A blog covering the health/care ecosystem and people.

A “rebel” is both a noun and a verb. As a noun, Merriam-Webster tells us that a rebel is a person who opposes or takes up arms against a government or a ruler. As a verb, “to rebel” is to oppose or disobey one in authority or control, or otherwise renounce and resist by force the authority of one’s government.” An additional definition of the verb is, “to feel or exhibit anger or revulsion.” If you’ve been a patient facing a diagnosis of an illness, whether rare or common, you may well have felt these various feelings stirring inside your self.

Reviewing the annual 2023 report from the IQVIA Institute for Human Data Science discussing The Use of Medicines in the U.S. is always a detailed, deep, and insightful dive into the state of prescription drugs. It’s a volume speaking volumes on the current picture of prescribed meds, spending and revenues, health care utilization trends, and a forecast looking out to 2027. In my read of this year’s review, I see a flashing light for U.S. health care: “Wake up, public health!” I’ve pulled out a few of the data points that speak to me about population health, prevention and early

“Tom Lawry reminds us that the health care industry can shift from glacial to warp speed when it needs to. Given the right tools, we can evolve from health systems to systems of health, baked with Responsible Intelligence to do good while embedded with respect, inclusion, and transparency. Health citizens deserve Tom’s vision to emerge,” I wrote in a quote on the back of Tom’s new book, Hacking Health Care: How AI and the Intelligence Revolution Will Reboot an Ailing System.                 Tom knows whereof he speaks and writes and opines: he has

In October 2021, the Consumer Technology Association (CTA) announced that Robert Ford, CEO and President of Abbott, would give a keynote speech at CES 2022, the world’s largest annual convention of the technology industry. “This marks the first time in CES history that a healthcare company will take the mainstage for a keynote at the show,” CTA’s press release stated. I covered this announcement in the Health Populi blog at the time, and today want to double-down on the significance of Ford’s leading presence at #CES2022. When announced, the news was a signal that health care and the larger tech-enabled

The FDA’s approval of the first therapy to treat Alzheimer’s Disease in over twenty years brought attention to a not-yet-convened debate of U.S. health care costs and spending, innovation, and return-on-the-investment (as well as “for whom” do the returns accrue). In my latest post for Medecision, I explore different angles on the Aduhelm and Alzheimer’s discussion, covering: The macro- and micro-economics of Alzheimer’s and the $56,000 list price for the drug The FDA regulatory process and aftermath U.S. consumers’ bipartisan support for drug price regulation through Medicare negotiation and private/commercial sector adoption Congressional legislation addressing the price of medicines in

People living in the U.S. have weathered over fifteen months of life-shifts for work, school, prayer, fitness, and social lives. So you might think that the most important public priority for Congress might have something to do with COVID-19, vaccines, or health insurance coverage. But across all priorities, it turns out that prescription drug costs rank higher in Americans’ minds than any other issue in the Kaiser Family Foundation Health Tracking Poll for May 2021. Two-thirds of U.S. adults said that allowing the federal government and private insurance plans to negotiate for lower prices on Rx drugs was their top

The hearts and minds of nurses are fertile and inspirational sources and engines for health care innovation. This past weekend, and for the second time, I had the privilege and opportunity to be a panelist for the perennial hackathon meet-up of Nurse Hack 4 Health, sponsored by Microsoft, Johnson & Johnson, Sonsiel, and DevUp. This round, the hackathon attracted hundreds of nurses from at least 20 countries and 30 U.S. states. Even a few students attended, a growing trend as academia recognizes the shortage of workers trained to solve thorny problems of the world. In health care, right here, right

Five years ago, in 2016, the W2O Group said that, “Relevance is reputation.” That year the firm began to study the relevance of, well, relevance for organizations especially operating in the health/care ecosystem. 2020 changed everything, the W2O team asserts, now issuing its latest look into the issue through the Relevance Quotient. Relevance is built on recognizing, meeting and exceeding stakeholder expectations of organizations. In the Relevance Quotient methodology, W2O Group defines key stakeholders as employees, patients (including the sick and the well, caregivers, consumers, et al), health care providers, advocacy groups, analysts and investors, policy makers, journalists and media outlets.

