A blog covering the health/care ecosystem and people.

The average person in the U.S. retiring in 2024 will need to bank $165,000 to pay for health care costs in retirement — a sum that does not include long-term care, Fidelity Investments advises us in the 23rd annual look at this always-impactful (and sobering) forecast. I’ve covered this study every year since 2011 here in Health Populi, continuing to add to this bar chart; in the interest of space and legibility, I started this year’s version of the chart at 2014, when the cost for a couple was gauged at $220K.             Fidelity began

The ability to book an doctor’s appointment ASAP, care available in-person and via telehealth, and control over my care — these are key factors Zocdoc explains in the company’s What Patients Want report published this week. Zocdoc learned the top reasons consumers booked medical appointments were for primary care, such as getting an annual physical or women’s preventive care services (e.g., pap smear, gyn exam), dermatology, and mental health issues. The top specialists booked were, consequently, primary care doctors, dermatologists, OB-GYNs, psychiatrists and psychologists, and dentists and vision providers.     In this first research study Zocdoc has conducted on

Years before we knew how to spell “coronavirus,” I gained Italian citizenship while retaining my U.S. citizenship. My family’s plan was to, soon thereafter, split time for work and life between the U.S. and the E.U. Then, COVID-19 emerged as a pandemic the world over, and the move to Brussels in January 2020 was quite short-lived. Now, the plan is in play and I’m writing this post from our home in Brussels, Belgium. Why Brussels? Among many smart reasons, the city is welcoming, our farm-to-table food style is doable, the walkability is brilliant, and the transportation options are accessible to

“Digital,” write large, has been a lifeline during lockdown for those with the access, skills, and confidence to benefit from connecting. “But too many [people] are still locked out,” the Good Things Foundation explains in Digital Inclusion in Health and Care: Lessons learned from the NHS Widening Digital Participation Programme. This report details how the National Health Service in the UK — the largest health care delivery system and single payor in the world — developed a model of “digital health hubs” to help address widening health inequities made worse through digital divides in the United Kingdom. There are many

Florence Nightingale, the founder of modern nursing, said, “Variety of form and brilliancy of color in the object presented to patients are an actual means of recovery.” We all need some #ArtTherapy in this #StayHome COVID-19 era, #AloneTogether to #FlattenTheCurve. Yes, I’ve been spending too much time connecting on social media. Can you tell I’m in dire need of some art therapy? #Truth. The coronavirus pandemic, like all desperate times, is inspiring amazing creativity across all media and channels. Today I’m obsessed with several art projects that delight me. My fall-outta-my-seat art therapy moment this week came from the Getty

Americans face high costs and hassle factors in health care. But more people are taking care into their own hands, and welcome a growing role for technology to play in enabling self-care, supporting prevention, and improving treatment of diagnosed conditions, according to The Future of Connected Health, a consumer survey from ResMed. For this research, ResMed interviewed 3,001 U.S. adults in June 2019, asking people to share perspectives on their health care experiences, the role of technology in healthcare, and devices they’d use to manage their care. Most Americans feel it should be easier to find the medical care that

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

We Are All Health Consumers Now. That’s the title of the first chapter of my new book, HealthConsuming: From Health Consumer to Health Citizen. I start this chapter quoting President Ronald Reagan in 1983, who recognized that health care costs were growing at three times the rate of inflation during the first term of his Presidency. It’s déjà vu in health care all over again, but 35 years later, it’s the patient now facing sticker-shock with first dollar payments in high-deductible health plans, six-figure prices on specialty drugs to treat cancers, and a poor return-on-investment for personal health spending. Thus

Most physician practices and hospitals in the U.S. have installed electronic health records (EHRs). But in a classic Field of Dreams scenario, we have made patients’ medical records digital, but people aren’t asking for them or accessing them en masse. “How do we make it easier for patients to request and manage their own data?” asks a report from the Office of the National Coordinator of Health IT (ONC), Improving the Health Records Request Process for Patients – Highlights from User Experience Research. The ONC has been responsible for implementing the HITECH Act’s provisions, ensuring that health care providers have met Meaningful

More Americans are worried about their out-of-pocket health care costs than they are about repealing the Affordable Care Act (ACA), according to the Kaiser Family Foundation (KFF) Health Tracking Poll published 6th January 2017, the first KFF poll for the new year. Cost worries fall into two buckets of concerns: the cost of health care, and the cost of prescription drugs. Managing the opioid epidemic falls in third place after health care costs. Repealing the Affordable Care Act? It’s #4 on Americans’ health care priorities as of mid-December 2016, followed by shrinking the Federal’s government’s role in and spending on

