Technical and Human Evolution

Humans did a pretty good job to evolve this far, but big changes are ahead.

As I wrote in Moore’s Law and the Future of Healthcare,

“Futurists regularly consider alternative scenarios and look at factors that can steer the future in one direction or another. That way, clients can select a preferred version of the future and know what they might do to make that future happen.

It’s relatively easy to extrapolate past trends, assuming that nothing prevents those trends from continuing at the same rate, but will they? One can also look at what’s possible by tracking research lab activity and then estimating how long it will take to bring those new technologies to market.

But a potentially better approach is to start with a solid understanding of market NEEDS and what drives the development of solutions for them, or factors that inhibit solutions. Changes in politics and public policy, for example, can be a huge driver, with Obamacare as an example, or a huge inhibitor. That’s why I’m so interested in various healthcare reforms that accompany tech innovation.”

In the following video, see how future technologies could impact human longevity, Earth’s environment, and artificial intelligence. Read More …

Inequality, Healthcare and the Economy

Because Congress is debating tax reform, I’m republishing this article to again raise the issue of inequality.

Rising income and wealth inequality leads to political inequality and threatens our democracy. A Washington Post article concluded that People have no idea what inequality actually looks like, and that caused me to respond and to enhance this article, which was published here two years ago. It features some disturbing videos that help us understand the corrupting influence of big money in politics and the direct relationships between:

  • Special interest lobbying and policies resulting in a widening of income & wealth gaps,
  • Between the widening wealth gaps and poverty,
  • Between Poverty and obesity,
  • Between obesity and diabetes and other chronic illness,
  • Between chronic illness and rising healthcare costs, and
  • Between rising healthcare costs and our economic problems.

Read More …

A Public-Private Hybrid Healthcare System


American Healthcare is Going Public, and Private. (Click to read article)

I published this article back in 2012 but updated it now because Senators Bill Cassidy and Lindsey Graham just introduced a bill they aim to ram through Congress without a CBO score or public hearings. Senator Bernie Sanders also has an Obamacare replacement. It’s a form of Medicare-for-All, and it’s gaining wide support among Democrats and the public.

GOOD NEWS UPDATE: Republicans failed to get enough votes to pass the Cassidy/Graham bill.

As founding editor of Modern Health Talk, I think both sides need to step back from partisanship, look at the big picture, consider all stakeholders, look to other advanced nations for inspiration, and combine the best properties of each into a public-private hybrid healthcare model.

Is Health Care a Right? — Dr. Atul Gawande, a surgeon and public-health researcher, wrote an amazing article for The New Yorker that asks a question that’s been dividing Americans. His interviews offer important new insights that were missing in the Republican push to repeal and replace the ACA without a single public hearing. Not only do we need to understand what other nations do, but we also need to understand the different perspectives of our own citizens. This amazing must-read article is a good companion to my own article on Single-Payer. Read More …

The Medical Cartel is Keeping Health Care Costs High

Watch "The Big Heist," a satyrical documentary about our broken healthcare systemBy Travis Klavohn and Dr. Laura Williams

In 2010, the small town of Collegedale, Tennessee had the dubious distinction of having the highest prevalence of Type II Diabetes in the world. Without a single endocrinologist in the small town, those suffering from this preventable and treatable form of the disease were unable to gain access to the treatment they needed.

Dealing with this issue firsthand, a local employer who operates a donut manufacturing plant decided to dedicate a portion of his warehouse to be used as a health clinic. By hiring an endocrinologist from Chattanooga to travel to his warehouse a few days a week, his employees were finally able to receive the help they so desperately needed. Read More …

Get the Health Incentives Right

Fixing our broken healthcare system, reducing costs, and improving care all comes down to getting the objectives and health incentives right.

Motivation - Fixing our broken healthcare system, reducing costs, and improving care all comes down to getting the objectives and health incentives right. This post is based on a comment I made when Pritpal Tamber called for “Creating a parallel system to health care” in MedCity News back in 2014.

At least for consumers, Modern Health Talk (www.mHealthTalk.com) can already be called the “Institute for New Health Thinking,” with well over 100 articles on Legislative, Public Policy, and Health Reform topics written for consumers, and over 700 on modern health topics in general.

I personally think fixing our broken healthcare system all comes down to agreeing on objectives and getting the INCENTIVES right, as I wrote five years ago when proposing a hybrid, public/private model of health care. The goal then was to exploit the different incentives of (1) capitalism and private sector organizations that measure success in business terms such as profit, ROI, and payback period, contrasted with (2) the public sector, which measures success quite differently and over much longer time periods.  Read More …

Politics and The Modern Killing Fields

Politics and The Modern Killing Fields

I begin with this widely shared Facebook post by Dr. Wallach that calls out unscrupulous doctors, and I follow with my perspective of the modern killing fields caused by public policy.