Artificial intelligence (AI) has begun to play a role in health care for predictive analytics, personalization, and public health. On 26th January, I’ll moderate a tweetchat at 1 pm Eastern time, brainstorming the current and future state of and opportunities for AI in health care. I’ll be co-chatting with Microsoft’s AI leader, Tom Lawry (@TCLawry on Twitter). In advance of that discussion, I wanted to feature remarks shared by Brad Smith, Microsoft President, that I recently heard at CES 2021, the annual (this year, virtual) meeting convening the largest community of consumer electronics stakeholders globally Smith wove a crucial, impactful

Citizens around the world unite around the concept that Trust is Dead. This is no truer than in the U.S., where trust in every type of organization and expert has plummeted in the wake of the COVID-19 pandemic, political and social strife, and an economic downturn. Welcome to the sobering 2021 Edelman Trust Barometer, released this week as the world’s technology innovators and analysts are convening at CES 2021, and the annual JP Morgan Healthcare meetup virtually convened. As the World Economic Forum succinctly put the situation, “2020 was the year of two equally destructive viruses: the pandemic and the

The first year of the coronavirus pandemic in America was a kind of stress test on the U.S. health care system, revealing weak links and opportunities for bad behavior. “These are not just about individual instances or bad apples,” Dr. Vikas Saini, President of The Lown Institute, explained, referring to them as “cautionary tales” of the current state of U.S. health care. Dr. Saini and his colleague Shannon Brownlee released the annual Lown Institute 2020 Shkreli Awards this week, highlighting their ten most egregious examples of the worst events in U.S. health care that happened in the past year —

Before the coronavirus pandemic, patients had been transforming into health care payors, bearing high deductibles, greater out of pocket costs, and financial risk shifting to them for medical spending. In the wake of COVID-19, we see health consumers-as-payors impacted by the pandemic, as well as for existing diagnoses and chronic care management. There is weakening in U.S. consumers’ overall household finances, the latest report from the U.S. Bureau of Economic Analysis (BEA) asserted (published 25 November 2020). In John Leer’s look into the BEA report in Morning Consult, he wrote, “Decreases in income, the expiration of unemployment benefits and increased

2020 will be remembered for disruption and dislocation on many fronts; among the major blips in the year will be it remembered as the largest funding year for digital health recorded, according to Rock Health’s report on the 3Q2020 digital health funding. This funding record (“already” before year-end, tallied by the third quarter as Rock Health notes) was driven by “mega”-deals accelerated during the public health crisis of COVID-19. In the third quarter of 2020, some $4 billion was invested in U.S. based digital health start-ups adding up $9.4 billion in 2020….so far. This is $1.2 billion more than two

Welcome to Day 2 of my #COVID19 holiday break, welcome to my ABCovid Journal, letters “F” through “J. If you hadn’t tuned into the Health Populi blog yesterday, 10th August 2020, you missed the first five letters of my Age of Corona alphabet, curated in my art journal created in the early weeks of the pandemic. Click the link to back-track and catch up with us… I should explain why I’m sharing this project in the Health Populi blog this week. Last month, long-time colleague and friend Colin Hung interviewed me on the #HITMC broadcast to discuss a lovely recognition

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this

Tonight, President Trump will present his fourth annual State of the Union address. This morning we don’t have a transcript of the speech ahead of the event, but one topic remains high on U.S. voters’ priorities, across political party – prescription drug prices. Few issues unite U.S. voters in 2020 quite like supporting Medicare’s ability to negotiate drug prices with pharmaceutical companies, shown by the October 2019 Kaiser Family Foundation Health Tracking Poll. Whether Democrat, Independent, or Republican, most people living in America favor government intervention in regulating the cost of medicines in some way. In this poll, the top

