A blog covering the health/care ecosystem and people.

Today marks eight days before #Election2024 in the U.S. While many political pundits assert that “health care is not on the ballot,” I contend it is on voters’ minds in many ways — related to the economy (the top issue in America), social equity, and even immigration (in terms of the health care workforce). In today’s Health Populi blog, I’m digging into  Access Denied: patients speak out on insurance barriers and the need for policy change, a study conducted by Ipsos on behalf of PhRMA, the Pharmaceutical Research and Manufacturers of America — the pharma industry’s advocacy organization (i.e., lobby

Let’s put “health” back into the U.S. health care system. That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). (FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).         NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. While the digital health stakeholder community is convening this week at VIVE in Los Angeles to share innovations in health tech, NABIP

The cost of living ranks top in U.S. voters’ minds among many issues Americans are feeling and following in late 2023. A close second in line is affordability of health care, as consumers’ household budgets must make room for paying medical bills — with prescription drug costs also very important as a discussion topic for 2024 Presidential candidates, we learn from the latest KFF Health Tracking Poll published 1 December. The monthly study focused on U.S. voters’ top issues and perspectives on the health system and care approaching the new year of 2024. KFF fielded the study among 1,301 U.S.

The best U.S. states to live in for health and health care are Hawaii, Massachusetts, Connecticut, Washington, Vermont, Rhode Island, and Maryland…             Those are the top health system rankings in the new 2022 Scorecard on State Health System Performance annual report from the Commonwealth Fund. If you live in Mississippi, Oklahoma, West Virginia, Texas, Missouri, Alabama, Georgia, or Arkansas, your health care and outcomes are less likely to be top-notch, the Fund’s research concluded.                 The Commonwealth Fund has conducted this study since 2006, assessing a range

In the U.S., patients have assumed the role of health care payors with growing co-payments, coinsurance amounts, and deductibles pushing peoples’ out-of-pocket costs up. This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. That hypothesis has not been well proven-out: even though more health care “sellers” on the supply side have begun to post price information for services, patients still haven’t donned

One in two people in the U.S. with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Gallup and West Health presented their study in a webinar earlier this week; in today’s post, I feature a few key data points that particularly resonate as I celebrate/appreciate yesterday’s U.S. Supreme Court’s ruling on the Affordable Care Act (i.e., California v. Texas) combined with a new study published in JAMA Network Open, discussed below the digital fold in

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

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

President Biden’s first few days on the job gave us a very clear view on how he sees conquering COVID: through a whole-of-government approach to public policies that bolster directly addressing the virus, along with the many forces shaping how we got here and how to come out of the pandemic era stronger. I cover this first wave of Biden health policy in my latest post for the Medecision Liberation blog titled, “Top Priorities for President Biden: COVID-19, Then Everything Else.” The plotline goes… On the day of inauguration, January 20, 2021, Joseph R. Biden was installed as the 46th

In the 2018 mid-term elections, U.S. voters were driven to polls with health care on their minds. The key issues for health care voters were costs (for care and prescription drugs) and access (read: protecting pre-existing conditions and expanding Medicaid). Issue #2 for 2018 voters was the economy. In 2020, as voting commences in-person tomorrow on 3rd November, U.S. voters have lives and livelihoods on their minds. It’s the pandemic – our physical lives looming largest in the polls – coupled with our fiscal and financial lives. Health is translating across all definitions for U.S. voters in November 2020: for

For a worker in the U.S. who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. The first chart illustrates the growth of the premium shares split by employer and employee contributions. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. The worker’s contribution share was 29% in 2010, and 26% in 2020. Single coverage reached $7,470 in 2020 and was $5,049 in 2010. Roughly the same proportion of companies offered health benefits to

I have always appreciated Medecision’s mission as expressed in the company’s tagline: “Liberating,” as in “liberate healthcare.” I began collaborating with Medecision as a client several years ago, a couple of years after I heard Todd Park, then Chief Technology Officer in the White House, joyfully assert the phrase, “Data Liberación!” at an early Health 2.0 Conference. Medecision published my blog about health citizenship this week on the company’s Liberate.Health site. The emergence of health citizens in the U.S. — people re-claiming their health, health care, and control of data — is part of liberating health in America. Please check

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

Seven in 10 Americans are concerned about the coronavirus outbreak’s impact on the economy, and 6 in 10 people worried about someone they love getting sick from COVID-19. But most Americans also get the politicized nature of the coronavirus and say they’re less likely to vote for President Trump in November based on his handling of the public health threat, according to a just-released survey from Protect Our Care fielded by Public Policy Polling. Some of the data points which demonstrate that Americans are taking the emerging coronavirus pandemic quite seriously are that: 53% disagree that President Trump and his

