A blog covering the health/care ecosystem and people.

“Peace and health are inextricably connected,” the Editors of the AMA Journal of Ethics introduce an issue of the journal devoted to Peace in Health Care published November 2024.             In this timely journal issue, we can explore nearly one dozen essays exploring the interrelationship between peace and health in various clinical, care, and community settings — including hospice, maternal/child care, built environments, and adjacencies looking at the use of psychedelics and music for quieting one’s inner voices. You, the reader, will find your own favorite issues to explore based on your work, values, and interests.

Only 20% of U.S. adults have a positive view of the pharmaceutical industry, garnering the lowest positive vibes among Americans in Gallup’s latest survey on peoples’ opinions of industries in America. About 1 in 3 Americans feel positively about health care in the U.S., on par with publishing and the electric/gas industries — on the lower end of these findings.             By far, the top-perceived industry in the U.S. is agriculture and farming, taking the first spot with 64% of Americans’ positive views. Restaurants and the computer sector get 52% positives, although Gallup points out

Women in the U.S. have lower life expectancy, greater risks of heart disease, and more likely to face medical bills and self-rationing due to costs, we learn in the latest look into Health Care for Women: How the U.S. Compares Internationally from The Commonwealth Fund.              The Fund identified four key conclusions in this global study: Mortality, shown in the first chart which illustrates women in the U.S. having the lowest life expectancy of 80 years versus women in other high-income countries; Health status, with women in the U.S. more likely to consume multiple prescription

Over one-half of people 50 years of age and older in the U.S. have felt financial strain in the past year, resulting in 1 in 2 folks cutting back on everyday expenses like groceries and gas. We learn that nearly one-half of people 50 and over say they’ve been impacted by inflation “a great deal” in Making Ends Meet: Financial Strain and Well-Being Among Older Adults, the latest report from the Institute for Healthcare Policy and Innovation’s National Poll on Healthy Aging based at the University of Michigan (my alma mater). The poll was conducted by NORC at the University

Most Americans follow some kind of eating regime, seeking energy, more protein, and healthy aging, according to the annual 2024 Food & Health Survey published this week by the International Food Information Council (IFIC). But a person’s household finances play a direct role in their ability to balance healthful food purchases and healthy eating, IFIC learned.              In this 19th annual fielding of this research, IFIC explored 3,000 U.S. consumers’ perspectives on diet and nutrition, trusted sources for food information, and new insights into peoples’ views on the GLP-1 weight-loss drugs and the growing sense

From bandages to home hygiene, OTC pain meds and DIY home projects, Morning Consult’s look into the most-trusted brands of 2024 give us insights into health consumers. I’ve been tracking this study since before the public health crisis of the coronavirus, and it always offers us a practical snapshot of the U.S. consumer’s current ethos on trusted companies helping people risk-manage daily living — and of course, find joy and satisfaction as well. In the top 15, we find self-care for health and well-being in many brands and products: we can call out Band-Aid, Dove, Colgate, Kleenex, and Tylenol. For

The Wall Street Journal reported yesterday that surging hospital prices are helping to keep inflation high.                 Hospital costs rose 7.7% last month, the highest increase in 13 years. This chart from WSJ’s reporting illustrates the >2x change in the CPI for hospitals vs the overall rate of price increases. Hospitals are not alone in price cliffs, with health insurance premiums spiking last year at the fastest rate in a decade, the Labor Statistics data showed. “For patients and their employers, the increases have meant higher health-insurance premiums, as well as limiting wage

In the past few years, what event or innovation has had the metaphorical impact of hitting you upside the head and disrupted your best-laid plans in health care? A few such forces for me have been the COVID-19 pandemic, the emergence of Chat-GPT, and Russia’s invasion of Ukraine. That’s just three, and to be sure, there are several others that have compelled me to shift my mind-set about what I thought I knew-I-knew for my work with organizations spanning the health care ecosystem. I’m a long-time practitioner of scenario planning, thanks to the early education at the side of Ian

As we start the month of April 2024 in the U.S., it’s tax season in America with Federal (and other) income taxes due on the 15th of the month. This is also the time my research clock alarm goes off for an important annual report that describes the latest profile of the patient-as-payer in the U.S. ‘Tis the season for J.P. Morgan’s InstaMed team to analyze health care payments data, describing the experiences of consumers, providers and payers in the Trends in Healthcare Payments Fourteenth Annual Report.                   The overall takeaway for