People in the U.S. rank prescription drugs, lab tests, emergency room visits, dental and vision care, preventive services, chronic disease management and mental health care as the “most essential” health care services, according to the 2019 Survey of America’s Patients conducted by The Physicians Foundation. When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election. The Physicians Foundation surveyed 2,001 U.S. adults between 27 and 75 years

“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

The health/care ecosystem continues to morph as the stakeholder groups themselves are blurring across and outside of their core businesses. Today’s example of this is Clover Health, which launched Clover Therapeutics this week. This research organization will develop medicines targeting older adults — which makes sense because Clover Health’s target consumer market is Medicare Advantage beneficiaries. “Clover Therapeutics was created to address the significant unmet needs in chronic progressive diseases in the Medicare population,” Cheng Zhang, Head of Clover Therapeutics, is quoted in the press release. The company will first collaborate with Genentech (Roche) to research and develop therapies based

“The promise of AI is undeniable…could AI help clinicians deliver better and more humanistic care?” This question is asked and answered in a JAMA viewpoint published January 1/8 2019 titled, Humanizing Artificial Intelligence. This theme motivated a conversation held over a dinner convened by Philips hosted by Frans Van Houten this week at HIMSS19. To provide context Geoff Colvin, Fortune‘s Senior Editor, first talked about taking friction out of industries, as Lyft and Uber have done in the transport sector. “Taking friction out of industries challenges and changes business models,” Geoff noted. With Uber’s IPO valuation approaching $100 billion, I’d say that’s

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

“Do no harm” has been the professional and ethical mantra of physicians since the Hippocratic Oath was first uttered by medical students. The origins of that three-word objective probably came out of Hippocrates’ Corpus, which included a few additional words: “to do good or to do no harm.” The proliferation and evolution of digital technologies in health care have the potential to do good or harm, depending on their application. Doing good and abstaining from doing harm can engender trust between patients, providers, and other stakeholders in health. Trust has become a key currency in provider/patient/supplier relationships: 94% of health executives

In the U.S., trust in the healthcare industry declined by 9 percentage points in just one year, declining from 62% of people trusting — that’s roughly two-thirds of Americans — down to 53% — closer to one-half of the population. I covered the launch of the 2018 Edelman Trust Barometer across all industries here in Health Populi in January 2018, when this year’s annual report was presented at the World Economic Forum in Davos as it is each year. The Edelman team shared this detailed data on the healthcare sector with me this week, for which I am grateful. Check

Healthcare was based on three pillars in 16th century Florence, Italy: diet, surgery, and pharmacy. Five centuries later, not much has changed in Italy or the U.S. But how healthcare gets funded and delivered in the context of these pillars significantly varies between the two countries, and impacts each nation’s health. To put this in context, visiting the Biblioteca Medicea Laurenziana (the Medici’s Laurentian Library) today in Florence was a trip through medical-surgical history, starting in the second half of the 16th century. The design of this magnificent library’s foyer and reading room was initially conceived by Michelangelo. The reading room

Over the past two weeks, we see two marketing campaigns emerge to market medicines: first, from the branded pharmaceutical association PhRMA, the #GoBoldly initiative with a theme of innovation and personalized medicine. Second, there’s a campaign from the Generic Pharmaceutical Association (GPhA), rebranding the organization as the Association for Accessible Medicines with the tagline, “keep medicines in reach.” What’s this all about? To put these marketing initiatives in context, let’s start with the publication of Express Scripts 2016 Drug Trend Report. “Drug trend” is short-hand for growth in prescription drug spending, year on year. The first graph illustrates the price index