THE KILLING FIELDS…. Dr. Joel Wallach

“The United States had lost 56,000 military personnel in Vietnam over a ten-year period, for an average of 5,600 per year. Millions of people poured out into the streets to protest these lost lives. We had political anarchy for the last three years of the Vietnam war because of these deaths. And because of these deaths, God forgive us, we shot and killed American students at Kent State in Ohio, who were just exercising their First Amendment rights to free assembly and free speech. YET NO GROUP WAS OUT MARCHING IN THE STREETS WITH PLACARDS PROTESTING THE KILLINGS BY THE MEDICAL PROFESSION. Read More …

Fixing Healthcare – Searching for a Healthcare Unicorn

Fixing Health Care is more than Searching for the Healthcare Unicorn

By Brian Holzer MD, MBA, President, Kindred Innovations

[This blog post, originally published on LinkedIn, is based on my personal view and does not in any way reflect the opinions of the current organization I work for].

Last week I came across the article titled, “Cuts threaten rural hospitals hanging on by their fingernails” which reported that 673 rural hospitals were at risk of closing. The data came from the Chartis Center for Rural Health, which also cited that states including California, Oklahoma, Louisiana, Alabama, and Georgia were most at risk with as many as 79% of their rural hospitals facing possible closure.

Reports like these that imply an impending doom of the healthcare system, as we know it are almost a daily event. And the sensationalism of healthcare by politicians and the media only adds further distractions to a system that is starving for patience and unbiased pragmatism. There is also no shortage of articles professing solutions that say nothing more than we need to 1) create a system that ensures that everyone has access to health insurance; and 2) make sure that we contain the huge cost increases.

The real problem we are facing as a society is that Healthcare is a Unicorn…Healthcare is not the same as other markets. There is a widespread lack of transparency about both the costs and the effectiveness of treatments, and many other details that a customer or end consumer might use to make purchasing and utilization decisions in healthcare. If life were as simple as it is often taught in business school classrooms, fixing Healthcare should be as easy as learning from other industries and adopting best practices. So, let’s [apply lessons from] two industries-airlines and auto insurance. Read More …

Republican Sabotage of Our Health Care System

Trump sabotage of Obamacare

EDITOR: Why does the self-styled “pro-life” party want so badly to raise the death rate through more guns and less healthcare? Some think it’s because white nationalists (aka white supremacists) fear that immigrants and minorities are getting more opportunities than they are. Others think it’s about wealthy elites maintaining political control in the face of sweeping demographic changes. Either way, it’s disgusting and tearing our nation apart. In the referenced article below, Congressional Democrats describe recent administration executive actions ACA Sabotage, to create a healthcare crisis, but Political Genocide may be a more fitting term.

OBAMACARE SABOTAGE CONTINUES

Since his first day in office, President Trump has created vast uncertainty in health insurance markets. Here are some examples:

His Administration has refused to commit to making cost-sharing reduction (CSR) payments and failed to commit to enforcing the individual mandate, putting the integrity of the risk pool and affordability of coverage in jeopardy. Trump’s obvious attempts to manufacture a crisis caused uncertainty in the marketplace and prompted insurers to sharply increase premiums for the upcoming plan year, or pull out altogether.

By another executive order in October, Trump will allow associations to offer group insurance plans with skimpy benefits and offer lower cost plans to members nationally across state lines. Trump’s order would allow association health plans to be exempted from core Obamacare requirements like coverage of essential health benefits. The ACA’s essential health benefits include hospital care, prescription drugs, maternity care, and mental health. The aim was to broaden the risk pool by preventing insurers from offering cheap plans tailored to young and healthy customers at the expense of older and sicker people. Experts worry this will damage ACA exchangers and result in overall higher costs.

Trump wants to make it easier for businesses to require employees to pay for their own insurance using reimbursements. He also wants to open more loopholes for people to buy insurance outside of ACA markets, attracting younger and healthier people away from current markets. Experts think this will destabilize Obamacare by leaving behind a smaller insurance pool of older and sicker people, resulting in fewer insurers and higher premiums.

Trump’s executive order finally terminates CSR subsidies paid to insurance companies to help people between 100% and 250% of the poverty level pay for the insurance and health care they get through ACA exchanges. Ironically, Trump’s constant threats to terminate CSR subsidies caused uncertainty in insurance markets that exacerbated two problems he blamed on Obamacare – namely, high premiums and the exit of insurers. This intentional sabotage will harm the 7.1 million people, or 58% of Obamacare enrollees, who qualified for subsidies this year.

