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 …

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 …

Getting Disability Benefits as a Caretaker

Getting Disability Benefits as a Caretaker

By Bryan Mac Murray, Outreach Specialist, Social Security Disability Help (Not affiliated with Social Security Administration)

Applying for Disability on Behalf of Someone Else

The Social Security Administration (SSA) knows that disability applicants are not always physically or mentally able to complete the application themselves. For this reason, there are processes in place that allow a caretaker to apply for Social Security disability benefits for someone else. Read More …

What is a Sleep Economist?

The Sleep Economist

By Wayne Caswell, Founder of Modern Health Talk and Sleep Economist at Intelligent Sleep

What is a Sleep Economist?

I’m a sleep economist. At least that’s how I present myself when I talk about the economic impact and benefits of sleep, and the science of Intelligent Sleep. But what does that mean? Let me explain.

According to the CDC (Centers for Disease Control and Prevention), “Insufficient Sleep is a Public Health Epidemic,” and getting enough sleep is an absolute necessity, not a luxury. They also say sleep quality should be thought of as a “vital sign” of good health because of the many ways it impacts us overall. Read More …

Smart Elder Orphans Prepare for Aging Stages

Asian woman is an Elderly Orphan living alone but with a plan for future care needs. She's an example of how to prepare for aging stages.

Image source: Huffington Post

By Carol Marak, Aging Advocate and Senior Care Contributor (original at Huffington Post)

This article about “Elder Orphans” is the second in a series, describing how to prepare for aging stages by first knowing what they are. If you missed the first article, here’s your chance.

I got interested in creating and sharing my own plan with Huffington Post readers after reading umpteen studies of senior isolation and how the harmful effects devastate our mental and physical health. Living alone suits me but isolation certainly does not. That’s why at age 64, I think a lot about my latter years. But doing that is a challenge, and even the renown geriatrician, Dr. Bill Thomas, admits to the misconceptions of aging.

Humans have a limited ability to predict accurately or even imagine the needs of their future self. That’s especially true when the future has scary possibilities.[EDITOR: See my collection of Famous False Predictions.]

However, if I don’t want to be stuck in suburbia away from social connections, an amped-up imagination is needed, with helpful tips from readers like you.  Read More …

Elder Orphans living alone need to avoid social isolation

Seniors living alone and socially isolated are Elder Orphans.

Source: Huffington Post

By Carol Marak, Aging Advocate and Senior Care Contributor (original at Huffington Post)

Seniors living alone and socially isolated are Elder Orphans. The deeper my age propels into my senior years, long-term care planning cannot delay. This is the first of a series on how I plan to avoid the problems of elder orphans. Like most over 60 years of age, we haven’t planned well, and adults like me who live without a spouse or children cannot afford to put it off. Even my parents delayed making arrangements. But they had four children they could rely on for care. I don’t, nor does my sister or many of my friends. But since I work with aging experts at SeniorCare.com, there’s no excuse to let the loose ends dangle. Read More …

The Financial Costs Of Moving Home

The Financial Costs of Moving Home

By JP Adams

Many family caregivers consider moving close to a loved one or parent as they become older. There they can help with cleaning, getting groceries, and driving to doctors’ appointments. Most importantly, this gives them and their loved ones an opportunity to connect.

At the same time, the decision to move home can be challenging. I often hear mixed feelings from families – “I’m not sure if it’s something I want to do,” OR “I want to be with her but I don’t really like the area where she lives.”

One thing is overwhelmingly clear.  Moving home is a significant financial decision. There are costs and benefits.  It’s important to go through each and make a rational decision.  Read More …

Patient Choices in the Used Car Lot of Healthcare

Used Car Salesman

Guest essay by Chris Oldenburg [with editor’s comments at the end]

In America we love our choices. Drive by any car lot and you might see 10 models that only differ in exterior color. We also love simplicity and service. Those cars had better have a clear cost taped to the windshield right next to a list of what’s included. Read More …

The 10 Best Cities for Technology-Assisted Living

by Christin Camacho, PR & Content Manager, REDFIN, a next-gen real estate brokerage

The National Conference of State Legislatures and AARP Public Policy Institute report that nearly 90 percent of people over the age of 65 want to stay in their home for as long as possible. [See below for brief summary.] Fortunately, in most cases, they won’t have to move as they age. According to Seniorly, a service that helps people find senior care, the majority of seniors do NOT need to move into a nursing home. They simply need some care equivalent to what they would find in an assisted living community, which includes assistance with daily activities like meals, medication, housekeeping, bathing and transportation.