In the past week, the Pharmaceutical Research and Manufacturers of America (PhRMA), the advocacy organization for the branded prescription drug industry, published Medicines: Costs in Context,” the group’s lens on the value of prescription drugs in the larger healthcare economy. Their view: that prescription drug costs comprise a relatively low share of health care spending in America, and a high-value one at that. PhRMA contends that 10% of the health care dollar was allocated to prescription drugs in 2015, the same proportion as in 1960. “Even with new treatments for hepatitis C, high cholesterol and cancer, spending on retail prescription

Pressures on the pharmaceutical industry are coming from every stakeholder touchpoint, driving companies to merge, set prices high for short-term gains, and (finally) put more resources toward providing patients services. Let’s call out just a few of the events from the past couple of weeks which, together, paint the current rocky landscape for pharma and life science companies: Last week on April 28th, termed “healthcare’s $45 billion day,” three big M&A deals hit the financial markets: Abbott sought to acquire St. Jude Medical (worth $30 bn alone), AbbVie looked to buy Stemcentrx for just under $6 bn, and Sanofi tagged

Prices for the most commonly used branded prescription drugs grew from a base index of $100 in 2008 to to $264 in 2015, based on the Express Scripts 2015 Drug Trend Report. This is illustrated by the upwardly-sloping blue line in the chart. In contrast, the market basket of the most commonly used generic drugs fell from the $100 index in 2008 to $29.73, shown by the declining black line in the graph. The $112.05 is calculated from a market basket of commonly purchased household goods which cost $100 in 2008, a relatively flat line which puts the 264% rise in

Americans’ views of the pharmaceutical industry have fallen in the past year, with negative perceptions outweighing positive ones, shown in the line graph from the Gallup Poll. Pharma’s low-lying reputation among consumers sits among others including the legal field, healthcare, oil and gas, and the Federal government which ranked lowest across all 25 sectors Gallup analyzed. Gallup surveyed 1,011 U.S. adults in in the first week of August 2015 via telephone. Since 2003, Gallup notes, the pharma industry has consistently ranked in the bottom third of industries operating in the U.S. Pharma respect is in the eye of the consumer-beholder

There’s a trifecta of books written by three brilliant doctors that, together, provide a roadmap for the 21st century continuum of health care: The Patient Will See You Now by Eric Topol, MD; The Digital Doctor from Robert Wachter, MD; and, Being Mortal, by Atul Gawande. Each book’s take provides a lens, through the eyes of a hands-on healthcare provider, on healthcare delivery today (the good, the warts and all) and solutions based on their unique points-of-view. This triple-review will move, purposefully, from the digitally, technology optimistic “Gutenberg moment” for democratizing medicine per Dr. Topol, to the end-game importance of

Moore’s Law is coming to medicine. And it will look and feel a lot like Uber: with rich technology underpinning,  consumer-service oriented and friendly, and shaking up the professionals at the front line of the business (from taxi drivers to physicians). Eric Topol, physician and editor-in-chief at Medscape, told a standing-room-only audience at the kickoff of the 8th annual Health 2.0 Conference that the democratization of health care is coming based on consumers’ use of eight drivers: sensors, labs, imaging, physical exams, access to medical records, transparency of costs, and digital pills. Dr. Topol referred to the cover ot TIME

Over the next few years, large global pharma companies will need to wring out an additional $35 billion worth of efficiencies in order to drive profitability. While the industry has most of the patent cliff challenge behind it, companies face price constraints with respect to health reform, static national economies, and access demands. As the pharmaceutical industry enters the value-based health care era, the industry must catch up with other vertical markets in adopting information technology. In particular, pharma has been slower to migrate to the cloud than other businesses, with concerns about security and health care particular needs. Today, the

4 in 5 U.S. patients – 81% of them – want an equal say in health care decisions with their care provider, according to a 2013 Institute of Medicine study. At the same time, patients choose to take “drug holidays,” opting out of taking three or more doses of medicines in a row, or adopt “trail mix” approaches to taking prescriptions, casually and inappropriately mixing Rx drugs. Welcome to your world, pharma industry: where people say they want control, but somehow don’t exercise it in the way you — drug companies — define as “compliance” or “adherence.” Customer experience in

