A blog covering the health/care ecosystem and people.

As I leave Asia, where I’ve been for the past two weeks, for the U.S. today, I am reading the daily newspaper, the Korea Joongang News. On today’s op-Ed age is The Fountain column titled, Embracing the do-it-yourself attitude. In it, Lee Na-ree writes, “Making something with your own hands is part of the American pioneer spirit.” He describes the Maker Faire events and the project of Caine’s Arcade, a game developed by a Los Angeles boy who used auto parts from his dad’s shop. Na-ree observes that Americans are ‘regretting’ mass consumption. Health Populi’s Hot Points: I happened upon

Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative

While most Americans largely believe in motorcycle helmet laws, seatbelt-wearing mandates, and regulations to reduce sale in packaged foods, most are also concerned about the nation turning into the United States of Nanny. The Harris Interactive/Health Day poll of March 20, 2012, finds a health citizenry “pro” most public and safety regulations, from banning texting while driving to requiring the HPV vaccination (e.g., Gardasil). Specifically, as the chart shows, – 91% of U.S. adults are for banning texting while driving – 86% are for requiring vaccination of young children against mumps, measles, and other diseases – 86% also like to

Employers expect total health costs to reach $11,664 per active employee this year, over $700 more than in 2011. Employees’ share of that will be nearly $3,000, the highest contribution by workers in history. In 2012, workers are contributing 34% more to health costs than they did 5 years ago. The metric is that for every $1,000 employers will spend on health care in 2012, workers will pay $344 for premium and out-of-pocket costs. Still, health care cost increases are expected to level off to about 6% in 2012, that’s still twice as great as general consumer price inflation. with

With mobile health consumer market projections for ranging from $7 billion to $43 billion, according to PricewaterhouseCoopers, a casual reader might think that a plethora of health citizens are tracking their health, weight, food intake, exercise, and other observations of daily living by smartphones and tablets. But as the chart shows, health self-trackers number around 1 in 20 U.S. adults, according to a survey conducted for HIMSS Analytics and sponsored by Qualcomm Life. HIMSS Analytics’ report, A New Prescription for Chronic Disease: remote monitoring devices, was published in conjunction with the annual HIMSS conference which highlights the latest health information technology

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

Chronic illness represents $3 of every $4 of annual health spending in the U.S. That’s about $1.5 trillion. Living Well With Chronic Illness, a report from The Institute of Medicine (IOM), issues a “call for public health action” to address chronic illness through: – Adopting evidence-based interventions for disease prevention – Developing new public policies to promote better living with chronic disease – Building a comprehensive surveillance system that integrates quality of life measures, and – Enhancing collaboration among health ecosystem stakeholders: health care, health, and community non-healthcare services. The IOM recognizes the social determinants that shape peoples’ health status

Less is more when it comes to health care utilization and outcomes. The U.S. allocates too many resources to a huge line item of waste in the health system – administrative (in terms of too many paper processes and staff to deal with them) and clinically (especially involving duplicated tests and ineffective treatments that aren’t based on evidence based medicine). “Take less” is the tagline of the company called help which is found at the URL http://www.helpineedhelp.com/.  This is a consumer-facing over-the-counter drug supplier. Their product line counts 7 mature products each packaged with the health complaint they target: “Help,” I have

Most U.S. primary care physicians realize the health of their patients is largely out of their hands — with their social needs ranking as important as addressing their medical conditions, according to the 2011 Physicians’ Daily Life Report, conducted on behalf of the Robert Wood Johnson Foundation by Harris Interactive in September-October 2011, results published in November 2011. In fact, unmet social needs are directly leading to worse health for Americans, say 9 in 10 doctors. With that recognition, most physicians feel they’re unable to address patients’ health concerns caused by unmet social needs. This has led to most doctors confessing

