Health and tax breaks in the U.S. – a global perspective
The U.S. has among the lowest tax-to-GDP ratios in the developed world, including state and local taxes. Only Mexico, Turkey and Korea have lower tax-to-GDP ratios among OECD members, at somewhere between 20 and 28%. The Organization for Economic Cooperation and Development (OECD) believes that U.S. tax rates are, in fact, too low and, even with modest tweaks upward, “would still keep the overall tax burden at a relatively moderate level and not impose excessive costs,” OECD states in its Economic Survey of the U.S., released today. “Tax breaks have grown significantly since the major tax reform of 1986,” the report notes, and
Prescription Drug Nation
In 2008, 2 in 3 people in the U.S. over 60 took 3 or more prescription drug medications in the past month, and 14% of kids 11 and under regularly took an Rx. The CDC’s National Center for Health Statistics latest issue brief on prescription drug use illustrates that prescription drugs are as much of American popular culture and life as fast-moving consumer goods. It’s the more intense use of Rx drugs, 5 or more, where the most significant growth has been since 1999-2000, when 6.3% of Americans took 5 or more prescription drugs in the past month. In 2007-8, the proportion
More employers will offer health insurance, RAND forecasts
What will employers do with their health insurance sponsorship once health reform kicks into full-implementation in 2014? Will they drop coverage? There’s been some speculation that more employers would exit covering employees, but researchers at RAND see quite the opposite scenario. An additional 13.6 million workers will be offered health insurance coverage in a post-ACA America, based on a forecasting model the RAND team constructed. This increases the percentage of employers offering workers health insurance from 84.6% of workers to 94.6% of workers post-reform. The increase is driven, the model predicts, by two key factors: More demand for coverage by workers due
A primer on primary care
More patients find doctor is not in, NPR asserted on August 30, 2010, as part of its ongoing series covering the primary care shortage in America. To understand why this statement is so important, let’s go back to the definition of “primary care.” The American Association of Family Physicians says the domain of primary care includes the primary care physician, other physicians who include some primary care services in their practices, and some non-physician providers. Central to the concept of primary care is the patient, according to AAFP. Thus, the first definition of primary care, AAFP says, is “care provided by physicians specifically
The role of retail health clinics post-health reform
Retail health clinics have served American health consumers for about a decade. What have we learned over these ten years? As retail clinics proliferate the U.S. health care ecosystem, what is their impact on the health system, health consumers, and the health economy? The RAND report, Policy Implications of the Use of Retail Clinics, responds to these issues. The key implications of RAND’s study are that: – Health programs should be designed and paid-for to incorporate the adoption of retail clinics and reduce fragmentation and dis-continuity of care. – Learn from the best practices and patient outcomes gained from
As employers’ health costs increase 8.9% in 2011, employees will have more skin in the game
Large employers expect health care costs to increase by 8.9% in 2011, up from 7.0% in 2011. To stem cost increases, employers will adopt an array of tactics, most prominently offering consumer-directed health plans (CDHPs) and expanding wellness programs that encourage incentives to healthy lifestyles. These expectations come from Large Employers’ 2011 Health Plan Design Changes, a survey report from the National Business Group on Health poll of large employers. 1 in 5 employers say CDHPs are the most effective approach for managing health care cost growth, as shown in the chart. 61% of employers will off CDHPs in 2011, 20% of whom will
How to save $40 billion in health care: implement health IT in hospitals
Electronic health records (EHRs) broaden access to patient data and provide the platform for pushing evidence-based decision support to clinicians at the point-of-care. This promotes optimal care for patients, reduces medical errors, optimizes the use of labor, reduces duplication of tests, and by the way, improves patient outcomes. When done in aggregate across all health providers, a team from McKinsey estimates that $40 billion of costs could be saved in the U.S. health system. Reforming hospitals with IT investment in the McKinsey Quarterly talks about the American Reinvestment and Recovery Act’s (ARRA) $20+ billion worth of stimulus funding under the HITECH Act
Addressing the primary care shortage: the importance of community health centers, coupled with mobile health technology
