Best Buy, Target, Walmart, and other retailers featuring the same or similar wearable health-tech. This week, Kohl’s announced a collaboration with WW, the newly-rebranded Weight Watchers, for the retailer to bring a WW “salon” space

Fewer than one-half of consumers trust in government and media. Three-quarters trust employers, who in 2019 are the top-trusted institution according to the 2019 Edelman Trust Barometer released last week in Davos at the World Economic Forum. Consumers in the U.S. over-index for trust in employers, with 80% of people saying they have a strong relationship with “my employer,” compared with 73% of Britons, 66% of the French, and 59% of people in Japan. What’s underneath this is employers being trusted to provide certainty: most workers look to their employer to be a trustworthy source of information about social issues and

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

Have you heard the story about a boy born in Yorkshire, England, who studies art in Birmingham, finds his way to Finland to work with design maestro Alvar Aalto, and then crafts a printer that Steve Jobs loved? I have, at CES 2019, when I sat down with Sean Carney, Chief Designer at Philips. It’s well-known that Philips has been firmly focused on health and health care, covering both clinical/professional healthcare as well as personal health for self-care. What you may not know is that underpinning the company’s innovations is a major commitment to all aspects of design. Design is embedded

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

All health/care is retail now in America. I say this as most people in the U.S. who have health insurance must take on a deductible of some amount, which compels that insured individual to spend the first dollar on medical services up until they meet their financial commitment. At that point, health insurance kicks in, and then the insured may have to spend additional funds on co-payments for general medicines and services, and coinsurance for specialty drugs like injectables and high-cost new therapies. The patient is a consumer is a payor, I asserted today during my talk on the expanding

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

If I’m going to spend a week someplace, it usually has to be Italy. So next week in Las Vegas, I’ll deal with that bias by staying at the Venetian Hotel for the entire week to cover all-things-health at CES 2019, the annual convening of electronics retailers and enthusiasts. Most of the 180,000+ folks come to Vegas from over 150 countries to kick the proverbial tires on TVs, autos, games, virtual reality, 3-D printing, drones, and other shiny new things. For me, for the past eight years, CES means consumer-facing health in a person’s hands, on her phone, and increasingly

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

As the CVS + Aetna merger crosses its last regulatory hurdle at the close of 2018, we enter 2019 facing a fast-growing and -morphing retail health landscape. I brainstormed retail health yesterday with Patrick Freuler, CEO of Audicus (developer of hearing aids sold direct-to-consumer over-the-counter) and Shai Gozani, CEO of NeuroMetrix, maker of the Quell device for pain management. The three of us will be on a panel addressing retail health disruption at CES 2019 on 9th January 2019 at the Digital Health Summit. I explained to Shai what I’m going to say in my talk about retail health at

Most people in the U.S. believe that the Federal government should ensure that their fellow Americans, a new Gallup Poll found. This sentiment has been relatively stable since 2000 except for two big outlying years: a spike of 69% in 2006, and a low-point in 2003 of 42%. In 2006, Medicare Part D launched, which may have boosted consumers’ faith in Federal healthcare programs. In contrast, in 2013 the Affordable Care Act was in implementation and consumer-adoption mode, accompanied by aggressive anti-“Obamacare” campaigns in mass media. That’s the top lighter green line in the first chart. But while there’s majority support

Most American families with children at home are concerned about paying bills on a monthly basis. One in two people have had at least one personal “economic crisis” in the past year, we learn in the American Family Survey 2018, released last week from Deseret News and The Brookings Institution. The project surveyed 3,000 U.S. adults across the general population, fielded online by YouGov. This poll, conducted since 2005, looks at the state of U.S. families through several issue lenses: the state of marriage and family, parents and teenagers, sexual harassment (with 2018 birthing the #MeToo movement), social capital and

From culture to travel, food and drink to retail and beauty, health will be baked into consumer goods and experiences in 2019. Welcome to The Future 100: 2019 from The Innovation Group at JWT. In the 100 emerging trends across ten categories, the future is clearly health-driven, according to the tea-leaf readers at JWT.a Health is all over, Culture Tech and innovation Travel and hospitality Brands and marketing Food and drink Beauty Retail Luxury Health (as a category itself) Lifestyle. I’ve mined this report in previous years – you can review my findings from the 2017 report here in the Health