When I would meet up with clients and friends during the latter half of 2011, people whom I hadn’t seen for months would do a double-take when they saw me. “What have you done?” they have asked. In this first post of 2012, I will share with Health Populi readers my story of 2011 — a year of living health-fully for me. One of the blessings of my work-life is that I have access to some of the great minds in health and health care. But not until I began to personally harness their wisdom, intentionally incorporating what they’ve learned into my own life-flow and

The Great American Recession of 2008 will reawaken in 2012, Goldman Sachs expects. In the current economic climate of a jobless recovery and dropping home values, the definition of The American Dream has changed. It’s more about personal fulfillment than financial gain, according to the 2011 MetLife Study of The American Dream: The Do-It-Yourself Dream. This is the rise of the “do-it-yourself” American Dream, MetLife found in its survey of 2,420 online adults conducted in September-October 2011. Across the generations — from Silent (born between 1920 and 1945) to Gen Y (born between 1978 and 1993), this redefining concept is relatively consistent.

Walmart issued a Request for Information to expand its retail health footprint in the communities in which the world’s largest company operates. That was a strong sign that retail health has surpassed a tipping point. Now, there are hard data to support this observation from a RAND Corporation research team. Trends in Retail Clinic Use Among the Commercially Insured, published in the November 25, 2011, issue of The American Journal of Managed Care, quantifies retail clinic utilization among a group of Aetna health plan enrollees between 2007 and 2009. In those two years, use of retail clinics grew 10-fold. RAND looked

The health status of the American workforce is declining. Every year, unhealthy behaviors of the U.S. workforce cost employers $623 per employee annually, according to the Thomson Reuters Workforce Wellness Index. People point to smoking, obesity and stress as the 3 most important factors impacting health costs. Thomson Reuters and NPR polled over 3,000 Americans on their health behaviors, utilization and costs of health care, publishing their results in a summary, Paying for Unhealthy Behaviors in October 2011. 4 in 5 overall — and 9 in 10 of those with over $50,000 annual income — believe that people with healthy behaviors should receive a

The signs of the primary care crisis in America are visible: A growing number of visits to the emergency room for treating commonplace ailments Waiting lists for signing up with and queuing lines to see primary care doctors Fewer med students entering primary care disciplines Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban. The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of

A picture’s not only worth the proverbial thousand words, but can save a life. So can a t-shirt…er, TeachShirt. At the Unniched meeting held on 25 October 2011 in NYC, I spent a few minutes talking with two members of Zemoga‘s brain trust: Sven Larsen, Chief Marketing Office, and the firm’s Principal Design guru, Dan Licht. We discussed how design is so critical a factor in health, and in life — particularly, in DIY health, where we are all taking on more responsibility for our own health care — clinical, financial, mental, social. Among Zemoga’s colorful and uber-creative portfolio is its concept, the

The recessionary, sluggish U.S. economy has had an impact on Americans’ mental and physical health. The least healthy citizens have experienced a disproportionately hard hit on their health and health care. But necessity being the mother of invention, some people are re-inventing their personal workflows in health care — and many of these tactics may well benefit their health in the long run. The Economy and Health: 10 Observations is the analysis from Euro RSCG‘s survey of U.S. adults’ views on their personal health in light of the continued economic downturn. The first chart shows the economy’s impact on the overall mood of

While women may equally ‘value’ healthy aging in the long-run, it’s their daily quality of life that may motivate them to stick with exercise routines. Simply put, immediate payoffs are more motivating to sustaining behavior change than the long-term promise of “health.” In Rebranding exercise: closing the gap between values and behavior, Michelle Segar and colleagues from the University of Michigan (disclosure: my beloved alma mater) describe the state of women and chronic illness, and the difficulty in sustaining physical activity especially in middle age. “While a number of interventions can help individuals successfully initiate an exercise program, most interventions have failed