How financially vulnerable are people with medical debt in the U.S.? Significantly more, statistically speaking, we learn from the latest survey data revealed by the National Financial Capabilities Study (NFCS) from the FINRA Foundation. The Kaiser Family Foundation and Peterson Center on Healthcare analyzed the NFCS data through a consumer health care financial lens with a focus on medical debt.          Financial distress takes many forms, the first chart inventories. People with medical debt were most likely lack saving for a “rainy day” fund, feel they’re “just getting by” financially, feel their finances control their life, and

At the end of each year since I launched the Health Populi blog, I have put my best forecasting hat on to focus on the next year in health and health care. For this round, I’m firmly focused on the key noun in health care, which is the patient – as consumer, as Chief Health Officer of the family, as caregiver, as health citizen. As my brain does when mashing up dozens of data points for a “trendcast” such as this, I’ll start with big picture/macro on the economy to the microeconomics of health care in the family and household,

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.

Two-thirds of U.S. consumers say they can’t afford to pay their medical bills on-time, based on the 2023 Consumer Survey from Access One, a financial services company focused on healthcare payments.               The report’s title page asks the question, “What options do consumers really want for paying healthcare expenses?” The survey report responds to that question, finding out that nearly one-half of patients have taken some kind of action to reduce their medical expenses. Furthermore, one-third of consumers are not confident they could pay a medical bill of $500 or more. Access One fielded

There is growing evidence on the connection between people’s financial health and their mental health, explored and explained in Understanding the Mental-Financial Health Connection, a study published by the Financial Health Network.             Keep that relationship in mind in the context of a new forecast from Kaiser Family Foundation estimate the 2023 cost for employer-sponsored insurance for a family to reach nearly $24,000 in 2023. That cost is a 7% increase over last year, and is expected to be split with companies covering $17K (about 70%) and employees about $6600 (roughly 30%). KFF heard that

One in two consumers in the U.S. feel their well-being or healing was negatively impacted by difficulty paying for their medical care. Welcome to the convergence of patients’ health care life with financial and retail lives, we learn from the 2024 Healthcare Financial Experience Study from Cedar.                   And that patient’s positive clinical experience can absolutely reverse the consumer’s perception of the provider, noted by this quote from OSU’s Chief Financial Officer Vincent Tammaro: “We’ve cured you of your ailment, but we’ve harmed you financially.” That’s a form of financial toxicity that

“Healthcare costs came roaring back in 2021” after falling in 2020. In 2023, that roaring growth in health care costs continues with expected growth of 5.6%.             For 2023, you could take your $31K+ and buy a Toyota Corolla Cross Hybrid auto, fund a year at the Gnomon School in Hollywood toward a degree in animation or game design, or buy healthcare for your family of 4. Welcome to this year’s annual look at health care costs for a “typical” U.S. family explained in the 2023 Milliman Medical Index (MMI).            

On April 11, 2023, three of the largest U.S. consumer credit rating companies — Equifax, Experian and TransUnion — planned to remove medical bill collections that were under $500 from consumers’ credit reports. The Consumer Financial Protection Bureau (CFPB) calculated that these medical bill “erasures” under $500 impacted nearly 23 million consumers and eliminated medical collections totally for 15.6 million people in the U.S. according to CFPB’s recently-published Data Point report. For some context, it’s useful to know that the CFPB was created as part of the Dodd-Frank Wall Street Reform and Consumer Protection Act passed by Congress and signed

In the U.S., price and the cost of medicines is tied to how people feel about the pharma industry, evidenced in the Global Pharma Study 2023 from Caliber. Caliber, a reputation and corporate strategy consultancy, fielded survey research among over 17,000 health consumers including U.S. adults between 18 and 75 years of age as well as health citizens living in Brazil, China, France, Germany, Japan, and the UK.                 Caliber assessed the reputation of 16 industries, globally, finding that pharma ranked 10th among the 16, just below automotive and just above chemicals (and well

People are sick of being sick, the New York Times tells us. “Which virus is it?” the title of the article updating the winter 2022-23 sick-season asked. Entering 2023, U.S. health citizens face physical, financial, and mental health challenges of a syndemic, inflation, and stress – all of which will shape peoples’ demand side for health care and digital technology, and a supply side of providers challenged by tech-enabled organizations with design and data chops. Start with pandemic ennui The universal state of well-being among us mere humans is pandemic ennui: call it languishing (as opposed to flourishing), burnout, or