“Seeing is not believing” when it comes to people seeing health information on social networks. Four in five people seeking healthcare information online in social media are concerned about the accuracy of that information served up. Therefore, most consumers a very satisfied with the healthcare information they receive from nurses, eye doctors, pharmacists, dentists, nurse practitioners, doctors, and dietitians. But social media influencers. patient organizations, online patient forums, and pharmaceutical companies? Not so much. Only one-half of U.S. consumers believe that health-related information on the internet is as reliable as information from medical professionals. Welcome to The Great American Search for

Investor, advisor, operator, podcaster, blogger, speaker, Board member, mentor, mother, wife, volunteer. Take inventory of the many hats of Lisa Suennen, aka the Venture Valkyrie, and you understand why I see her as the Renaissance Woman of Healthcare. Ron Popeil couldn’t incorporate this many features into a contraption – yes, she slices and dices healthcare and technology, places bets on the best of them, and she deploys a whole lot more tools in her Mary Poppins-rich toolbox. Two months ago, Lisa announced she was leaving GE Ventures, where she was Senior Managing Director, to do something new. This week, she

Most patients wish their doctors would have a conversation with them about non-medical issues. The Doctor-Patient Conversation, a survey conducted for the Samueli Foundation by the Harris Poll, examined how patients feel about their health, healthcare, and relationships with physicians. The Samueli Institute, has several missions including integrative health with a focuses on evidence-based practices for healing, wellbeing and resilience. Patients are keen to learn about non-medication alternatives, like food-as-medicine, meditation, and acupuncture. But most doctors base their conversations with patients on purely medical options like lab test results and surgical procedures. The top issues doctors discuss with patients are

As Tip O’Neill’s mantra goes, “All politics is local.” In the U.S. 2018 midterm elections, healthcare voting seems to have translated as a local issue, falling into O’Neill’s axiom. In this election, healthcare was the most important voting issue for consumers, PwC found, ranking above the economy, national security, and education. On this morning after 2018 midterm election results are (mostly) out, it looks like healthcare was a local and state issue for U.S. 2018 midterm voters. The Democrats flipped more than 23 seats in the U.S. House of Representatives to gain control of that chamber. The Senate is up

“Let’s get this thing f-ing done,” Martha McSally passionately asserted on May 4, 2017. Paul Ryan said, on the floor of the U.S. House of Representatives without cursing, “A lot of us have waited seven years to cast this vote.” McSally, who represents Tucson, Arizona, in the U.S. Congress, is running to replace retiring Senator Jeff Flake. McSally was one of the 217 Republicans in the House who voted to repeal the Affordable Care Act, subsequently celebrating a victory in the Rose Garden of the White House with jubilant peers. The final vote was 217-213. Here’s the final roll call

Notwithstanding mass adoption of antivirus protection and firewalls among healthcare providers, there remains a security gap for biomedical technologies, according to a report from Zingbox. This concerning finding was confirmed in recent observations from Gartner, which wrote in a market trends report that, “generally, medical devices are not replaced for at least ten years, with many running old software that has not been updated or patched.” Zingbox learned that most healthcare executives say they’re confident in their ability to protect connected medical devices: 79% of health IT professionals say they have real-time information about which connected devices are vulnerable to

With seven days until voters go to the polls for what some call the most momentous U.S. election in decades, most Americans say that healthcare costs are a major stress, second only to money. So warns the Sixth Annual Nationwide TCHS Consumers Healthcare Survey, with the tagline: “Stressed Out: Americans and Healthcare.” Perhaps this is why healthcare has become a top voting issue for the 2018 mid-term elections that will be held on November 6 one week from today. The first chart illustrates that healthcare costs, the economy, and family responsibilities all closely cluster as sources of stress for a

One in three working-age people in the U.S. have seen a doctor about something stress-related. Stress is a way of American life, based on the findings in The United States of Stress, a survey from Everyday Health. Everyday Health polled 6,700 U.S. adults between 18 and 64 years of age about their perspectives on stress, anxiety, panic, and mental and behavioral health. Among all sources of stress, personal finances rank as the top stressor in the U.S. Over one-half of consumers say financial issues regularly stress them out. Finances, followed by jobs and work issues, worries about the future, and relationships cause