The new mantra for employers who sponsor health benefits is: “a healthy workplace leads to a healthy workforce.” Employers that sponsor health plans are now in the behavior change business, according to Aon’s 2011 Health Care Survey. Health plans are tightly focusing on wellness, motivating and sustaining positive personal health changes, with carefully designed incentives (carrots and sticks) informed by behavioral economics. The paradigm is value-based insurance design (VBID) that removes barriers to essential, high-value health services to bolster treatment adherence, improve productivity, and reduce overall medical costs. The top five priority tactics for employers in health are: To offer incentives

In an interview in March 2011 with the Los Angeles Times, Dr. Regina Benjamin, the U.S. Surgeon General, said, “We can’t look at health in isolation. It’s not just in the doctor’s office. It’s got to be where we live, we work, we play, we pray. If you have a healthy community, you have a healthy individual.” Ford’s announcement last week that the automaker would team up with WellDoc to incorporate mobile health sensors into the company’s SYNC connectivity system  follows Toyota’s mhealth concept, the RiN, launched in 2007. Among various applications envisioned at this preliminary stage: Glucose monitors, from Medtronic, will

Apple has supplanted Google as the world’s #1 most valuable brand, worth more brand-wise than Microsoft and Coca-Cola combined (#5 and #6). the other most valuable global brands are IBM, McDonalds, AT&T, Marlboro, China Mobile, and GE. Technology brands have significantly grown in value with consumers allocating more personal disposable income to products like tablet computers and smartphones, even in the face of recessionary economics the world over. Technology companies are now 1/3 of the top 100 brands. Millward Brown, the brand consultancy that is part of WPP, the global communications firm, has conducted the BrandZ top 100 most valuable

Representatives from eight U.S. Federal government agencies, including the FDA and Veterans Administration, among others; health financiers (VCs, angels); health tech start-ups; providers, life science companies, and analysts, attended the Health Care Innovation Day DC sponsored by West Wireless Health Institute on April 28, 2011. The meeting had the tagline, A Discussion with the FDA, setting the stage for a day-long consideration of the role of regulation vis-a-vis health innovation. The $2.5+ trillion question (annual spending on health care in the U.S.) is: can innovation drive making health care “cheaper?” This was the underlying theme of the panel on which I sat

Wellness and disease prevention were the meta-themes at Health 2.0’s Spring Fling held earlier this week in San Diego. where the discussions, technology demonstrations, and keynote speakers were all-health (as opposed to health care), all-the-time. Dr. Dean Ornish told the attendees in the standing-room-only ballroom space that the joy of living is a greater motivator than the fear of death. And the 1.0 version of managing health risks has been more the latter than the former. As a result, Ornish’s two decades of research have shown that health is more a function of lifestyle choices than it is drugs and surgery. In fact, people have

J.D. Power and Associates, known for its insights into consumers’ opinions on cars, insurance and telecomms, published its latest poll on consumers’ favorite health plans. The verdict: health citizens like integrated health insurance plans where providers and insurance are part of the same organization like Kaiser Foundation Health Plans (rated in the top 3 in virtually every market where they operate polled by J.D. Power), Health Alliance Plan of Michigan, Geisinger in Pennsylvania, Dean Health Plan of Minnesota, and Group Health Cooperative of the northwest. Each of these integrated plans grew up based on local medical, economic and political cultures.

“If nothing else, the health reform bill has signaled the beginning of the end of the health plan as we know and love it,” David Brailer, once health IT czar under President GW Bush and now venture capitalist, is quoted in Reuters on Hot Healthcare Investing Trends for 2011. One health plan Brailer called out that could be relevant in the post-reform, post-recessionary US health world is Humana. I had the opportunity to spend time with Paul Kusserow, Chief Strategy Officer for Humana, during the HIMSS11 meeting. Our conversation began with me asking why the chief strategist for Humana would