Food features central in any holiday season, in every one’s culture. For Thanksgiving in the United States, food plays a huge role in the history/legend of the holiday’s origins, along with the present-day celebration of the festival. At the same time, in and beyond the U.S., families’ finances will also be playing a central role in dinner-table conversations, shopping on the so-called “Black Friday” retail season (which has extended long before Friday 25th November), and in what’s actually served up on those tables. Let’s connect some dots today on food, finance and health as we enter the holiday season many

People who need people aren’t just the luckiest people in the world: they derive greater benefits through monitoring their health via apps that make it easier to make healthy choices. Channeling Barbra Streisand here to call out a key finding in new consumer research from Kantar on Connecting with the Health & Wellness Community.           Kantar polled 10,000 online consumers in ten countries to gain perspectives on health citizens’ physical and emotional health and the role of technology to bolster (or diminish) well-being. The nations surveyed included Brazil, China, France, Germany, India, Singapore, South Africa, Spain,

Three in four people in America grade health care costs a #fail, at grade “D” or lower. This is true across all income categories, from those earning under $24,000 a year to the well-off raking in $180K or more, we learn in Gallup’s poll conducted with West Health, finding that Majorities of people rank cost and equity of U.S. healthcare negatively. Entering the fourth quarter of 2022, several studies were published in the past week which reinforce the reality that Americans are facing high health care costs, preventing many from seeking necessary medical services, and hitting under-served health citizens even harder

“The odds are against hospitals collecting patient balances greater than $7,500,” the report analyzing Hospital collection rates for self-pay patient accounts from Crowe concludes.       Crowe benchmarked data from 1,600 hospitals and over 100,00 physicians in the U.S. to reveal trends on health care providers’ ability to collect patient service revenue. And bad debt — write-offs that come out of uncollected patient bill balances after “significant collection efforts” by hospitals and doctors — is challenging their already-thin or negative financial margins.           The first chart quantifies that bad debt attributable to patients’ self-pay payments

Nearly 100 million people in the U.S. cut back on healthcare due to costs in the first half of 2022, according to the latest poll on health care costs form Gallup and West Health, gauging Americans’ financial health in June 2022. That’s the month when inflation in the U.S. reached 9.1%, a 40-year high.             Among Americans’ cuts to household spending was the most common medical self-rationing behavior, delaying or avoiding  care or purchasing prescription drugs, the survey found. Nearly 4 in 5 people in the U.S. had delayed care or prescription meds between January

People whose sense of well-being shifted positively in the past two years are finding greater personal purpose and financial health, we see in Sharecare’s Community Well-Being Index – 2021 State Rankings Report.                   Sharecare has been annually tracking well-being across the 50 U.S. states since 2008. When the study launched, Well-Being Index evaluated five domains: physical, social, community, purpose, and financial. In 2020, Sharecare began a collaboration with the Boston University School of Public Health to expand the Index, including drivers of health such as, Healthcare access (like physician supply per 1,000

Even as spending on healthcare per person in the United States is twice as much as other wealthy countries in the world, Americans’ health status ranks rock bottom versus those other rich nations. The U.S. health system continues to be marred by health inequalities and access challenges for man health citizens. Furthermore, American workers’ rank top in the world for feeling burnout from and overworked on the job.             Welcome to The Consumer Dilemma: Health and Wellness,, a report from GWI based on the firm’s ongoing consumer research on peoples’ perspectives in the wake of

“Inflation is the big story,” the economics team at Morning Consult told us yesterday in a call on “How to Think Like An Economist.” While I already thought I did that, Team @MorningConsult updated us on the current state of consumers and what’s weighing most heavily on their minds…inflation being #1. An hour after the Morning Consult session, I brainstormed the topic of consumers-as-payers of medical bills and prescription drugs with GoodRx strategy leaders. In my data wonkiness, inflation certainly played a starring role in setting the stage for Mind, Body and Wallet — the title of one of the sources

Each year, the first Sunday in June marks National Cancer Survivors Day. This year’s NCSD occurred two days ago on Sunday, 5th June. When you’re a cancer survivor, or happen to love one, every day is time to be grateful and celebrate that survival of someone who has come through a cancer journey. We all know (or are) people who have survived cancer. We know that the recipe for battling cancer goes beyond chemotherapy. We know of the resilience and grit required in the process: body, mind, and spirit. “Celebrate Life” is the mantra of NCSD, as this year’s campaign