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

Health care continues to be the top-ranked voting issue in the U.S. looking to the November 2020 Presidential and Congressional elections. The Kaiser Family Foundation conducts the monthly poll which gauges U.S. adults’ perspectives on health care, and this month’s January 2020 Kaiser Health Tracking Poll explores Americans’ views on broad healthcare reform plans and specific medical policy issues. Overall, Americans point to prescription drug costs and the preservation of the Affordable Care Act’s protections for people with pre-existing conditions, the first chart tells us. Third and fourth on voters’ minds are protecting patients from surprise medical bills and better

Several new studies reveal that more patients are feeling and living out their role as health care payors as medical spending vies with other household line items. This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. In research from HealthPocket, 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. One in four people in the

ABBA sang the song “Money Money Money” back in 1976. The lyrics feel, sadly, spot-on when thinking about health care costs, job-lock and Americans’ home economics in 2019. “Work all night, I work all day, to pay the bills I have to pay Ain’t it sad And still there never seems to be a single penny left for me That’s too bad… Money, money, money must be funny In the rich man’s world.” That year, ’76, wasn’t just the U.S. bicentennial — it was a year when the U.S. allocated 8.6% of the nation’s Gross Domestic Product for health care.

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).

Today is the bridge day between The Battle of the Democratic Primary Candidates Debate #2 Part 1 and tonight, Part 2. So it’s a good time to take stock of U.S. voters’ views on health care, through the lens of the Kaiser Family Foundation’s Health Tracking Poll for July 2019 published yesterday. Health care is the top issue Democrats want to hear about in the debates, well ahead of climate change, women’s issues, immigration and gun policy. Let’s start with an overall context statistic from this poll: that is that 86% of insured U.S. adults like their health insurance plan

“The Dow Jones Industrial Average was on the brink of claiming a thousand-point milestone for the first time since January 2018, ending the longest period without crossing such a psychologically significant level since the blue-chip benchmark crossed the 19,000 threshold three weeks after Donald Trump was elected president in November 2016,” Mark DeCambre of MarketWatch wrote yesterday morning. He noted that President Trump, “tweeted a simple call-out to the intraday record: ‘Dow just hit 27,000 for first time EVER!'” clipped here from Twitter. Indeed, the U.S. macro-economy has nearly full employment and the stock market hit a high mark this

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

The last chapter (8) of HealthConsuming considers whether Americans can become “health citizens.” “Citizens” in this sense goes back to the Ancient Greeks: I return to Hippocrates, whose name is, of course, the root of The Hippocratic Oath that physicians take. Greece was the birthplace of Democracy with a capital “D.” Hippocrates’ book The Corpus is thought to be one of the first medical textbooks. The text covered social, physical, and nutritional influences, and the concept of “place” for health and well-being. Here, the discussion detailed the roles of air and water for health. The Hippocratic texts also coached doctors to

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

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

…because it does. “Citizens scare politicians,” I heard Governor John Kasich say to Nicole Wallace on her show Deadline: White House yesterday, just hours from today’s U.S. 2018 midterm elections. Governor Kasich has led the Buckeye State since 2011, and his second and final term ends in January 2019. The Governor expanded Medicaid under the Affordable Care Act in the State of Ohio, discussed in this insightful Washington Post article. “I am my brothers’ and sisters’ keeper,” Kasich told Wallace. The Governor asserted this in the context of the role of protecting his fellow citizens for health and well-being, for

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

Pre-existing conditions impact Americans north, south, east and west, the Kaiser Family Foundation maps. But those maladies aren’t evenly distributed across the U.S.: the highest incidences of people with pre-existing conditions are generally dotted in the eastern half of the U.S., in diverse metropolitan areas. This study looks at non-elderly adults, people between 18 and 64 years of age. That is, working-age U.S. adults who would be prospects for private health insurance coverage, whether through employers or on the individual insurance market. A striking aspect of this map is that one metro that has a higher rate of people with

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

There are countless chasms in the U.S. this moment in social, political, and economic perspectives. but one issue is on the mind of most American voters where there is evidence of some agreements: health care, as evidenced in the June 2018 Health Tracking Poll from Kaiser Family Foundation. Top-line, health care is one of the most important issues that voters want addressed in the 2018 mid-term elections, tied with the economy. Immigration, gun policy, and foreign policy follow. While health care is most important to voters registered as Democrats, Republicans rank it very important. Among various specific health care factors, protecting