An Explanation of Benefits (EOB) came in the U.S. mail yesterday. A plain piece of white 8.5″ x 11″ printed in tiny font with black ink, the logo of my health insurance company in the upper left of the form, and several lines of words and numbers showing me names of providers and facilities, dollar amounts billed, dollar amounts discounted, dollar amounts paid to the providers, and dollar amounts that were the patient’s responsibility — that would be me. The procedure was for a colonoscopy, for preventive screening and base lining for future reference. The good news: my colon looks just fine, and I’ll be reminded

Bet on it, live from Las Vegas at this week’s Consumer Electronics Show (CES): the new home health hub is digital, mobile and personal. More consumers are morphing TV and video watching from the “set” to the computer and mobile platforms, and DIYing more activities of daily living. Health (for both wellness and sickness care) is transforming in this process. This transformation is enabled through consumers’ adoption of technologies that they’re using in their daily lives for entertainment, household management, and communications. Broadband and wireless provide the infrastructure for health care to move beyond the doctor’s office and the hospital, so engaged patients who choose to do

As health citizens the world over vow to lose N zillion pounds in this first week of 2011, they’ll go beyond buying into Weight Watchers’ tempting offer to join “for free” (not really, folks), purchasing Home Shopping Network’s “Today’s Special” Earth brand Exer-Trainer sneaker, and getting motivated by Jillian Michaels gut-busting workouts on The Biggest Loser (her last season, by the way). People wanting to lose weight will adopt mobile health apps in record numbers in 2011. This category of mHealth apps is among the largest and most downloaded apps available. By the fourth quarter of 2011, most phones on the street

One of the favorite holiday gifts I sent people this season was Mark Bittman’s work, The Food Matters Cookbook: 500 recipes for conscious eating. Health Populi’s definition of ‘health’ comes from the World Health Organization: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. So with an eye toward conscious eating as part of everyday health, I headed to two wonderful restaurants on a trip to New York City last week that fit the definition: Rouge Tomate, built on a philosophy of great design and sustainable, balanced food (with locations in

Americans trust their supermarkets and local hospitals more than other industries they deal with. while tobacco and oil companies remain at the bottom of the trust-list for U.S. consumers, health insurance and managed care aren’t much ahead of them. Pharmaceutical companies rank fairly low, with only 11% of U.S. adults seeing them as “honest and trustworthy.” As a result, nearly one-half of Americans would like to see increased regulation on pharma. Over 1 in 3 Americans would like to see managed care and health insurance companies more regulated. The latest Harris Poll has found that oil, pharmaceutical, health insurance and tobacco are

With peoples’ adoption of mobile phones, broadband, and apps for which they pay out-of-pocket, the new person-centered medical home is…the home. Policy wonks can wax lyrically and econometrically spin models about how to bend the health cost curve. But patients are the most under-utilized resource in the U.S. health system, as Dr. Charles Safran testified to Congress in 2004. In 2010, patients are getting more engaged as they DIY more at-home: photograph development, travel planning, stock trades, and home improvement. So health care comes home. A column written by Dr. Steven Landers of the Cleveland Clinic, featured in the October 20th 2010 issue of

Their website now talks about it being the “Nutrition, Health and Wellness Company.” Most of us still think of it as the biggest food company in the world. It’s spending one-half billion dollars to expand in health. Nestlé, which brings baby food, bottled water, bars of chocolate and breakfast cereal to kitchen tables is now bringing us Health. The new group will be known as Nestlé Health Science. The company’s existing health business is already valued at about $1.6 billion.  “The combination of health economics, changing demographics and advances in health science show that our existing health care systems, which focus on treating

4 in 5 U.S. health citizens are trying to take better care of ourselves in light of increasing health care costs. A growing number of people are also talking with doctors about treatment options and costs, and searching for cheaper health insurance and less expensive providers. One-quarter of people didn’t fill or skipped doses of prescribed medications in response to increased costs, the same proportion as in 2009. The 2010 Health Confidence Survey from EBRI shows an eroding sense of faith in the American health system, with people expecting challenges for accessing health services and paying for health care in the future.