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

There’s a growing number of wearable digital health devices on the market, and more will appear at the 2015 Consumer Electronics Show in Las Vegas. Four new such products competed live today at CE Week’s Battle of the Bands, an event launched by Living in Digital Times. The competitors included GoQii, Healbe, Skulpt, and Wellograph, Wellograph calls itself “the world’s first wellness watch.” Made of sapphire crystal, the watch has a sleek design, targeting a working professional audience who wants a view on health throughout the day. The watch has an Integrated heart rate sensor, taking readings from the wrist for pulse,

While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average

It’s become evident that more health care does not often lead to better health: Shannon Brownlee’s seminal book, Overtreated, uncovered the negative relationship between more health care and worse outcomes. However, when it comes to accessing primary care, more may be a good thing. In Extended Office Hours and Health Care Expenditures: A National Study, published this week in the Annals of Family Medicine, researchers found that offering longer office hours, into evenings and weekends, leads to lower total health care expenditures for patients than practices without extended hours. Extended hours are also associated with lower prescription drug and office visit

Nearly 1 in 2 U.S. adults now uses social media in health, according to Manhattan Research’s latest look into Cybercitizens, fielded in Q311. That 45% of U.S. health consumers use social media in health is a significantly higher percentage than recent studies fielded by PwC and Deloitte, which have found about 1 in 3 consumers using social media for health. Manhattan Research defines social media use in health as having created or consumed health-related user-generated content on blogs, social networks, health ratings websites, online health communities and message boards, or patient testimonials. Key findings are that, 14% of health-social media folks are

“I’m not a class warrior. I’m a class worrier,” Robert Reich told a standing-room only crowd of thousands of health IT geeks as he delivered the first keynote address of the annual meeting of HIMSS, the Healthcare Information Management and Systems Society. This year’s crowd will have reached about 31,000 people interested in health information technology’s transformative role in health care. The 31K represents an 18% increase in attendance from last year’s crowd. The HIMSS economy is strong. Robert Reich warns, however, that the U.S. macroeconomy is far from healthy…and health care costs will be a long-term threat to the

What doctors are most likely to use patients’ personal electronic health records? Fewer than 1 in 2 are willing to. Those who most likely would include Hispanic physicians, doctors who practice in rural areas, those employed in hospitals, and surgeons. As part of the HITECH Act included in the American Recovery and Reinvestment Act (ARRA) 0f 2009, U.S. physicians have the opportunity to receive a portion of the $20.8 billion carved out as incentive payments to those who adopt and “meaningfully use” electronic health records (EHRs). Many EHRs include portals which allow patients to access a slice of their personal health information.

EURO RSCG has polled 1,000 online Americans’ views on romance through the lens of digital media, publishing results in a paper, Love (and Sex) in the Age of Social Media. This ‘digital love’ survey was conducted in January 2011.  [It’s interesting to note that EURO RSCG won the business for the Durex condom line in November 2010.] In its introduction, EURO RSCG suggests that, “the Internet is the most powerful erogenous zone that the world has ever known.” There are five aspects to digital love, based on these findings: 1. Observing love online. As more people do more daily activities online like banking,

In February 2011, 1 in 10 jobs in the U.S. is in health care employment; nearly 14 million people in the U.S. work in health care employment, with health care representing 10.7% of all jobs in America. The growth rate of health care jobs rose 1.2 percentage points since the recession kicked in late 2007. Since the start of the recession, health employment grew 6.3%; the number of non-health jobs fell by 6.8%. The chart starkly illustrates this story. Altarum Institute has crunched the health job numbers from the Bureau of Labor Statistics (BLS) and published their analysis in Health Sector Economic Indicators, published

Women’s #1 priority is health and wellness. Wellness means taking care of herself, based on a survey of women by Saatchi Wellness.  Women are coming out of the recession with the modus operandi of a “me-covery,” according to Saatchi Wellness’s read on women’s attitudes about the economy’s impact on their wellbeing and health priorities among 800 women polled online in August 2010. The 5 elements of the “me-covery” for women are: To eat right. This doesn’t mean “diet;” it’s striking a balance and buying healthier, and more organic, food. People most negatively impacted by the economy are buying less fast food. To

What do Dora the Explorer, Scooby-Doo and Shrek have in common? They’re persuading kids to eat less nutritious food, according to a study in the July 2010 Pediatrics journal (Volume 126. Number 1). A team from The Yale Rudd Center for Food Policy and Obesity studied children’s taste for food that’s sold in cartoon-character themed packages, versus products in plain packaging. The verdict? Kids think the cartoon-themed food tastes better.  The study was done among 40 so-called “ethnically diverse” children 4-6 years old in New Haven, CT, preschools. Health Populi’s Hot Points: Since Vance Packard wrote the seminal book on advertising, The Hidden