There’s a shortage of medical providers in the United Kingdom, a nation where healthcare is guaranteed to all Britons via the most beloved institution in the nation: The National Health Service. The NHS celebrated its 70th anniversary in July this year. The NHS “supply shortage” is a result of financial cuts to both social care and public health. These have negatively impacted older people and care for people at home in Great Britain. This article in the BMJ published earlier this year called for increasing these investments to ensure further erosion of population and public health outcomes, and to prevent

Today, October 16, is World Food Day. At Health Populi and THINK-Health, we celebrate the birthday of the Food and Agriculture Organization (FAO), allied with the United Nations. FAO was founded to address malnutrition and bolster a sustainable, healthy food supply for people. World Food Day 2018 has four objectives: Don’t waste food Produce more food with fewer resources Advocate for #ZeroHunger by 2030, and, Adopt a healthier, more sustainable diet. All four of these pillars play a role in health, but I’ll focus today on the fourth: the role of food as a major social determinant of health. Hunger

    CVS Health’s acquisition of Aetna was approved this week by U.S. Federal regulators after months of scrutinizing the antitrust-size-market control implications of the deal. I wrote this post on the deal as an inflection point in American healthcare on 3rd December 2017 when CVS and Aetna announced their marriage intentions. This post updates my initial thoughts on the deal, given the morphing US healthcare market on both the traditional health services front and fast-evolving retail health environment. The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal

It’s National Health IT Week in the US, so I’m kicking off the week with this post focused on how digital health can bolster economic development. As the only health economist in the family of the 2018 HIMSS Social Media Ambassadors, this is a voice through which I can uniquely speak. In February 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act (ARRA), less formally known as the Stimulus Bill. This was the legislation best known for addressing and helping to bring the U.S. out of the Great Recession. A lesser-known component of ARRA was Title

Family premiums for health insurance received at the workplace grew 5% in 2018: to $19,616, according to the 2018 KFF Employer Health Benefits Survey released today by the Kaiser Family Foundation (KFF). These two trends combine for a 212% increase in workers’ deductibles in the past decade. This is about eight times the growth of workers’ wages in the U.S. in the same period. Thus, the main takeaway from the study, KFF President and CEO Drew Altman noted, is that rising health care costs absolutely remain a burden for employers — but a bigger problem for workers in America. Given that

Obesity, diabesity, food deserts and food swamps co-exist across America, factors that cost the U.S. economy over $327 billion a year just in the costs of diagnosed diabetes. In addition, America’s overweight and obesity epidemic results in lost worker productivity, mental health and sleep challenges, and lower quality of life for millions of Americans. Food — healthy, accessible, fairly-priced — is a key social determinant of individual health, wellness, and a public’s ability to pursue happiness. There’s a lot the U.S. can learn from the food culture, policy and economy of Italy when it comes to health. This week, I have the

Most physicians feel some level of burnout, hassled by electronic health records and lost autonomy. No wonder, then, that a majority of doctors favor some type single payer health system — one-quarter fully single payer, a la Britain’s National Health Service; and another one-third a single payer combined with a private insurance option, discovered in the 2018 Survey of America’s Physicians report on practice patterns & perspectives, published by The Physicians Foundation. Eight in ten physicians are working at full-capacity or are over-extended, the survey found. Furthermore, 62% of doctors are pessimistic about the future of medicine. Physician burnout is a

The prices of medicines prescribed in outpatient settings rose, on average, 10.3% in 2018. Wages increased about 2.6%, and consumer prices, 1.3%, based on the 2019 Segal Health Plan Cost Trend Survey. Segal forecasts that medical cost trends will moderate for 2019, lower than 2018 rates. But to the patient, now feeling like a consumer dealing with high-deductibles and the growing sticker shock of specialty drug prices, a so-called “moderate” trend still feels like a big bite in the household budget. Specifically, specialty drug trend is expected to be 14.3% in 2019, compared with 17.7% in 2018 — still several

The impact of health and wellness is on most consumers’ minds, Nielsen’s consumer research has found. Sarah Schmansky, Nielsen’s strategy leader for health, wellness and “fresh,” moderated a panel at the GMDC Health-Beauty-Wellness Conference in Orlando today that brainstormed how consumers are shopping for health. Underneath that “how” is more than the next-best-me-too-product for allergy or acne. It’s about efficacy of the product at the core, but bundled with social responsibility and sustainability, informative packaging, transparency of ingredients, and education that empowers the individual. “Self-care is the driver of growth,” Sarah began the discussion. But these needs under the self-care umbrella