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

WellDoc received approval from the Food & Drug Administration (FDA) on August 2 2010 to market the company’s DiabetesManager system. This signals the regulator’s openness to mobile health solutions — a market moment that may usher in the new-and-improved era of personal health management. DiabetesManager uses the mobile phone as a platform for patients with Type 2 diabetes to gather, store and communicate personal health data such as blood glucose measurements; these data then feed into WellDoc’s algorithms that communicate personalized health coaching support back to patients in real-time. This process creates a closed-loop system that helps bolster patients’ decisions and behaviors throughout the day. Health

Two weeks ago, I bought a package containing 100 caplets of Tylenol PM caplets from my grocery store’s pharmacy aisle. I checked the lot number marked on the box against the list on the McNeil consumer healthcare website, and my lot appears to be fine. Today, Avandia, the prescription drug that treats diabetes, hit the headlines of the world’s major newspapers: Avandia Panel Hints At Doubts of Credibility, says the New York Times Avandia Hearings To Reveal True Dangers of Popular Drug, according to FOXNews GlaxoSmithKline Hid Negative Avandia Data: Lawmakers, reads ABC News Glaxo to Pay $460 million in Avandia Settlement, notes Reuters. And there’s also

  The health care cost crisis has hit at least 1 in 2 American families, based on the latest Kaiser Family Foundation Health Tracking Poll. KFF found that 30% of Americans have had trouble paying medical bills in the past 12 months. Challenges paying for health care increase if you’re black, Hispanic, earning under $40,000 a year, or….in poor health. There are two angles on dealing with the costs of health care dealt with in the KFF poll. First, looking to the government to regulate health costs: 42% of Americans said the government doesn’t regulate the cost of health insurance

  Did you ever play the whac-a-mole game? As Wikipedia describes it, “A typical Whac-A-Mole machine consists of a large, waist-level cabinet with five holes in its top and a large, soft, black mallet. Each hole contains a single plastic mole and the machinery necessary to move it up and down. Once the game starts, the moles will begin to pop up from their holes at random. The object of the game is to force the individual moles back into their holes by hitting them directly on the head with the mallet, thereby adding to the player’s score.”   Health care

The book Connected was recommended by my colleague, intellectual beacon and friend, Susannah Fox of the Pew Internet & American Life Project. In the midst of late nights analyzing health reform scenarios and medical microeconomics, I’ve made the time to read this book in its entirety. It’s been a worthwhile investment. Previously, the authors of Connected, Nicholas Christakis and James Fowler, found evidence on connectedness in health in the areas of obesity, smoking cessation, binge drinking, and other lifestyle behaviors that directly impact good or bad health.  This week, another team of innovative thinkers led by John Caccioppo from the

The relationship between patients and their physicians is a key driver in how and if people proactively manage their health. But cost often gets in the way of that relationship between a patient-consumer and a primary care doctor. The #1 reason why Americans deter proactive health care is cost. No American, whether insured and unemployed or working and covered, is immune from postponing or otherwise actively managing care when they are still well, according to a survey from IBM on health consumers in the U.S. 55% of Americans say they can’t afford the cost of wellness visits out-of-pocket. This is

  U.S. hospital finances are so stretched in the current recession, infection prevention efforts have begun to be curtailed.   32% of health facilities say that reductions in staffing and infection prevention (IP) departments have reduced their capacity to deal with IP in their institutions. The Association for Professionals in Infection Control & Epidemiology (APIC) has released the 2009 APIC Economic Survey – The Economic Downturn and Infection Prevention, published in June 2009. 41% of APIC’s polled members reported budget cutbacks for infection prevention in the past 18 months, due to the economic downturn. Among several areas negatively impacted that

The use of complementary and alternative medicine (CAM) by Americans has held steady since 2002; however, the types of therapies adopted have changed over five years. The Use of Complementary and Alternative Medicine in the United States, from the NIH’s National Center for Complementary and Alternative Medicine, follows up the agency’s 2002 report. This round, NCCAM offers more details on the use of CAM in kids, as well as CAM use by demographic factors including racial and ethnic groups.   CAM is “Complementary” when used with conventional medicine, and “Alternative” when used as a substitute. The most commonly used CAM

