Why American Health Care is So Expensive

[Private] Health Spending as share of GDP

This video by Vox and Ezra Klein explains why American health care is so expensive, and it does so simply and effectively. It mentions each of the top issues I write about here at Modern Health Talk, including the political influence of a medical cartel that profits from treating illness and injury with a fee-for-service business model.

The video gives me an opportunity to highlight the many issues contributing to our high costs, with a short description and reference articles for each.

  1. There’s No Easy Fix
  2. Market Forces Don’t Work in Health Care
  3. A Medical Cartel Influences Public Policy
  4. Direct to Consumer Advertising Influences Public Attitudes
  5. Incentives are Misaligned with Goals
  6. Health is Not a Policy Objective but a Political Weapon
  7. Inequality affects Health Wealth, Opportunity & Influence
  8. Single-Payer is Not Enough
  9. Public Health Programs are Effective
  10. Medical Schools teach Diagnosis & Treatment, not Prevention
  11. Disruptive Business Models Break From Fee-for-Service
  12. Tech Solutions Define the Future of Healthcare
  13. Aging Populations Stress Support Systems
  14. Important Documentaries

Read More …

Inequality, Healthcare and the Economy

Wealth Inequality in America

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 that threatens our democracy. After a Washington Post article concluded that People have no idea what inequality actually looks like, revised and republished this article, which I’m again revising today. 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 …

Shouldn’t Health be Primary

Health is PrimaryAmerica’s Family Physicians are promoting Health is Primary, a communications campaign that reflects the values of family medicine, puts patients at the center of their care, and aims to improve the health of all Americans, as well as costs. The Washington Post last week carried their sponsored article about A Health Care Solution We Can’t Afford to Ignore: PRIMARY CARE.

These physicians are apparently frustrated by Congress and partisan politics that is so toxic to our healthcare system, and our health. The United States is known to spend twice as much per capita as other advanced nations on healthcare, but with worse outcomes, so I’m happy to see this organization expand the debate beyond just how to PAY for care and who bears the burden. I’m glad to see their goal of actually improving wellness and care delivery, because even Benjamin Franklin knew that “An ounce of prevention is worth a pound of cure,” and that was two centuries ago. Read More …

Is Health Care a Right or a Privilege?

Is health care a right or a privilege?

It’s easy to ask, “Is Health Care a Right or a Privilege,” but to answer the question we must dig deep into our souls and understand the plight of others.

I like to think I’m a compassionate person, able to empathize with others born into the wrong family or environment, and even those who just didn’t get as many breaks in life that I did, but it’s not always easy.

I also think sometimes about what it must be like for those living a life of privilege. That’s why the video featured here had such an impact on me, and I hope on you too. It directly relates to our political debates over healthcare and other social issues too. Read More …

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 …

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 …

Tissue Nanotransfection can Heal Organs with a Touch

Tissue Nanotransfection can Heal Organs with a Touch

According to this article at MedicalXpress.com

Researchers at The Ohio State University Wexner Medical Center and Ohio State’s College of Engineering have developed a new technology, Tissue Nanotransfection (TNT), that can generate any cell type of interest for treatment within the patient’s own body. This technology may be used to repair injured tissue or restore function of aging tissue, including organs, blood vessels and nerve cells. 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 …

10th Apple iPhone Anniversary and Computing Progress

Apple iPhone - 10 years later Before Steve Jobs died, he introduced the Apple iPhone at the Macworld convention in January 2007. The first iPhone units actually shipped to the public on June 29, 2007, so today marks the 10th iPhone anniversary.

This is a good time to look back on the past and project ahead to the future of tech-enabled healthcare. That future will be driven by the exponentially accelerating pace of tech innovation that we call Moore’s Law. Intel co-founder Gordon Moore first observed the trend of circuits and components getting two times smaller, faster and cheaper every year or two.