Signing up for insurance under Obamacare will be a lot harder this year. Trump has shortened the annual open-enrollment period (Now Nov.1 to Dec.15) and announced plans to take HealthCare.gov offline for 12 hours at a time during peek enrollment times, “for maintenance.” He also cut ACA enrollment advertising by 90% and cut funding for Navigator groups who help people navigate the complex enrollment process and pick a plan under the ACA exchanges or Medicaid.

Trump and GOP attacks on Obamacare could come back to bite them politically, because although they have pleased their base, they also made health care more expensive and more unavailable for many Americans, many of whom are in the red states where Trump won.

It’s Not Just Me, or the mainstream press, Saying This

U.S. Congress seal
Analysis by the nonpartisan Congressional Budget Office has shown that every Republican House and Senate bill to replace Obamacare would (1) increase overall costs significantly and (2) cause tens of millions of people to get health insurance coverage. Sabotage can be even worse, and Congressional Democrats have weighed in on that issue.

Democratic members of the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions recently released a report warning that Republican actions are causing uncertainty in health insurance markets that is resulting in higher premiums and insurers pulling out. A Manufactured Crisis: Trump Administration and Republican Sabotage of the Health Care System is summarized here with quotes from insurance companies and regulators across nearly 20 states. Read More …

Trumpcare will kill more Americans than Terrorists have

Trumpcare protesters say, "We need Care, not Chaos."

Today I commented on The Senate’s Trumpcare Bill Will Kill 50 Times More Americans Than Terrorists Have. This FORBES article frames the issue in a way that puts the large numbers in perspective.

According to the bipartisan Congressional Budget Office, “15 million people losing insurance translates to at least 18,000 preventable American deaths.” If Republicans simply repeal Obamacare instead, 38,400 would die – or 100 times more than Terrorists have killed. Do I have your attention yet?

My Comment:

Forget politics and ideology for a moment, and look at healthcare from a business perspective, but ignoring the spin of the industry itself. To improve profits, you can either cut costs or increase revenue, or do both. Read More …

A Single-Payer Healthcare System for All Americans

Will Fisher Explains Single Payer With Jelly Beans

Watch Will Fisher Explain Single Payer With Jelly Beans (YOUTUBE)

For most of us, getting healthcare in this country is way too hard, as the video at the end shows. So to those in Congress who would make it even harder, I say, “Keep It Simple, Stupid,” with a single-payer system providing universal coverage and healthcare for all.

Because so few people know what single-payer is, Will Fisher uses jelly-beans to explain it. To begin with, single-payer is NOT where the government employs the doctors and directly provides the care. That would be single-provider care.

Will’s jelly-bean analogy shows how we currently Pay for care and the savings from a single-payer system. But read on to see why even Bernie Sanders’ Medicare-for-All plan, doesn’t go far enough to achieve the far greater savings potential I so often write about.
Read More …

Let’s Change the way we see Health Care

Rather than a Wall, America needs to build a Giant Mirror to reflect on what we've become.

Rather than argue over who pays for what and who gets health insurance or access to care, and who doesn’t, maybe we need to step back and ask different questions, starting with…

“Is basic health care a human right, or is it an earned privilege?”

And if people can’t afford it, does that mean they aren’t working hard enough, aren’t determined enough, or are just Losers and don’t deserve it? Read More …

When Caregiver Robots Come for Grandma

Failing the Third Machine Age: When [Caregiver] Robots Come for GrandmaWhen Robots Come for Grandma is a long and thought-provoking article by Zeynep Tufekci, published in 2014. It builds a case against “caregiver robots,” arguing that they are both inhumane and economically destructive. She got me thinking, and I hope this has the same effect on you.

I would have liked to add my own perspectives and contrarian view with links to related articles here at Modern Health Talk. I’d start with Will Robots Take Over in Health Care? Unfortunately there was no space to add comments, so I use her article as a basis for mine and hope you’ll share your thoughts in the space I give below. Read More …

FCC Broadband Health Imperative – how we responded

FCC Broadband Health Initiative - Modern Health Talk respondsAs a retired IBM technologist, market strategist, futurist, consumer advocate, and founding editor of Modern Health Talk, I am please to respond to this FCC action and will describe my background afterwards. What follows is the detailed docket (16-46) with my responses inserted and key points highlighted. Read More …

People Like the ACA, so it’s hard to Repeal. Here’s why.