And these days, there’s an app for that. An elderly woman can take an Uber to her friend’s home, find someone to walk her dog through Rover.com, schedule her lawn to be mowed or her house to be cleaned through Porch, get groceries delivered through Instacart, and schedule a professional caregiver to assist with bathing, meal preparation and other daily living activities through CareLinx. Or, for those seniors who aren’t tech-savvy, friends and family can use these technology-based services to arrange care for them. Read More …

The End of Moore’s Law? Don’t Bet on it.

Digital MindIn Moore’s Law and The Future of Health Care, I offer a vision of healthcare based on exponential advancements in tech innovation as described by Gordon Moore. Moore is an Intel cofounder and is credited with observing that computer circuits have shrunk in size and doubling in compute capacity every two years. Moore’s Law is what drives down costs & size, but that logarithmic trend is not easy to grasp. So let’s look at two analogies explaining a 60,000 improvement in cost and 90,000 improvement in speed since Intel started tracking computer chips in the 1960’s.

COST — If the price of cars and gas improved exponentially at the same rate as computer chips, we’d be able to buy a new car for about 8-cents today and would only spend 2-cents per year on gas. At that rate, cars would be disposable, and we might just buy a new one for each trip, as a fashion accessory matched to our outfit.

SPEED — If the speed of air travel advanced at the same exponential rate as computing, today we’d be able to fly from the U.S. to Japan in less than a second, but the plane would be just over 1-tenth of an inch long.

Industry analysts keep predicting the end of Moore’s Law, arguing for many reasons that computer chips can only get so small or so cheap, and today I responded to another article about The End of Moore’s Law. Here’s my response, which shows optimism from my 30 years at IBM (I retired in 1999) and my interest in technology as a futurist. Read More …

The Cost of Aging in America

 

Income levels for aging Americans are increasing,
but not as quickly as “The Cost of Aging in America.”

The infographic below was produced by the Milken Institute School of Public Health at George Washington University. It explores the serious financial burdens faced by aging Americans, their loved ones, and industry — as well as steps our health care system might take to counteract this trend. I gladly feature it today to complement other articles here about health reform, public policy, and the future of healthcare.

Some highlights:

  • The number of seniors 85 and older will triple by 2050, an important statistic because these are people who need the most expensive care.
  • The cost of healthcare in America is already over $3 trillion/year, and that doesn’t even include the roughly $450 billion provided by unpaid family members.
  • Paid caregivers earn just $18-20K per year, and while demand for their services will likely double by 2022, their wages likely won’t increase much.

Read More …

Investor Look at 2015 Healthcare Opportunity

Bull MarketEditorial by Wayne Caswell

While I’m not a financial advisor or Wall Street analyst, I took issue with a MedCityNews article by Paul Beckley, “An investor’s 2015 healthcare roundup.” In short, he said to “BELIEVE in the business of health.” While I’m bullish on the future of healthcare, I sure hope he’s wrong, because the amount Americans spend on healthcare needs to go way down, not up. Here’s my reader comment and investor advice.

Beckley’s article bills Healthcare as an immensely profitable industry. It is, because it brings in $3T/year. But since that’s twice what other nations pay per person, yet we still live sicker and die younger (per the World Health Organization), investors should prepare for some very big losses in my view. At least that’s what I hope happens, and while it may not be good for clueless healthcare investors, it would be immensely good for the economy.

Our nation should “theoretically” be able to cut overall costs in half (like $1.5T/year) with health reform, digital innovation and new business models and still improve outcomes. There will be many winners among the innovators, but there will also be a great many losers who aren’t insightful enough to see the handwriting on the wall or quick enough to adapt.

As Charles Darwin said, “It is not the strongest or the most intelligent who will survive but those who can best manage change.”

That, and the fact that 429 of the original Fortune 500 companies [1955] are no longer in business today, is a scary thought for those sitting at the top of the healthcare mountain. They know they must adapt to health reform die, and they’re looking down with fear at hungry innovators who are already exploiting the many healthcare MiniTrends and their important intersections. For those innovative entrepreneurs, these are times of great opportunity, and they’re climbing up the mountain.

See 101 MiniTrends in Health Care. It’s a “must read” for investors and entrepreneurs looking at the 2015 healthcare opportunity.

How Much does Caregiving Cost?

Nearly Half of Family Caregivers Spend
Over $5,000 Per Year on Caregiving Costs

30% Spend More than $10,000 Per Year, 21% Don’t Know How Much They Spend

Caregiver Costs

San Mateo, CA; September 15 2014 — Almost half (46%) of family caregivers spend more than $5,000 per year on caregiving expenses, according to a new Caring.com report. A family caregiver is defined as someone who takes care of a family member or friend, but is unpaid for their services. Their caregiving expenses include out-of-pocket costs for medications, medical bills, in-home care, nursing homes and more. Read More …

Reframing the Question of Doctor Frustration

Frustrated DoctorBy Dr. Stephen Schimpff

Editor: I just love this doctor’s thinking and have published several of his articles here. I’m happy to feature another one from HealthWorksCollective.