Can we age more slowly? And if so, what impact would senescence — delaying aging — have on health care costs on the U.S. economy? In addition to reclaiming $7.1 trillion over 50 years, we’d add an additional 2.2 years to life expectancy (with good quality of life). This is the calculation derived in Substantial Health And Economic Returns From Delayed Aging May Warrant A New Focus For Medical Research, published in the October 2013 issue of Health Affairs. The chart graphs changes in Medicare and Medicaid spending in 3 scenarios modeled in the study: when aging is delayed, more people qualify

The prescription drug cost curve is bending…for the time being. Spending on medicines fell by 3.5% in 2012 and will continue to fall below overall health spending over the next five years to 2017. But different from general health spending, there’s a new game in town called specialty medicines, and they cost a whole lot more than the generics and the aging brands that bent the cost curve in 2012. The declining Rx spending story is only part of a complicated tale told in great detail in a comprehensive report from the IMS Institute for Healthcare Informatics, Declining Medicine Use

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

Wearing his Walking Gallery jacket painted by (im)patient advocate, Regina Holliday, Dr. Eric Topol evangelized the benefits of digital medicine and consumer empowerment in health care, largely summarizing his epic (pun intended – wait for Hot Point, below) book, The Creative Destruction of Medicine. A founder of the West Wireless Health Institute (now known as West Health), Dr. Topol is a physician and researcher at Scripps and was recently named as editor at Medscape. A new piece of Topol Trivia for me is that GQ magazine called him a rock star of science. Dr. Topol is one of the more

1 in 3 online consumers (36%) is interested in receiving customer service from the pharmaceutical industry. In particular, these engaged health consumers want contact, first and foremost, with a clinical expert associated with a pharmaceutical company: namely, a doctor or a nurse. In third place would be a patient advocate representing the pharmaceutical company. During the recording of a podcast this week hosted by Med Ad News‘s managing editor Josh Slatko, featuring Monique Levy, VP of Research at Manhattan Research, Adam Budish, SVP of Sales with Epocrates, and me, Monique mentioned this data point from the latest ePharma Consumer study conducted by

Some 500 data analytics gurus representing the health care ecosystem including hospitals, physician practices, life science companies, academia and consulting came together on the lush campus of SAS in Cary, North Carolina, this week to discuss how Big Data could solve health care’s Triple Aim, as coined by keynote speaker Dr. Donald Berwick: improve the care experience, improve health outcomes, and reduce costs. Before Dr. Berwick, appointed as President Obama’s first head of the Centers for Medicare & Medicaid Services, Clayton Christensen of the Harvard Business School, godfather of the theory of disruptive innovation in business, spokee about his journey

The ability to get the data is the #1 obstacle that will slow the adoption of data analytics in health care, according to IBM’s report, The value of analytics in healthcare: from insights to outcomes. Healthcare “high performers,” as IBM calls them, use data analytics for guiding future strategy, product research and development, and sales and marketing functions. 90% of healthcare CIOs told IBM that developing “insight and intelligence” were key focuses of their organizations over the next 3 to 5 years. Underneath this macro objective are 3 business goals that data analytics addresses in healthcare: to improve clinical effectiveness

A health system that’s built to last: this is the latest sound-bite echoing through health policy circles. The theme of sustainability is permeating all matters of policy, from education and business to health care. Enter IBM, with a rigorous approach to Redefining Value and Success in Healthcare: Charting the path to the future, from the group’s Healthcare and Life Sciences thinkers. What’s inspiring about this report is the team’s integrative thinking, bridging the relationship between operational effectiveness built on a robust information infrastructure that enables team-based care (the “collaboration” aspect in the middle of the pyramid), which then drive personalized healthcare