In the wake of the pandemic and growing consumer preferences, the hospital-to-home movement is gaining traction among health systems. Amidst bullish forecasts for the promise of hospital-to-home discharges, the ability for many patients to make this migration would be a difficult bridge to cross.           On the promising front, recent studies reviewed through a meta-analysis published in JAMA found that hospital-to-home programs can be clinically and cost-effective for inpatients discharged from hospital. Earlier this year, McKinsey addressed how “Care at Home” ecosystems can reshape the way health systems — and people — envision patient care. This

A couple retiring in 2022 should budget $315,000 to cover their health care costs in retirement, based on the 21st annual Retiree Health Care Cost Estimate from Fidelity Investments. For context, note that the median sales price of a home in the U.S. in April 2022 was $391,200.             It’s important to understand what the $315,000 for “health care costs” in retirement does not cover, explained in Fidelity’s footnoted methodology: the assumption is that the hypothetical opposite-sex couple is enrolled in Original Medicare (not Medicare Advantage), and the cost estimate does not include other health-related expenses

“Until now, focus on….the social determinants of health has been for government and civil society. The private sector has not been involved in the discussion or, worse, has been seen as part of the problem. It is time this changed,” asserts the report, The Business of Health Equity: The Marmot Review for Industry, sponsored by Legal & General in collaboration with University College London (UCL) Institute of Health Equity, led by Sir Michael Marmot.               Sir Michael has been researching and writing about social determinants of health and health equity for decades, culminating publications

Inflation and rising prices are the biggest problem facing America, most people told the Kaiser Family Foundation March 2022 Health Tracking Poll. Underpinning that household budget concern are gas and health care costs. Overall, 55% of people in the U.S. pointed to inflation as the top challenge the nation faces (ranging from 46% of Democrats to 70% of Republicans). Second most challenging problem facing the U.S. was Russia’s invasion into Ukraine, noted by 18% of people — from 14% of Republicans up to 23% of Democrats. The COVID-19 pandemic has fallen far down Americans’ concerns list tied third place with

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

s in the seventh annual 2022 Brand Relevance Index from Prophet. The research developed a list of 50 companies representing what Prophet characterizes “the brands that people can’t live without in 2022.” For the 7th year in a row, Apple tops the study. Following Apple, the nine companies rounding out the top ten most relevant brands were Peloton, Spotify, Bose, Android, Instant Pot, Pixar, Fitbit, TED, and USAA. There are relative newbies in this list, representing consumers’ collective response to the COVID-19 pandemic and new life-flows. Put Calm and AfterPay in that category, along with Beyond Meat, and Zelle. The

People around the world have made health a “proactive priority,” most important to live a longer, healthier life, to avoid preventable diseases, to protect against disease, and to look and feel healthier, according to NielsenIQ’s latest health and wellness report. As the triangle here illustrates, NielsenIQ has turned Maslow’s Hierarchy of Needs upside down, shifting protective and physical needs to the top rung and altruistic — the “me-to-we” ethos — at the base. Note the translations of these needs, on the ride, into the “care” flows — moving from urgent care down to self-care, preventive care, innovative care, and selfless

I cannot recall a season when so many health consumer studies have been launched into my email inbox. While I have believed consumers’ health engagement has been The New Black for the bulk of my career span, the current Zeitgeist for health care consumerism reflects that futurist mantra: “”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run,” coined by Roy Amara, past president of Institute for the Future. That well-used and timely observation is known as Amara’s Law. This feels especially apt right “now” as we enter 2022,

Most U.S. householders that experienced COVID-19 expect their 2021 December holidays will be impacted in terms of reducing their holiday gift or decor spending, canceling holiday travel plans to see family or friends, or canceling holiday events, according to the 2021 Aflac Health Care Issues Survey. Aflac polled 1,003 U.S. adults in September 2021 to gauge Americans’ financial health perspectives approaching the end of Year 2 of the COVID-19 pandemic in America. Families with children feel particularly strapped for the 2021 holiday season: while they will be less likely to reduce holiday spending, one-half are concerned about medical expenses compared with

Even with growing inflation in the U.S. and post-pandemic job growth in 2021, the cost of health insurance premiums rose faster than either the price of goods or wages. That family health plan premium reached $22,221, an increase of 22% since 2016, we learn in the annual report from Kaiser Family Foundation, 2021 Employer Health Benefits Survey. This report is our go-to encyclopedia of statistics on health insurance year-after-year, surveying companies’ annual health insurance strategies for coverage and tactics for managing spending and workers’ health outcomes. This 2021 update takes into account the impacts and influence of COVID-19 on workers’