There has been a lot of interest in the Daily Beast article written by Dr Daniela Drake, about very frustrated primary care physicians (PCP.) She quoted both Dr Kevin Pho and myself. Dr Drake noted that nine of 10 doctors would not recommend medicine to their children as a career and that 300 physicians commit suicide each year. “Simply put, being a doctor has become a miserable and humiliating undertaking.”  Dr Pho offered his own commentary here pointing out that “it is important to have the discussion on physician dissatisfaction….demoralized doctors are in no position to care for patients…To be sure many people with good intentions are working toward solving the healthcare crisis. But the answers they’ve come up with are driving up costs and driving out doctors.” Read More …

Managing My Costs of Care [ESSAY]

MedicaidDollarsManaging My Costs of Care is a well-written essay by Jay Warner.

I recommend it, because this one example shows just how easy it “should” be to cut healthcare costs in half to get down to what the rest of the world pays — for better care and outcomes — and save $1.5 trillion/year. It all comes down to getting the incentives right, because with employer-provided health insurance, Jay had no incentive (or ability) to comparison shop. Now he does.

The healthcare landscape is changing as payers pressure providers for more price transparency and seek other ways to contain costs and maintain profitability now that they can no longer cherry-pick the healthiest customers or cut them off when care gets too expensive.

Other disruptive changes include remote sensor monitoring (telemedicine) that can follow trends and identify problems earlier, remote consultations (telehealth) that can replace in-person office visits, medical tourism when it’s less expensive and has better outcomes than local surgeries, and an overall shift away from the fee-for-service insurance model. That model once served as pre-paid medical care, but now payers are starting to view insurance as protection against catastrophic illness and injury with consumers paying for the small stuff out of pocket. With that trend comes two others: (1) increased competition and (2) an increased focus on overall health and wellness, including nutrition, exercise, and sleep as it’s pillars.

A side benefit of wellness, beyond dramatic reductions in health care costs, is improved safety and performance. Restorative sleep, for example, is associated with improved alertness, attention, creativity, decision-making, focus, learning ability, mood, reaction & recovery times, and working memory, all of which contribute to better grades at school, better productivity at work and in sports, and fewer motor vehicle accidents and deaths.

Public Health in 2030, alternative scenarios

Least Desirable ScenarioBy Wayne Caswell

As a retired IBM technologist, health consumer advocate, and amateur futurist, I’ve often written about The Future of Healthcare and highly recommend this report by the Institute for Alternative Futures.

Public Health 2030: A Scenario Exploration is supported by funding from the Robert Wood Johnson Foundation and the Kresge Foundation and presents alternative futures to help shape decision-making and public investments in a preferred version of the future while avoiding things that would lead to a less desirable version. Read More …

Poverty in America — living below The Line

The Line is an important documentary that covers the stories of people across the country living at or below the poverty line. They have goals. They have children. They work hard. They are people like you and me. Across America, millions are struggling every day to make it above The Line.

As shown in the Stats below and the accompanying infographic, poverty is a drag on the economy that also affects the cost of healthcare, as I’ve written before in this blog. Read More …

Medical Tourism is a Growing Trend

Medical TourismToday’s short post features my response to a Forbes article by Dr. Robert Pearl, Offshoring American Health Care: Higher Quality At Lower Costs?, about the Cayman Islands, which are known for inviting coral-sand beaches, laid-back island culture and tax-free status.

Medical Tourism is a growing trend

This trend is not just in the Cayman Islands. Over 8 million people worldwide, and 1.3 million Americans, cross international borders for better and cheaper care. That trend will increase as insurers offer low-cost policies with high deductibles that encourage consumers to seek the best value in health care and lifestyle decisions. Read More …

The Underestimated Caregiver Burden

The number of family caregivers is declining.By Henry Moss (original at American Society on Aging)

Caregiver burden is emotional and subjective. We try to measure it by looking at rates of depression and anxiety disorders in the caregiver population, and at the seriousness of these disorders. We know the highest rates of emotional burden and the deepest levels of depression are felt by caregivers who experience entrapment—a sense of powerlessness, aloneness and suffering associated with long periods of caregiving for the most difficult elders, especially those with dementia. We are aware of the many studies showing how excess stress and emotional burden can impact a caregiver’s health, finances and family life, creating even more anxiety and depression.

We already know that the 45- to 64-year-old population will grow only 1 percent between 2010 and 2030, while the age 80 and older baby boomer population increases by 79 percent. As the age 80 and older baby boomer cohort grows, the number of family caregivers available to assist them drops dramatically, from 7.5 in 2010 to 2.9 in 2050, a more than 50 percent decline. Alarm bells have been going off and researchers and advocates have been busy estimating the impact on the long-term-care system. Read More …