In our Amazon-Primed world, the future of retail is not ten years from now; it’s “tomorrow.” So GMDC, the association of retailers and brands who supply them, has formed a program called Retail Tomorrow to turbocharge the supply side with consumers who are already demanding convenience, immediate (or “soon”) gratification, and health where she/he “is.” That’s personalization, and that’s where retail health can and is making a difference in Everyday Peoples’ lives. In our DIY culture, we’re pumping our own petrol, making our own airline and hospitality reservations (from Expedia to Airbnb), trading stocks online, and cooking at home enabled by

The complexity of the U.S. healthcare system erodes Americans’ health literacy, Accenture asserts in their report, The Hidden Cost of Healthcare System Complexity.                             And that complexity costs, Accenture calculated, to the tune of nearly $5 billion in administrative cost burden to payors. Accenture developed a healthcare system literacy index to quantify the relationship between peoples’ understanding of how health insurance works and what a lack of understanding can cost the system. The index looks at consumer comprehension of health insurance terms like premium, deductible, copayment, coinsurance, out-of-pocket

Using digital health tech is a new normal for U.S. consumers, including Seniors, found in the 2018 digital health consumer survey from Deloitte. The title of the report, “Consumers are on board with virtual health options,” summarizes the bullish outlook for telehealth. That’s the consumer-demand side of the equation. But the tagline begs the supply side question: “Can the health care system deliver?” For a decade or longer, we’ve noted the slow uptake of telehealth and digital health tools among healthcare providers. But the consumer pressures, along with evidence-based self-service options for health – both for “care” and for wellness,

Most Americans have been surprised by a medical bill, a NORC AmeriSpeak survey found. Who’s responsible? Nearly all Americans (86% net responsible) first blame health insurance companies, followed by hospitals (82%). Fewer U.S. patients blamed doctors and pharmacies, although a majority of consumers still put responsibility for surprise healthcare bills on them (71% and 64% net). Most of the surprise bills were for charges associated with a physician’s service or lab test. Most surprise charges were not due to the service being excluded from a health plans provider network. The poll was conducted among 1,002 U.S. adults 18 and over

Looking for health information online is just part of being a normal, mainstream health consumer, according to the third Rock Health Digital Health Consumer Adoption Survey published this week. By 2017, 8 in 10 U.S. adults were online health information hunters. Six in 10 Americans looked for reviews of healthcare providers online, another new-normal consumer digital health activity. But only one in four people had used wearable technology for health, and one in five had participated in a live video telemedicine encounter. The Rock Health team observes that “the needle has not moved equally across every type of digital health solution.” Thus the

In the U.S., the growing prevalence of multi-morbidity is contributing to increased mortality and healthcare cost growth in America. Underlying this clinical and economic phenomenon is obesity, which primary care doctors are challenged to deal with as a chronic condition along with typically co-occurring comorbidities of hypertension, diabetes, and hyperlipidemia. The line chart come from a new study into Multimorbidity Trends in United States Adults, 1988-2014, published in the July-August 2018 issue of the Journal of the American Board of Family Medicine. The authors, affiliated with the West Virginia University Department of Family Medicine, call out that obesity (the pink-red line)

With the acquisition of GreatCall, a mature player in the aging-tech space, Best Buy is doubling down on consumer health technology@retail. This week at Best Buy. the electronics retailer,  it’s out with CDs and in with technology for aging at home. The company announced that it would buy GreatCall for $800 million. A snippet from the announcement from Best Buy’s press release is shown in the first diagram, noting that GreatCall’s membership is approaching 1 million subscribers who use mobile phones and connected devices, “providing peace of mind to their loved ones.” Beyond the obvious “falling and I can’t get

Today’s financial news reports and the bullish stock market generate headlines saying that the U.S. economy is riding high. President Trump forecasted in late July, “we are now on track to hit an average GDP annual growth of over 3% and it could be substantially over 3%,” Trump said. “Each point, by the way, means approximately $3 trillion and 10 million jobs. Think of that.” Indeed, unemployment is at its lowest rate in decades at 4%. Today, NASDAQ reported that, “the U.S. economy stays strong as the Fed holds steady.” For mainstream working people, though, even with a job in a high employment