It’s a fairly even split between voting first on gun policy, jobs, or healthcare for the 2018 mid-term elections, ac cording to the May 2018 Kaiser Family Foundation Health Tracking Poll. Arguably, gun policy can cut in two ways: in light of the Stoneman Douglas High School shootings and wake-up call for #NeverAgain among both students and the public-at-large, vis-a-vis Second Amendment issue voters. And, as a growing public health issue, “guns” could also be adjacent to health. “If it isn’t a health problem, then why are all these people dying from it?” rhetorically asked Dr. Garen Wintemute, professor of emergency

Two weeks in a row, The Economist, the news magazine headquartered in London, included two special reports stapled into the middle of the magazines. Universal health care was covered in a section on 28 April 2018, and coverage on financial inclusion was bundled into the 5th May edition. While The Economist’s editors may not have intended for these two reports to reinforce each other, my lens on health and healthcare immediately, and appreciatively, connected the dots between healthcare coverage and financial wellness. The Economist, not known for left-leaning political tendencies whatsoever, lays its bias down on the cover of the section here: universal healthcare

Healthcare — availability and affordability — is a more intense worry for Americans in March 2018 than crime and violence, Federal spending, guns, drug use, and hunger and homelessness. The Gallup Poll, fielded in the first week of March 2018, found that peoples’ overall economic and employment concerns are on the decline since 2010, at the height of the Great Recession which began in 2008. While 70% of Americans were worried about economic matters in 2010, only 34% of people in the U.S. were worried about the economy, and 23% about unemployment, in March 2018. Gallup has asked this “worry”

Over four in 10 U.S. workers were enrolled in a high-deductible health plan in the first 9 months of 2017, according to the latest research published by the National Center for Health Statistics, part of the Centers for Disease Control in the U.S. Department of Health and Human Services. The report details Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2017. About 28 million people were uninsured in the U.S. in 2017, about the same proportion as in 2016 — but nearly 20 million fewer than in 2010, as the line chart illustrates. The

Health care ranks highest among working Americans as the top critical issue facing the country, well above terrorism, the role of the Federal government, unemployment and jobs, education, immigration and taxes. Over half of American workers also rate the country’s healthcare system as “poor” or “fair,” based on the results of the EBRI/Greenwald & Associates Health and Workplace Benefits Survey. Workers dissatisfaction with U.S. healthcare is based largely on cost: one-half of workers experienced an increase in health care costs in the past year. Furthermore, only 22% are satisfied with the cost of their health insurance plan, 18% are satisfied

Americans’ approval of the Affordable Care Act reached its apex in December 2017, the Pew Research Center found. The proportion of people approving the ACA has been growing since the middle of 2016, now at 56% of the public. The timing of this survey, conducted at the end of November and first few days of December 2017, coincides with Congress’s arm-wrestling a tax bill that would eliminate the individual mandate for health insurance which is an ACA building block for universal coverage in the United States. Most people in the U.S. also believe that the ACA has had a positive

The math is straightforward. Assume “A” equals $59.039, the median household income in 2016. Assume “B” is $18,142, the mean employer-sponsored family insurance premium last year. B divided by A equals 30.7%, which is the percent of the average U.S. family’s income represented by the premium cost of health insurance. Compare that to what American households spent on food: just over $7,000, including groceries and eating out (which is garnering a larger share of U.S. eating opportunities, a topic for another post). Thus, health care represents, via the home’s health insurance premium, represents 2.5 times more than food for the

U.S. consumers feel positive about the roles of technology and social determinants in improving healthcare, but are concerned about costs, according to the 2017 Patient Survey Report conducted for The Physicians Foundation. The survey gauged patients’ perspectives across four issues: the physician-patient relationship, the cost of healthcare, social determinants of health, and lifestyle choices. Two key threads in the research explain how Americans feel about healthcare in the U.S. at this moment: the role of technology and the cost of health care. First, the vast majority of consumers view technology, broadly defined, as important for their health care. 85% of people

The average cost of an employer=sponsored health plan for a family reached $18,764 in 2017. While this premium grew overall by a historically relative low of 3.4%, employees covered under that plan faced an increase of 8.3% over what their plan share cost them in 2016, according to the 2017 Employer Health Benefit Survey published today by the Kaiser Family Foundation. [Here’s a link to the 2016 KFF report, which provided the baseline for this 8.3% calculation]. Average family premiums at the workplace rose 19% since 2012, a slowdown from the two previous five-year periods — 30% between 2007 and 2012, and