It’s not surprising that so many people like the ACA (Affordable Care Act), and that it’s been difficult for Republicans to repeal.

ACA (Obamacare) versus AHCA

Here are 12 reasons people like the ACA (also known as Obamacare), along with detail in supporting charts that compare it with the Republican’s American Health Care Act (AHCA). Most of this work is attributed to The Century Foundation.

1.  The uninsured rate across all ages and income levels has fallen to the lowest level on record, thanks to the ACA’s health insurance exchanges, Medicaid expansion, and other provisions.

Read More …

Ask the Right Questions about Healthcare

Politicians Need to Ask the Right Questions about Healthcare (Photo credit: SupremePatriot.com)

By Wayne Caswell, Founder of Modern Health Talk

Politicians Need to Ask the Right Questions about Healthcare

In Healthcare: Mandatory Coverage or Universal Access?, Dr. Josh Luke presents one perspective – that of a hospital CEO. Readers should know that he represents the medical industrial complex, which also includes insurers, drug companies, equipment providers, and testing companies. Their collective interest is to protect the perverse profits that come from illness and injury, and the fee-for-service incentives that encourage ongoing treatment of symptoms. I found Dr. Lukes’ framing of the healthcare issue too partisan, so I had to respond. My responses form the basis of today’s posting.

What’s the DIFFERENCE between Universal Healthcare and Universal Access? Republican politicians have promoted Universal Access, confusing it with Universal Healthcare. Access, however, only means you can get health care if you can afford it. That’s like having the ability to buy a luxury yacht or summer home, but only if you have enough money to afford it. Progressives instead want Universal Healthcare, a concept I endorse here at Modern Health Talk. It’s efficient and what other advanced nations have. So let’s reframe the issue by asking different questions.  Read More …

American Health Care Act, a Summary & UPDATE

 

By Wayne Caswell, founding editor

UPDATE 3/24/2017 — Not enough Republicans agreed to pass the American Health Care Act, which would repeal much of Obamacare and kill thousands of Americans by leaving them without health care, so they pulled it.

UPDATE 3/24/2017 — Republicans in the U.S. House of Representatives scheduled a critical vote today but could not secure enough votes within their own party to pass the American Health Care Act. So Speaker Paul Ryan and and President Trump decided to pulled it. The bill to partially repeal Obamacare would partially fulfill a campaign promise and give tax breaks to wealthy benefactors, but it would also steal from the Medicare Trust Fund, gut Medicaid, and result in the deaths of Americans by leaving them without health care. Pulling the bill was a better option than facing angry constituents, 85% of whom were against it. Read More …

Healthcare as Public Utility

healthcare as a public utility - image of health care practitioner with handheld mobile deviceComputing functions once associated with PCs are moving back to big servers in the Internet Cloud, leaving mobile client devices to handle the user interface (UI) but not the data storage and analysis. I find this shift especially interesting, having grown up in the mainframe world at IBM as computing functions moved to PCs.

In the case of speech recognition and Apple’s SIRI artificial intelligence, even the UI function is now split between client & server. This has huge implications for healthcare, with IBM’s Watson and AT&T’s analytics engine aimed at different parts of the healthcare problem.

The networked mobile device (phone, tablet, etc.) will serve as a health gateway between a host of medical & environmental sensors and cloud-based services that collect & analyze the collected data. The benefits will not just target individual patients but be applied across large populations.

Read More …

Medical Errors versus Malpractice Lawsuits

Medical Errors versus Malpractice Lawsuits

With every legislative session, lawmakers seem to further reduce the rights of people injured by medical errors and malpractice.

Often described as a form of corporate welfare, Tort Reform makes it more difficult for people to file lawsuits and caps any award they get for damages. Some states even require the losing party to pay the court costs of the opposing party, making malpractice lawsuits extremely risky for individuals facing opponents with deep pockets. Read More …

Why Republicans Want to Repeal Obamacare

Robert Reich on Why Republicans want to Repeal Obamacare

Here’s what Reich says about an Obamacare repeal:

  • 32 million people will lose coverage, [23M-24M if replaced with Senate or House versions, per CBO]
  • Tens of thousands of American’s will die as a result (over 50 times as many as killed by terrorists),
  • Medicare and Medicaid will be left in worse shape, and
  • The rich will get richer in a massive redistribution of wealth.

Missing from this list, and discussed after the video, is what appears to be racist resentment of having a black President in the White House, no matter how qualified. Repeal is also pragmatic, because it helps Republicans contain a demographic shift works against them and maintain control of Congress, the Presidency and the Supreme Court. Read More …