1 in 2 parents is keen on going online with their kids’ pediatricians to refill prescriptions, get clinical advice, obtain lab results, and obtain immunization records. The National Poll on Children’s Health, conducted for the C.S. Mott Children’s Hospital at the University of Michigan, found that fewer than 10% of parents can currently go online for administrative tasks like scheduling an appointment or completing a form before going for a well-kid visit. But there’s pent-up demand for so-called ePediatrics, the poll discovered. The key obstacles to doctors engaging in ePediatrics, the survey researchers say, are doctors’ concerns about medical liability

It’s good to be a kid in Norway, Australia, Iceland, Sweden, and Denmark. The worst country to be a kid on the planet is Afghanistan, which ranks lowest based on the Mothers’ Index Ratings in Save the Children’s State of the World’s Mothers 2010 report, the 11th annual version of this project. You might notice the United States hasn’t yet been mentioned. That’s because it’s not in the top 5 best places to be a woman or a kid; but the U.S. is also far, far from the worst nation in terms of childhood and maternal health metrics. The U.S. ranks

The impact of health reform could be devastating to the budgets of states by 2014 — the year that Governors must kick in substantial additional expenses that will cover the uninsured who are absorbed into existing health care programs. The Patient Protection and Affordable Care Act of 2010 builds on existing state health programs (read: Medicaid and CHIP for children) to provide coverage for uninsured Americans in 2014. Moody’s, the credit rating agency, has issued a report, Healthcare Reform Expected to Create Longer Term Financial Pressure for States, which finds that the states with largest gains in Medicaid enrollment will have the most

In the current paradigm of Too Big To Fail, are cancer drugs and care Too Costly To Consume? A plethora of evidence says that, for a growing number of health citizens, the answer is “yes.” First, think about the scope of the cancer challenge in the U.S. The March 17 2010 issue of the Journal of the American Medical Association focused on cancer: prevalence, treatment, and cost. Elkin and Bach’s article talks about addressing cancer’s next frontier – not treatment innovation, but costs. In their article on caring for patients with cancer, Pasche et. al. write, “With the current lifetime probability of being diagnosed

Among the limiting factors that will prevent full realization of the benefits of health reform, one is most pressing: the deficit of primary care providers (PCPs). A comment in the April 21st 2010 Journal of the American Medical Association lays out the facts about the primary care shortage with several data points: 1. There are 900 million visits to physicians each year in the U.S. 50% of these go to 200,000 physicians who call themselves primary care clinicians. 2. Most of these visits deal with the super-sized conditions of diabetes, hypertension and obesity, along with infections and general exams. 3.

Urban and town design, coupled with transportation planning, have everything to do with health. As suburban sprawl became the fashion after World War II as the U.S. economy expanded the middle class, green spaces and sidewalks disappeared. As Joni Mitchell sang, we paved paradise and put up a parking lot. That proverbial parking lot serves the many autos that people drive as they traverse the highways funded by the U.S. Department of Transporatation and approved by town zoning managers. Health is tied to urban planning and transport because the dots directly connect from there to obesity, mental health, respiratory health, accessibility and

In the global village of health care, where do Americans stand on issues compared with fellow health citizens in Canada, France, Germany, Switzerland and the United Kingdom? Deloitte Center for Health Solutions asked this very question and found some intriguing differences between people from six of the wealthiest countries on the planet. The most striking difference between the U.S. health system and the other 5 analyzed by Deloitte is that the U.S. has an employer-sponsored financing system coupled with public sector sponsorship for Medicare and Medicaid, along with health plans for Veterans and armed forces and their families. But it’s

Ted Kennedy spoke from the grave on Monday 22nd March, saying through the earthly voice of Nancy Pelosi that the passage of health reform was “the great unfinished business of our society.” Universal health coverage has been part of developed Europe for decades, and those countries spend a lot less overall and per capita on health care with arguably at least as good outcomes as the U.S. I’ve spent the past week in Europe, and while I was away, 219 Democrats voted in favor of health reform for America. I’ve had the opportunity to read various Euro-papers and listen to

70,000 young Americans between 15 and 39 years of age are diagnosed with cancer every year. This population falls in a gap between pediatric and adult cancer. Newly-diagnosed young adults often find themselves in a no-patients’-land, confronting a lack of targeted clinical trials and knowledgeable clinicians in local health markets.The National Cancer Institute says that survival rates for this group of cancer patients haven’t improved in over 30 years.That’s definitely cause to flip cancer the bird, and that’s exactly what the young actor, Zac Efron, has done.Efron is photographed with a young cancer patient, Emily Hobson, to focus on Stupid