8 in 10 Americans want President Trump and his administration to do what they can to make the Affordable Care Act work, according to the latest August 2017 health tracking poll from Kaiser Family Foundation (KFF). By political party affiliation, this includes 95% of Democrats, 80% of Independents, and 52% of Republicans (that is, to emphasize the point, just over half, a majority, of Republicans). More Americans are also relieved and happy, versus disappointed and angry, that the ACA repeal did not occur (thus far), the second chart illustrates. To be sure, a majority of Republicans register anger and disappointment,

On July 23, 1967, I was a little girl wearing a pretty dress, attending my cousin’s wedding at a swanky hotel in mid-town Detroit. Driving home with my parents and sisters after the wedding, the radio news channel warned us of the blazing fires that were burning in a part of the city not far from where we were on a highway leading out to the suburbs. Fifty years and five days later, I am addressing the subject of health equity at a speech over breakfast at the American Hospital Association 25th Annual Health Leadership Summit today. In my talk,

I quote directly from the Twitter feed of Anthony Scaramucci, @scaramucci: “@dhank2525 agree. We already have Univ Health Care, we made decision long ago to treat everyone that enters an emergency room.” Mr. Scaramucci is President Trump’s Communications Chief, replacing Sean Spicer. Mr. Scaramucci is neither veteran journalist nor healthcare policy wonk. He’s a successful businessman, which I respect for his savvy and ability to build a fund, attract investors, and create a media persona which he has telegenically broadcast on CNBC and elsewhere over the past decade. He’s got a engaging public personality, and goes by the moniker, “Mooch.” But

Between 2014 and 2015, death rates increased for eight of the ten leading causes; only death rates caused by cancer fell, and mortality rates for influenza and pneumonia stayed flat. The first chart paints this sobering portrait of Americans’ health outcomes, presented in the CDC’s data-rich 488-page primer, Health, United States, 2016. Think of this publication as America’s annual report on health. Every year, it is prepared and submitted to the President and Congress by the Secretary of the Department of Health and Human Services. This year’s report was delivered by DHHS Secretary Tom Price to President Trump and the

Only 14% of U.S. adults think that the American Healthcare Act (AHCA) fulfills all or most of President Trump’s campaign promises on health care, according to the May 2017 Kaiser Health Tracking Poll, released today. But political party lines surface when people area asked, overall, “given what you know about this proposed new health care plan, do you have a generally favorite or unfavorable opinion of it?” 55% of U.S. adults have an unfavorable view of the AHCA; however, the split across parties is quite clear: 84% of Democrats have an unfavorable view of the AHCA 57% of Independents ahve

The FDA is delaying the public posting of calorie counts, a policy that President Obama’s administration had pioneered for public health and wellness. Menu labeling has applied to grocery stores, gas stations, convenience stores, movie theaters and sports stadiums that sell prepared food. “Health and Human Services Secretary Tom Price said the menu labeling requirements would be ‘unwise and unhelpful’ as currently written, and added that the FDA is looking for ways to make the rules ‘more flexible and less burdensome.'” Former FLOTUS Michelle Obama took on the issue of healthy food and fitness for America’s children. Except for keeping her White

“Overall, Council members express pessimism about the health are landscape in the wake of the Trump administration’s proposed plans, citing no clear winners, only losers: patients, clinicians, and provider organizations.” This is the summary of the Leadership Survey report, Anticipating the Trump Administration’s Impact on Health Care, developed by the New England Journal of Medicine‘s NEJM Group. The first chart illustrates the “biggest healthcare losers” finding, detailed on the bottom three bars of patients, clinicians, and provider organizations. The stakeholders that will fare best under a President Trump healthcare agenda would be drug companies, payers, and employers. The biggest loser

Health care costs are out-of-reach for more Americans, among both people who have insurance through the workplace or via health insurance exchanges. The first chart illustrates the growing healthcare affordability challenge for American health consumers, discussed in a data note to the Kaiser Family Foundation Health Tracking Poll in March 2017. In 2017, 43% of consumers found it difficult to meet the health care deductible before insurance would kick in 37% of consumers found it difficult to pay for the cost of health insurance each month 31% said it was difficult to pay for copayments for doctor visits and prescription drugs.

The non-vote for and withdrawal of The American Health Care Act on March 24, 2017, was a win for the retail health market, at least in the short-run. Before the vote, there had been some pronouncements that the passage of the AHCA would have been a boon to retail health. Here’s one story stating that, “A boom in medical tourism to Mexico predicted if Obamacare ends.” Another article asserts, “Why the American Health Care Act Works for Retailers,” a public policy statement from the National Retail Federation (NRF). But NRF, please don’t fret. Retail health is consumer-driven and will persist beyond the