“More than a year and a half into the COVID-19 outbreak, the recent spread of the highly transmissible delta variant in the United States has extended severe financial and health problems in the lives of many households across the country — disproportionately impacting people of color and people with low income,” reports Household Experiences in America During the Delta Variant Outbreak, a new analysis from the Robert Wood Johnson Foundation, NPR, and the Harvard Chan School of Public Health. As the HLTH conference convenes over 6,000 digital health innovators live, in person, in Boston in the wake of the delta

“Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. In the 19th and 20th centuries, segregated black hospitals were emblematic of separate but unequal health care,” begins the editorial introducing an entire issue of JAMA dedicated to racial and ethnic disparities and inequities in medicine and health care, published August 17, 2021. This is not your typical edition of the Journal of the American Medical Association. The coronavirus pandemic has changed so many aspects of American health care for so many people, including doctors. Since the second quarter of 2020,

As the COVID-19 pandemic shifts to a more endemic phase — becoming part of peoples’ everyday life for months to come — impacts on peoples’ mental health will persist, according to new research from CVS Health in the company’s annual Health Care Insights Study. CVS conducted the annual Health Care Insights Study among 1,000 U.S. adults in March 2021. To complement the consumer study, an additional survey was undertaken among 400 health care providers including primary care physicians and specialists, nurse practitioners, physician assistants, RNs and pharmacists. CVS has been tracking the growing trend of health care consumerism in the

“What if…healthcare happened where we live, work, play, pray and shop, delivering the highest levels of retail experience?” I asked and answered in my book HealthConsuming: From Health Consumer to Health Citizen. The chapter called “The new retail health” began with that “what if,” and much of the book responded with the explanation of patients evolving toward health consumers and, ultimately, health citizens empowered and owning their health and care. This week, Dollar General announced the hiring of its first Chief Medical Officer, Dr. Albert Wu. With that announcement, America’s largest dollar-store chain makes clear its ambitions to join a

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

In the COVID-19 pandemic, health care spending in the U.S. increased by a relatively low 6.0% in 2020. This year, medical cost trend will rise by 7.0%, expected to decline a bit in 2022 according to the annual study from PwC Health Research Institute, Medical Cost Trend: Behind the Numbers 2022. What’s “behind these numbers” are factors that will increase medical spending (the “inflators” in PwC speak) and the “deflators” that lower costs. Looking around the future corner, the inflators are expected to be: A COVID-19 “hangover,” leading to increased health care services utilization Preparations for the next pandemic, and

To pay for health care expenses, the average nest-egg required for a couple retiring in the U.S. in 2021 will be $300,000 according to the 20th annual Fidelity Investments Retiree Health Care Cost Estimate. I’ve tracked this survey for over a decade here on Health Populi, and updated the annual chart shown here to reflect a $40,000 increase in retiree costs since 2016. While the rate of increase year-on-year since then has slowed, the $300,000 price-tag for retiree health care costs is a huge number few Americans have saved for. That $300K splits up unequally for an opposite-gender couple (in

The United States has among the highest per capita incomes in the world. The U.S. also has sustained among the highest death rates per 100,000 people due to COVID-19, based on epidemiological data from the World Health Organization’s March 28, 2021, update. Higher incomes won’t prevent a person from death-by-coronavirus, but risks for the social determinants of health — exacerbated by income inequality — will and do. I have the good fortune of access to a study group paper shared by Paul Sheard, Research Fellow at the Mossaver-Rahmani Center for Business and Government at the Harvard Kennedy School. In reviewing

COVID-19 ushered in the era of our homes as safe havens for work, shopping, education, fitness-awaking, bread-baking, and health-making. In my latest essay written for Medecision, I weave together new and important data and evidence supporting the basic social determinant of health — shelter, housing, home — and some innovations supporting housing-as-medicine from CVS Health, UnitedHealth Group, AHIP, Brookings Institution, the Urban Land Institute, and other stakeholders learning how housing underpins our health — physical, mental, financial. Read about a wonderful development from Communidad Partners, working with the Veritas Impact Partners group, channeling telehealth to housing programs serving residents with

With a vaccine supply proliferating in the U.S. and more health citizens getting their first jabs, there’s growing optimism in America looking to the next-normal by, perhaps, July 4th holiday weekend as President Biden reads the pandemic tea leaves. But that won’t mean Americans will be ready to return to pre-pandemic health care visits to hospital and doctor’s offices. Now that hygiene protocols are well-established in health care providers’ settings, at least two other major consumer barriers to seeking care must be addressed: cost and access. The latest (March 2021) Kaiser Family Foundation Tracking Poll learned that at least one

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