Health Populi marks 10 years with 10 milestones

A look back to the key themes the Health Populi blog has covered since 2007.
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Healthcare economist Jane Sarasohn-Kahn celebrates 10 years of healthcare blogging with a look at critical markers.

Happy anniversary to me…well, to the Health Populi blog! It’s ten years since I launched the blog to share my (then) 20 years of experience advising healthcare stakeholders in the U.S. and Europe at the convergence of health, economics, technology and people.

To celebrate the decade’s worth of 1,791 posts (all written by me in my independent voice), I’ll offer10 healthcare milestones that represent key themes covered from early September 2007 through today.

1. Healthcare is one-fifth of the national U.S. economy and the top worrisome line item in the American family’s pocketbook. You can read more about this in Health Populi from day 1 in 2007 to late August 2017 with more evidence that healthcare costs are top-of-mind for U.S. health citizens. For the immediate future, patients will assume a greater share of healthcare spending given employers’ growing adoption of consumer-directed health plans – high-deductibles coupled with health savings accounts.

2. The Affordable Care Act worked to get health insurance to millions of uninsured Americans. But there is more work to do, and this week Congress re-convenes with some evidence of green shoots of bipartisan cooperation to fix, not repeal, the ACA. American workers highly value their health benefits, well-knowing how much it could cost them to fetch health plans on the individual market. As President Trump recently cut the Federal ACA budget for communicating health insurance marketplace options, the U.S. faces a situation where the nation’s President may be mindfully contributing to Americans’ reduced access to being health-insured by reducing access and on-ramps to consumers’ needed information. But state and local insurance navigators are working to fill this gap.

3. Sticker-shock is a mainstream reaction for American patients who fill branded prescription drugs. The course of a drug treatment to cure Hepatitis C reached $98,000 in 2014. The retail price of an EpiPen, $500 in 2016, driving angry patients in New York City to protest in front of Mylan’s offices. The latest entry into the pharma cost Hall of Fame is Kymriah, a new-new gene therapy treatment for treating young people with acute lymphoblastic leukemia, approved by the FDA last week. ALL is the most common form of cancer in young people. The list price will be $475,000 for a one-time treatment. Lowering the cost of prescription drugs is one health reform issue Americans across the political spectrum agree on.

4. Most patients’ personal health information has moved from manila paper folders with hand-written notes to digitized, electronic health records. Most patients want to connect with their physicians using digital means, but privacy concerns remain. Trust must be earned to garner health engagement, as I recently discussed in light of Aetna’s breach of peoples’ HIV status in a mailed letter. Still, we know from research via the PatientsLikeMe community and other patient social networks that people managing serious diseases are willing to share personal health information when there is a value-exchange.

5. More personal health information is being generated through wearable technology. In the past decade, I’ve attended the annual Consumer Electronics Show. Beyond big-screen TVs and tricked-out cars, one of the fastest-growing areas at CES is digital health. While Fitbit wrist bands and Withings Wi-Fi scales represented the early generation of wearable tech for health (or mHealth), shiny new things are emerging via Apple Watch and heart-activity enhancements that are gathering data that’s getting stored in clouds (Amazon Web Services and Apple to Samsung and dozens of others). Data are mashed into algorithms that can then inform patients, consumers, caregivers, and clinicians to coach and inform decisions.

6. Beyond wearing tech, our homes and autos (the so-called “third space”) are getting filled with “things” in the growing Internet of Things environment. Light bulbs, washing machines, refrigerators and, of course, voice-powered digital assistants (THINK: Amazon Echo and Alexa) have begun to collect data on our daily habits, and health is already growing its IoT chops.

7. Virtual health and telehealth passed a tipping point for adoption. This very minute as I write this post, telehealth technology is helping thousands of people in Texas hurt by Hurricane Harvey get needed healthcare and medical attention sooner rather than later.

8. Health is social. Health is contagious. So are negative health behaviors. The research of Christakis and Fowler published in their book, “Connected,” demonstrates people can kick-off a virtuous cycle of health for themselves that influences not only their immediate social network of friends and family, but positively influences their networks further out in the social web. This is at the root of public health: we are our brothers’ and sisters’ keepers, and this is the evidence for why social determinants of health are so powerful in communities. Loneliness is also a social determinant of health, as I wrote here about new research into our purpose and our wellness.

9. Health disparities continue to mar American healthcare. People of color and lower-income people have worse health outcomes, and for many conditions and procedures, less access to the latest evidence-based standards of care. This year marked 50 years since the 1967 Detroit riots, and 70 years since the Nuremburg Code emerged. Healthcare in the U.S. must confront these health inequities and bring greater “health symmetry” to all health citizens in the nation. Aside from issues of justice, a healthy citizenry is a productive one that generates tax revenue for a nation.

10. Patients are morphing into healthcare consumers, seeking transparency, management tools, information, and support from both health industry players and from each other, in peer-to-peer networking. Amazon has ‘primed’ healthcare customers and will be taking its place among the new entrants helping to improve peoples’ healthcare experiences. Consumers’ most recent excellent experience in retail defines their current benchmark for expectations in all sectors –including healthcare.

This blog was first published on Health Populi.

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