There’s more evidence that green = health. No, not tea, but more green space.   More specifically, access to green space lessens health disparities between the wealthy and the not-so-rich in the community.   Green spaces reduce the health gap between rich and poor, according to a study published in the Lancet, Effect of exposure to natural environment on health inequities: an observational population study by Dr. Richard Mitchell and Dr. Frank Popham, Scottish researchers in public health and geography, respectively.   Mitchell and Popham found that health disparities between the rich and the poor can be halved with citizens’

Employee wellness is a growth business: 57% of large employers provide wellness programs to employees, increasing from 49% of large employers in 2006. According MetLife’s Sixth Annual Employee Benefits Trends Study, nine of ten companies that offer wellness believe these programs are effective in reducing medical costs. For the average employer, MetLife found, 58% of the total benefits spend goes to medical coverage — an even higher percentage for smaller employers. The most popular wellness programs include smoking cessation, weight management, an exercise regimen and cancer screening among others. While 4 in 5 employers provide incentives to “nudge” people into

If employers got their collective hands on Aladdin’s lamp, they’d wish for: Increased employee accountability Reduced health risks Tailored health management programs that account for risk Health data and measurement tools that feed into analytics and outcomes measures, and Integrated and well-managed benefits and programs. These wishes are brought to you by Hewitt Associates’ 2008 survey, The Road Ahead: Driving Productivity by Investing in Health.   38% of employers plan to develop strategies for employee health and productivity in the next 1 to 2 years; 21% plan to do so within 3 to 5 years. 1 in 5 (19%) aren’t

I’m enjoying a weekend with London-based friends who travel the world and know what’s what. Today, we spent hours relishing (literally) the Borough Market in Southwark, located south of the Thames. This is London’s oldest food market, established when the Romans built the first London Bridge. The Market in its current state has been around for a quarter of a millenium.    The Market boasts and hosts a glorious array of green grocers, bread bakers, Spanish food purveyors, brownie makers, organic tofu purveyors, and parmigiano reggiano vendors in one spot I’ve seen, perhaps ever. It is foodie heaven and a

Or, The Lovely Bones (health care version).   I have an acquaintance whose bone density scan told her she is at high risk for osteoporosis. No surprise: the condition runs in her family. For several years, she has been paying a luxury-segment department store counter $300 every two months for her skin creme, which promises that she will be ageless as she ages into her fifties, sixties, and beyond.   But she has not yet filled her prescription for an osteoporosis-preventing drug.   She doesn’t have prescription drug coverage. She thinks the drug is too high-priced. It’s about $300 for

The annual national hospital bill may reach $1 trillion by 2008. This forecast is brought to you in a new report from the Agency for Healthcare Research and Quality (AHRQ). Hospital charges in 2005 totalled $873 billion in 2005, nearly doubling in ten years. The hospital bill was covered primarily by three payor segments: Medicare, which paid nearly one-half of the total hospital bill; private insurance, covering nearly one-third; and Medicaid, at 14% of the total. What are we spending money on in hospitals? Putting aside pregnancy/childbirth and infant care, the top three conditions are heart-related: coronary artery disease ($46

The Financial Times celebrates the 20th birthday of Prozac in the newspaper’s Nov 17/18th issue. It’s valuable to look at the rise and fall of Prozac, the brand; the rise of its generic equivalent; and how the drug has profoundly impacted one consumer’s life. Prozac Market. Before it treated depression, Prozac was thought to be an anti-hypertensive. When that didn’t seem to work, Eli Lilly considered it for an anti-obesity treatment. Strike two, clinical-wise. Finally, Lilly took the drug to market to fight depression after it was approved by the FDA on December 29, 1987. In two years, Prozac became