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

Rest-in-peace, Hummer. Last week, GM announced that after 18 years, the gas-guzzling icon of car excess would be tossed to the proverbial scrap heap. The Tale of the Hummer provides a useful parable for American health care, especially for context this week as the annual HIMSS conference kicks off. (Please skip to the end-note to learn more about HIMSS, for those Health Populi readers unfamiliar with the acronym or organization). Why did GM send the Hummer to its resting place? There are several factors that eroded the demand for the Hummer: among them, First, the price of gas, generally trending

In the coming months and years, I anticipate that Monster.com and other online job services will grow their revenues from the health industry. Three important studies this month confirm that, while health care eats up nearly one-fifth of the U.S. economy, there are shortages of professionals to fill two important jobs that are growing: primary care physicians (PCPs), nurses, and health information technology (HIT) workers. Let’s talk about the doctors, first. The Journal of the American Medical Association (JAMA) reports this week that doctors cut back their working hours since 1998 to 2008. At the same time, the second chart

This year, it’s academics, experts, and industry analysts we trust — as for a “person like yourself?” Not as much — but in health, it is different.The Edelman Trust Barometer for 2010 finds that specialists are the most credible sources for information about companies. Edelman cites a ‘trust rebound’ since last year, except for general news media, including radio news, TV news, and print news which are seen as less trustworthy year-on-year.Conversations with friends and peers also lost ground as a credible source of information on companies. What’s most striking this year is that consumers’ views on corporate reputation aren’t

With President Clinton’s stent operation of February 11, Americans are reminded of the epidemic of heart disease which will cost the nation $503 billion in 2010. Heart disease and stroke kill 1 in 3 Americans. But 25% of heart and stroke patients say they can’t afford the treatment they need, whether they lack insurance coverage or don’t have the money to pay for services, medicines, and procedures. The situation is tougher for stroke patients than CVD patients: 32% of stroke patients don’t have sufficient coverage to deal with their conditions. 16% of heart/stroke patients under 65 don’t have any health

Adam Bosworth has been working very hard since he left Google Health to build an application that engages, inspires, and assists health citizens to manage their health. That effort is called Keas, and this week the project welcomes a partner that should further help people along their health journeys. For some people fortunate enough to be well, they may want to engage with daily lifestyle choices that increase their chances of staying well. For those people diagnosed with a chronic condition they want to manage, life is more complex beyond managing daily white carbohydrate intake, fat calories, and pedometer-measured steps.

What are the implications for electronic health records in an era of consumers’ adoption of mobile phones and online social networks?That’s the question posed and pondered by Aviv Shachak and Alejandro Jadad of the University of Toronto, published in this weeks Journal of the American Medical Association (JAMA).The opportunity is to build a people-centered health system, they say, the kind envisioned in the IOM’s report, Crossing the Quality Chasm. Drs. Shachak and Jadad propose 7 building blocks to use when adopting EHRs that will help the U.S. get to the Holy Grail of people-centered health:1. Use tools to promote health,

In 2010, health isn’t a top policy priority for Americans. Instead, the top 3 concerns are the economy, jobs and terrorism. At least 8 in 10 Americans cite these 3 areas at the top of their lists. Medicare, health care, and health insurance fall below Social Security and education, according to The Pew Research Center For The People & The Press‘s latest survey into Americans policy priorities. It is Medicare, in fact, that ranks above health care and health insurance for more Americans. Roughly 1 in 2 Americans cite health insurance or health care as a top priority for 2010.

Ensuring that all Americans have health insurance has fallen below other more pressing health reform issues such as tax credits for small business, health insurance exchanges, and front-burner health insurance regulations like guaranteed issue and covering dependents to age 25. Kaiser Family Foundation’s (KFF) latest Health Tracking Poll demonstrates Americans’ continued divide on the major health reform issues. About the same proportion, 56% and 55%, support covering at least 31 million uninsured and no federal money going toward abortion, respectively. A majority of Americans does not support the individual mandate and penalty for individuals not buying health insurance continues. Only

Employers aren’t happy with their health insurers. Satisfaction with health plans has eroded in the past year, according to a survey from PricewaterhouseCoopers (PwC). While 64% (about 2 in 3) of large employers were satisfied with their health plans in 2008, only 59% were in 2009. PwC says, “What employers want from health insurers in 2010: Better information, more value,” which is the name of the report covering the survey. As large employers morph to small ones, health benefits become much less important, the survey found. The smaller the company, the lower the satisfaction with health plans.The two key components

The chart shows that MinuteClinic retail health clinics have a better track record in following evidence-based guidelines than the average primary care practice in the U.S. (This chart replaces one I posted yesterday that did not start the origin point at ‘0.’ Thanks to reader Jason Rothstein at J-blawg for pointing this out – my apologies if I mislead anyone). The National Center for Policy Analysis (NCPA) pulled out this statistic in its Brief Analysis on Retail Clinics: Convenient and Affordable Care. The NCPA argues here that the solution to America’s lack of convenient, low-cost care is urgent care clinics.

