Diet and Nutrition. Natural Health, and Healthy Living

Recently, a somewhat starry-eyed op-ed in the New York Times suggested that a $100 billion annual investment in universal health care is just the medicine that our economy needs. The goal, declared Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology: “Covering every American.”

It is an appealing proposition. But let me suggest that we cannot blindly invest billions in an already bloated health care system. We need to think through where we want the reform dollars to go. Which sectors of a $2.3 trillion health care economy should we stimulate to insure that patients receive the safest, most effective care at a price that they can afford?

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The New York Times published a story this month about one of the biggest medical trials ever organized by the federal government, a study that showed that the newest, most expensive drugs used to treat high blood pressure (a.k.a. hypertension) work no better than inexpensive diuretics—water pills that flush excess fluid and salt from the body. Moreover, the research revealed that the pricier drugs increase the risk of heart failure and stroke.

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Health care costs in the U.S. are approaching 17 percent of the GDP and may be as high as 20 percent in the next few years.

What is causing the US to have the highest cost and lowest value for the healthcare dollar? Simple - it's overtreatment.

Overtreatment takes many forms - from over ordering expensive diagnostic tests to the prescribing of expensive and sometimes unneeded therapeutics.

There are many reasons for this. Here are just a few:

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This post came as a comment by SR to Dr. Kibbe's piece on electronic medical records. It's a great consumer perspective and worth reprinting in full. -- THCB Staff

Health Care consumers and patients have a wide range of interests, needs and values that vary across our lifespans and circumstances and hopefully there will be many different tools, products and services provided to both providers and users of health care.

For example, my 70-year-old retired father is the head of a neighborhood wellness program with over 3,000 people and maintained a family blog during my mom's cancer treatment but doesn't own a cell phone and would rarely change physicians despite differences in quality. I am rarely ill, and yet expect SMS alerts if a lab test is done and want my clinical records to link with my Nike tracker in my shoe as well as apps on my Iphone.

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Today is the Great American Smokeout, and while San Franciscans are doing their part to help people battle nicotine addiction, I became aware recently that not all the health insurance plans for our county workers in San Francisco -- nor in many other counties around California – were covering all of the smoking cessation benefits recommended by the Center for Disease Control.

The City of San Francisco has embraced a multi-faceted approach to reduce tobacco use, while protecting individuals from insurance coverage barriers as they battle their addiction to nicotine:

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Our IxAction Alliance focused our monthly IxInsights Webinar this week on the synergies between Health 2.0 and information therapy (Ix). This marks the first of a series of activities for the IxCenter on the H20-Ix intersection as we gear up for next spring’s “Health 2.0 Meets Ix” conference in Boston (April 22-23, 2009).

In today’s Webinar, Indu Subaiya, Matthew Holt, and I provided some context for the exploration of the intersection of these two movements. We focused on several key tensions and challenges including:

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Big pharma has big problems. The root cause is a lack of research and development productivity, which means a dearth of new products to make up for looming patent expirations. Something near half of big pharma’s revenues will be threatened by generic competition within the next three to four years, and that will radically change the face of the industry.

The R&D productivity problem isn’t exactly new. When I was at the Boston Consulting Group (BCG) in the mid-90s we were already talking about the “NCE gap,” which referred to the number of new chemical entities that needed to be developed to justify pharma companies’ valuations at the time. Back then, there was still a possibility that new discovery tools would boost productivity and prevent a collapse of the industry.

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In this interview on “The Business Case for Health 2.0," Ken Shachmut, Senior VP Strategic Initiatives, Health Initiatives, and Health Re-engineering at Safeway, shares is thoughts on some of the highly impressive results that the company has obtained by introducing market-based health plans.

SS: Ken, thanks for making time today. Tell me a little about your background?

KS: I have been active as an executive and management consultant for over 30 years. I graduated from Princeton in Engineering and later obtained my MBA from Stanford. In consulting, I worked first with McKinsey & Company, later at Booz Allen Hamilton, and for awhile independently. I had done some consulting for Safeway. I later joined Safeway and have been there the last 15 years in various capacities.

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The stage is down, the cameras are gone, more than1,000 people have headed home (other than the 50 or so at the Healthcamp which is happening right now)

some reflections in stream of consciousness fashion….

I think I know why so many people at the un-conference were crowded around the topic “Pharma & Social Networking” (there’s a crowd of companies looking for support and a crowd of Rx companies….….in the breakouts I was amazed that Wellness 2.0, Gaming,& Social Networks had a couldn’t-get-in-the-door-crowd, while Genomics (with many more millions in VC) was much emptier……I loved the videos showing how wild people got at the IDEO session and it was fun to hear Doug Solomon tell the tale……we put our trust in James Mathews (as did his panelists) and, boy, was that repaid—what’s happening outside the US is amazing and James is too…..why is Jon Bush running Athenahealth and not a full-time stand-up comic (props to Chris Lawton for somehow managing to “interview” him!)….how come at the wrap up panel it was five guys allwith beards?…..we did lots and lots of preparation for all our demos (thanks Jen!), but we could and should have done more—and demanded more from some presenters. But the ones who demanded the most from us had many ofthe best demos (yes, Yael & Elif, I do mean you!)…..the exhibit hall was indeed buzzing, rocking, anda hive of exchange—everyone I spoke with said that they had more partnership and customer leads than they could follow up with…..I was stopped by two people who had real live Health 2.0 experiences, theirrelatives went into hospital during the show, they sought out Health 2.0 companies (PharmaSurveyor was one, DoubleCheckMD another) and stopped mis-diagnoses in its tracks—this dam is bursting and will burst wide open as these clinical tools for consumersget better and better……and then I got this email “How do we keep a breast of H20 developments between conferences? It would be such a drag to miss out.” Can’t imagine what that’s referring to……..But the answer is to use the Health 2.0 Networkto keep in touch with everyone else….and of course please remember to download the One Slide from Engage with Grace (we won’t mind you crying when you see the soon to be upAlex Drane’s speech, everyone else did….)

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Thank you to The Health Care Blog for this opportunity to share my patient’s perspective on health care and how it has helped shape my new book, Original Faith: What Your Life Is Trying to Tell You. I should mention at the outset that the book speaks to human experiences and actions, not doctrine. It argues neither for nor against any form of religious belief.

My progressive illness began with the sudden onset of what was misdiagnosed for several years as Myofascial Pain Syndrome. Despite eleven years of research and medical travel, no diagnosis was ever reached. For the past several years I’ve been housebound, increasingly bedridden and essentially without access to medical care related to my condition, which includes severe peripheral neuropathy and osteoporosis, connective tissue degeneration, and special adaptive needs. My situation may be a good starting point for considering the cracks – or crevasses – in the system.

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