The Affordable Care Act (ACA), aka health reform, will move 32+ million Americans to the insured population, and looks to the primary care ‘front-end’ of health care delivery to take in these newly-covered patients. Today’s USA Today reports on the primary care shortage in America. How to reconcile the influx of new patients in the U.S. health system with the deficit of primary care providers? First, the Community Health Center is one part of the solution to the primary care supply challenge. Furthermore, CHCs are integrated into ACA, seen as a key component for redesigning American health care delivery to improve quality, lower
That’s Dr. Geek Squad to you
Best Buy is teaming up with Cardiac Science, targeting potential purchasers of electronic health records (EHRs) and noninvasive cardiac devices. The venture looks to take advantage of economic stimulus funding available through the HITECH Act aimed at motivating physicians to adopt EHRs. Cardiac Science is a medical device company focused on the noninvasive management of heart disease. Their products include defibrillators, ECG/EKG devices, stress testing equipment, Holter and vital sign monitors. These heart-hardware products are designed to connect with electronic health records systems in hospitals and physician offices. and are used in many settings outside of health institutions including schools, emergency
Mayberry RFDHHS
Now showing in a 60-second spot during the 6 o’clock news: Andy Griffith’s got the starring role in promoting the peoples’ use of the Patient Protection and Affordable Care Act of 2010 (PPACA). Here is the announcement of the ad in The White House blog of July 30 2010. In the ad, Andy, now 84, recalls the signing of Medicare by President Johnson and moves into some details about the good things PPACA brings to seniors in the U.S. The Christian Science Monitor covers the story and shows the video here. This has caused quite a stir among Republicans who say
Women win in health reform
Women, on average, have far more contact with the health care system over their lifetimes than men do. So kicks off an analysis of the Patient Protection and Affordable Care Act of 2010’s (PPACA) impact on women, published by The Commonwealth Fund. Realizing Health Reform’s Potential explains that PPACA should insure some 15 million women as well as give fiscal relief to those women who are under-insured or have pre-existing conditions. One of the key underlying factors which stacks the deck against women in health insurance coverage is the fact that insurance companies see young women a higher risk than
Health reform = meaningful use among health executives
Meeting meaningful use for inpatient EHRs is the top priority among the many challenges health executives face when considering how the Patient Protection and Affordable Care Act (PPACA) will impact their organizations. Overall, 2 in 3 health execs place MU for inpatient EHRs as the “highest priority;” among health IT executives, the proportion citing this as the highest priority is 84%. The second-most pressing PPACA priority for health executives is preparing for new models of payment, cited by 17% of health execs overall, and 31% of non-IT executives. CSC surveyed health executives in July to gauge their temperatures on several PPACA line-items including
Designing for meaningful use
In the crush of crowds on the vendor floor at the HIMSS10 exhibition this week in Atlanta, booths are strategically designed with Pantone-matched colors and icons and clever taglines. Sales teams are festooned in corporate logo-emblazoned polo shirts (orange is popular this year). Colorful banners exclaim this year’s HIT mantras: lots of “HIE spoken here!” and “We are connectivity.” With all the thought and dollars allocated to health information technology sales and marketing, I wonder how much the line item known as “design” gets? As I spend a lot of time with pharmaceutical companies in the past two decades, I’m
Only 1 in 10 unemployed people buy into COBRA
Because of high premiums, only 9 percent of unemployed workers have COBRA coverage. Maintaining Health Insurance During a Recession: Likely COBRA Eligibility, a study from The Commonwealth Fund (CMWF), clarifies how COBRA is actually used by unemployed people in the U.S. CMWF calculates that: – Two of three working adults are eligible to buy into COBRA under the 1985 Consolidated Omnibus Budget Reconciliation Act (COBRA) if they became unemployed. – Under COBRA, workers pay 4 to 6 times their current premium for health benefits. – Thus, only 9 percent of unemployed workers have COBRA coverage due to the high price
I was invited to be a Judge for the upcoming CES 2025 Innovation Awards in the category of digital health and connected fitness. So grateful to be part of this annual effort to identify the best in consumer-facing health solutions for self-care, condition management, and family well-being. Thank you, CTA!
Thank you Team Roche for inviting me to brainstorm patients as health citizens, consumers, payers, and voters in the Healthcare Transformers series.
For the past 15 years, the annual CES conference in Las Vegas has been my go-to meeting for updating my research and network in digital health and consumer-facing electronics that people find meaningful for their well-being, families, and home lives. I'll be back in Vegas in January for a full week of Media Days, one-on-one meetings, and speaking about my perspectives on health consumers.