Blue Shield of California is going where few health plans have: into the world of consumer ratings, a world beyond the plan’s control. The insurance company has worked with Bazaarvoice to develop a member ratings and review site. This is being rolled out to some members in a first phase, to be expanded over time. A press release on the plan’s website says, “Our members want to be heard and want to be able to interact with us and with each other in exciting new ways…we’re proud to be the first health plan in the country to be fully transparent.”

With the sobering headlines that “35 is the new 40” for Americans and a national erosion in optimism, Philips has published its 2010 Index on America’s Health and Well-being. The skin-deep, top-line finding is that 74% of Americans age 18-65 say their health is good or very good; however, there’s a disconnect and discontent that runs below this otherwise happy data point.I spent some time talking with Katy Hartley, Director of the Philips Center for Health and Well-being, about the study. She identified four key findings:1. People feel older, younger. That’s the “35 is the new 40” headline. When Americans

The health industry added 631,000 new jobs since the recession began, according to data from The Bureau of Labor Statistics released for January 2010. Critique the proportion of the GDP that the U.S. spends on health care if you must, but remember that the bioeconomy is a jobs engine for the nation and one of the few bright spots of innovation in the American economy.There’s another dynamic of jobs and health care that’s more good news: health reform would have a positive impact on job growth in the U.S. David Cutler (whom I talked about yesterday in Health Populi) and

Unemployment can quickly lead to uninsurance if a newly-laid-off worker doesn’t buy into COBRA. That’s the reality since the monthly cost of COBRA consumes, on average, about 84% of the average monthly unemployment payment for American workers. This calculation was made by Families USA in 2009, appropriately titled, Squeezed. When I wrote about COBRA here exactly one year ago, I posited that without significant subsidies, the newly-unemployed would quickly morph into the newly-uninsured. I can happily report that subsidies began to flow to laid off workers last spring and this led to a pick-up in COBRA enrollment throughout 2009. The

In the long run, it’s said, nothing is sure but death and taxes. In addition to those, there’s an increasingly sure thing: no retiree health benefits from employers. Once considered a “throw-away benefit” in the 1940s and 1950s when there were few retirees, retiree health benefits are an endangered species. In Implications of Health Reform for Retiree Health Benefits, the Employee Benefit Research Institute (EBRI) details the recent history and impacts of legislation on retiree benefits. Starting with FAS 106, the accounting rule change that passed in 1990, the financial treatment of employer-sponsored benefits negatively impacted access to health benefits

The long end-tail of the recession and the rising costs of health care — both medical trend/clinical and administrative — are creating uncertainty for employers who cover retiree health benefits. This picture is even more cloudy for pre-retirement benefit plan design.The bottom line: how do employers balance burdensome health costs with legacy promises?This question is addressed in Retiree Medical Challenges and Opportunities, December 2009, the fifth annual Towers Perrin–ISCEBS survey.Among this survey’s respondent employers, 80% have laid off workers in this recession, 32% have enacted voluntary staff reductions, and 26% have cut benefits. Nonetheless, 70% are continuing to provide retiree

The over-arching challenge facing health care in the U.S. for 2010 is managing costs, according to PricewaterhouseCoopers‘ forecast, titled appropriately, Squeezing the Juice Out of Healthcare. PwC says that health stakeholder organizations will have to redefine their roles given the ‘squeeze’ on incoming revenues, forcing focused management of operational costs. “Flat is the new growth for many industries outside of healthcare,” PwC asserts. Businesses in health will have to get used to that economic reality in 2010. 2009 saw big increases in costs which could result in pricing pressures in 2010.Value-based purchasing is taking hold in both the public and

Nearly 8 million Americans 65 and over visited Facebook in November 2009. Nearly 8 million older Americans visited YouTube in November, too. After Google Search and Windows Media Player, the two big social networks are the most-visited websites among older Americans. So found The Nielsen Company, reported in the nielsenwire on December 10, 2009. One year ago, Facebook was the 45th most visited site by seniors. Today, it’s #3. 8.2% of social network visitors are over 65. That’s only 0.1 percentage points less than the proportion of teens visiting social network sites, according to Nielsen’s data based on November 2009