Most Americans are healthcare cost-conscious, concerned about various kinds of healthcare expenses, data from McKinsey’s research has found presented in Healthcare consumerism 2018: An update on the  journey. McKinsey’s consumer research identified four themes: affordability as a pressing consumer concern; lack of continuity of care for many consumers; growing demand for digital convenience and access; and, greater willingness to partake in health care programs that lower costs, if made available. Personal and household concerns about healthcare costs is top-of-mind for U.S. consumers, as I’ve pointed out in previous studies such as Kaiser Family Foundation’s look at top “pocketbook issues,” here on

All sectors who are stakeholders in the healthcare ecosystem aren’t created equal, Accenture explains in their report, Healthcare’s future winners and losers. Observing the influx of new flavors of entrants like Amazon and Google, start-ups like Iora Health, Oscar and FetchMD, begs the question: how will legacy healthcare system players fare? Who will survive, and what will be the success factors that bolster long-term viability? To answer that question, Accenture points to three market trends that set “new rules” in healthcare: Blurred lines, which are the grey areas and adjacencies between technology, service, finance, and retail The middle of nowhere,

There are health facts that are based on rigorous scientific evidence. And, there are people who, for a variety of reasons, make irrational healthcare decisions without regard to those health facts. An important new report discusses the all-too-human aspects of people-as-patients, who often make health decisions based more on emotions than on the cold, hard truths that could save their lives and protect the well-being of loved ones. Preventative care and behavioural science: The emotional drivers of healthcare decisions is that report, sponsored by Pfizer Vaccines and written by the Economist Intelligence Unit (EIU). The report analyzes the psychological factors that shape consumers’ health

While Amazon and Google get lots of positive PR and media attention as major healthcare industry disruptors, don’t forget about two big “W’s,” Walgreens and Walmart, in the healthcare innovator mix. I recently read The Four in which Scott Galloway explains the dominance of Amazon, Apple, Google and Facebook in consumers’ everyday lives. These four tech-behemoths each have their particular designs on healthcare innovation, or disruption in the eyes of, say, Epic and Cerner working on health IT systems, or GE and IBM if you’ve been pioneers in health data or big-iron information technology. Then in the past week, the

President Trump and his administrative have been trying to make the ACA fail, claim most U.S. adults. Thus, the public holds the POTUS and the Republican party responsible for moving the Affordable Care Act forward….or not, according to the July 2018 Kaiser Health Tracking Poll conducted by the Kaiser Family Foundation (KFF). Health care will be a key issue in the 2018 mid-term elections that will be held in November. Among U.S. voters’ key health care concerns in 2018, one ranks “most” or “very important” for two-thirds of Americans: that is continuing to protect people with pre-existing health conditions. Other issues

  Consumers are more bullish demanding virtual and digital health tools from their physicians than doctors are in providing it, based on the research findings in What can health systems do to encourage physicians to embrace virtual care? from Deloitte. One-third of physicians have concerns about using virtual care services, such as medical errors that may result, access to technology, and data security.               One in two U.S. consumers are now tracking health via digital tools, and one-half of these share the data generated by their apps. That sharing is limited by doctors’ ability to

It will cost about $275,000 for a couple retiring in the U.S. this year to cover their healthcare costs for the rest of their life in retirement, Fidelity estimated. But Americans are notoriously pretty undisciplined about saving money, compared with peers living in other developed countries. How to address this challenge? Show people what improving their personal health can do to boost their 401(k) plans. This tactic is discussed in Health & Retirement Savings: Leveraging Healthcare Costs to Drive 401(k) Contributions & Improve Health, from HealthyCapital, a joint venture of Mercy health systems and HealthView Services.   The chart illustrates three

In this moment post-Cambridge Analytica/Facebook, the launch of the GDPR, and the everyday-ness of data breaches, consumers most trust doctors for sharing personal information. I’ve mined, through my health economic lens, the U.S. data published in the insightful report, Data Privacy: What the Consumer Really Thinks, a global research study from Axciom and the Data & Marketing Association (recently acquired by the Association of National Advertisers) working with Foresight Factory. The report compares consumers’ personal views on privacy and trust in ten countries: Argentina, Australia, Canada, France, Germany, the Netherlands, Singapore, Spain, the UK, and the US. We learn that Americans