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

Randomized controlled trials (RCTs) have been the rational cornerstone of medical decision making for decades. RCTs demonstrate a drug or therapeutic course’s efficacy – that is, the extent to which a specific intervention, procedure, or regimen produces a beneficial result under ideal conditions. Of course, how a particular therapy works in an individual is highly personalized based not only on a body’s biochemistry, but personal preferences, perceptions, and personality. That’s why Dr. Andrew Weil and his colleagues, Dr. Scott Shannon and Dr. Bonnie Kaplan, say that medical decision making should take into account the patient perspective. In Medical Decision Making in

The Federal government covers about $1 in every $3 of spending on prescription drugs in the U.S. That equates to $78 bn of the total $250 bn spent on Rx in 2009. Between 2006 and 2010, the indexed cost of the usual and customary price for commonly used branded prescription drugs grew by 8.3%; in that period the price of commonly used generic drugs fell by 2.6%. The General Accounting Office (GAO), those nonpartisan bean-counters in Washington DC, analyzed pricing trends of prescription drugs over the most recent five years, based on changes from first quarter to first quarter in each subsequent year. The GAO also

It’s year-end, so the forecasts abound whether we’re talking about trends in technologies, products and services. Gartner says cloud and mobile computing are hot, but managing customer expectations will require heavy lifting  On the food front, Epicurious predicts that food halls will be all the rage (think Harrods in London or Takashimaya in Tokyo), Korean cuisine in demand, and sweet potatoes crowned the vegetable of 2011. For colors, Pantone is Queen and they see that honeysuckle (a salmon-pink) is the new black. In health technology, there’s no better list to read than CSC’s The Future of Healthcare: It’s Health, Then Care, which offers up top 10 technologies

While two-thirds of American adults use the internet (including social media) to seek health information, only 11% use a pharmaceutical company website most often. It is intriguing that 2 in 3 adults who seek information about health care online are looking for information on illnesses and conditions from a pharmaceutical company. But the pharma company website isn’t the top-of-mind, go-to place. In fact, 2/3 of health citizens whose households use prescription drugs say their trust in medications is not heavily influenced by advertising by pharmaceutical companies.  These insights into the new pharmaceutical consumer come out of The Evolving  Consumer and The

Two reports, from Consumers Union and the AARP, put the pharmaceutical industry in the spotlight again this week, and not in a good way. First, Consumer Reports polled U.S. adults who take prescription drugs and found that 39% took some action to reduce costs. 27% didn’t take the Rx as prescribed: 16% didn’t fill the prescription, 12% took a drug past its expiration date, and 4% shared a prescription with someone else. These and other survey findings are discussed in Consumers say big pharma influence on docs is concerning, published in the Consumer Reports Health Blog on August 24, 2010. Second, the AARP calculated

Most consumers give thumbs-up to “fair and balanced” information on risks and benefits delivered in prescription drug ads on TV. But online? Not so much. This finding comes from one of the most highly anticipated surveys in the pharma business, the annual Prevention Magazine consumer survey on direct-to-consumer advertising (DTC). The FDA takes this survey seriously and its results inform FDA approaches to regulation. The 13th annual poll was published on July 15, 2010, titled, Consumer Reaction to DTC Advertising of Prescription Drugs. Most consumers find that “fair balance,” which is FDA required for presenting risks and benefits, is indeed “fair and balanced” on broadcast and in magazines. However,

The most highly rated aspects of living in America are science and technology, The Constitution, quality of life, colleges and universities. What can’t get consumers’ respect are 4 systems of American life: the political system, the economic system, the education system, and the health care system. HarrisInteractive polled 2,503 Americans in May 2010 on how they felt about various elements of life in the U.S. Entertainment, movies and TV also rank high on Americans’ scorecard. Health Populi’s Hot Points: Roughly 2 in 3 Americans rate the nation’s health system fair or poor. While marginally more Republicans than Democrats like the U.S.