In Moore’s Law and the FUTURE of Healthcare, I explored that trend and the eventual blending of science and technology (INFO + BIO + NANO + NEURO). We’re already seeing the effects, with the ability of many doctor functions to move down-market from hospitals & clinics to consumers at home. A continuation of that trend will have a profound effect on future healthcare, as I’ve already written about many times on this blog. Future-MooresLaw

In my Moore’s Law article I described the IBM System/370 Model 158-3 mainframe computer that I worked on in the early-1970s as a computer operator. It cost about $3.5M, required a large computer room, and consumed so much electricity that liquid cooling of the processor was needed to supplement room air conditioning. I compared it to an iPhone 4S, which then had 100 times more memory, was thousands of times faster, and had wireless access to the Internet, running on batteries.

We often take for granted how much compute capacity we carry in our pocket — more than it took to land a man on the moon — so as we imagine the future, it’s helpful to reflect on just how far we’ve come, and how fast. 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 …

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 …

Wall-E, End of Work, and Universal Basic Income

EDITOR’S NOTE:  I’m reposting this article with new information from a U.N. report that warns countries to prepare for the day when technology, automation, and artificial intelligence replaces jobs. They expect 75% of the world population to become unemployable, and that day is coming sooner than most people realize. It will have immense social consequences.

Wall-E is a fun & warm-hearted animated movie by Pixar that also warns against ignoring environmental pollution and the obesity epidemic. It presents future humans as super-obese couch potatoes living in a robot & technology-dominated world set some 700 years in the future. By then, mankind had so completely trashed Earth’s environment that humans were forced to relocate to spaceships and evolved into large, floating fat blobs – the Axioms.

But the future doesn’t have to be as foretold. We learned that from the classic movie, A Christmas Carol. By knowing the risks of possible futures that our current behavior may take us to, we can change. We can change course to save the environment, improve our health & well being, and find solutions to wide unemployment.

I hope you enjoy the video clips below, as well as the additional links and discussion that follows.

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 …

US Healthcare System has Cancer. Can Trump Fix it?

By Wayne Caswell, founding editor, Modern Health Talk

Dr. Sudip Bose says, "The epicenter of health care is the doctor-patient relationship."

Opening his January 16, 2017 Huffington Post article, Dr. Sudip Bose said, “One thing is certain about the future of Obamacare, and that is that it will change under a Donald Trump presidency.“ Given his public statements, Trump will clearly make sweeping changes sooner than later, but what those changes will be is anything but clear. That’s why today’s article describes what I hope for, if not what I expect.

The US healthcare system has cancer – a malignant form that started way before Obama became President, and it has taken decades to grow to its current condition, where our very existence is threatened. It’s my hope (remember Hope & Change?) that healthcare reform under Trump will not just treat the symptoms of a growing healthcare cancer, like the lack of insurance competition or price transparency. I hope Trump will recognize the need to treat our healthcare system’s cancer aggressively, naturally and holistically. Will he? Read More …

The Big Heist – Become a Benefactor

The Big Heist, a satyrical documentary about our broken healthcare systemYou can be part of History by becoming a benefactor of The Big Heist, at any amount. This documentary-in-process is a satirical, follow-the-money film about healthcare, the status quo, and efforts to fix our broken system from the ground up.

The Big Heist blends the comedy & parody styles of ZDoggMD and The Daily Show — to entertain and educate with the goal of transforming the public’s understanding of our nation’s healthcare system, along with the causes of its dysfunction, and how to truly fix it. This has been my personal passion since founding Modern Health Talk five years ago. I’ve already published over 100 articles on different aspects of healthcare reform public polity, sharing my own technical & futurist perspective and insights, and I love hearing other viewpoints with similar aims. Read More …

Are Crypto-Currencies Safe?

Here's a Bitcoin - at least a representation of one since they're actually electronic

Here’s a Bitcoin – at least a representation of one since they’re actually electronic

Last week Yvonne and I closed on the sale of our Austin home and the purchase of another home in the Dallas area. The process was simpler than I remember from the past, and since we paid cash for the new home, we didn’t even need a notary. I just downloaded a few forms, signed them on the kitchen table, scanned into the computer, and sent them back to the Title Company through a secure email service. This experience foretells the future, but are crypto-currencies safe? Really safe?

The US Department of Health and Human Services (HHS) is soliciting research papers related to blockchain applications in healthcare. Blockchain is the enabling technology behind BitCoin and other crypto-currencies, and it’s catching on fast — maybe too fast. Judge for yourself. Read More …