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Healthcare Economics: Employers Incentivize Healthy Lifestyles With Penalties And Rewards

How do companies curb health care costs?

Do healthier employees lead to increased productivity?  Several progressive companies believe so and have committed to providing employees with programs to help engage them in a healthier lifestyle.

As part of the incentives to lead a healthier lifestyle some employers have instituted a penalty and reward system tied to the companies’ benefits.  For example, smokers may incur a significant surcharge to the cost of their health insurance plan while nonsmokers could see a reduction in cost.

According to an article in The New York Times, a growing numbers of companies including Home Depot, PepsiCo, Safeway, Lowe’s and General Mills are seeking higher premiums from some workers who smoke, similar to Wal-Mart’s addition of a $2,000-a-year surcharge for some smokers.

Escalating health care costs Read more »

*This blog post was originally published at Health in 30*

How ePatients Can Help Heal Healthcare

ePatient Dave, who shared his story (video below) with my students in the “Internet in Medicine” course this semester, is about to publish his own book: “Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer.”

Now three of his friends have written essays about this important issue:

We who’ve worked on it hope it will provoke thought about how healthcare is changing because of what e-patients can contribute, empowered as individuals and enabled by the Internet. To start that process, we’re publishing the introduction.

Three friends and mentors generously offered introductory essays. These essays they have little to do with my story, and everything to do with how e-patients can help heal healthcare:


My message to @Berci’s Medicine 2.0 course, March 25 2010 from e-Patient Dave deBronkart on Vimeo.

*This blog post was originally published at ScienceRoll*

Why Physicians Should Weigh In On Healthcare Reform

It’s interesting to see how different things are over at The Health Care Blog.  First, it’s different to have to write “health care” instead of healthcare.  I personally am all for not using up or resources by adding the space between the two words.  Ihaveconsideredeliminatingspacesaltogether, but it gets confusing.  Iwon’tdothat.

One of the big differences I see is the perspective of the readers and commenters.  I write here for a group of people I largely consider friends, cohorts, or at least sympathetic to my cause.  After all, people are coming here by their own volition (I assume nobody is getting this blog forced upon them as some sort of punishment, although that may be a bad assumption).  But the readers at THCB (as we insiders call it) are much more argumentative and much more likely to be “experts” in the area of healthcare delivery.  Certainly the other folks writing there are far more sophisticated than me (not that that’s a hard thing), and are much more well-read in the area of HC reform.  The debates in the comments section are quite stimulating, although sometimes you have to wipe a little blood off of your screen. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

New Media Summit: Matthew Holt, Dr. Roy Poses, And Me

I was a panelist at Edelman’s CHPA New Media Summit today in New Brunswick, NJ. Matthew Holt (of the Healthcare Blog and Health 2.0) was the keynote speaker, and I participated on a panel discussion with Dr. Roy Poses. It was exciting to meet Roy in person for the first time, as I’ve been following his policy blog for some time.

Matthew presented a very rosy picture of Health 2.0 (consumer-driven healthcare), more or less suggesting that it could provide a large part of the solution to our current healthcare crisis. I countered with a more cautious view, explaining that expert engagement would be critical to Health 2.0′s success.

Matthew argued that sites like Patients Like Me were enabling patients “to do their own clinical trials online,” and that this was opening a whole new avenue for research. Dr. Poses and I were fairly concerned about this suggestion, primarily because we understand how easy it is to draw false conclusions from data, especially when the data are not collected in a systematic fashion.

I explained to the audience that association does not prove causation (E.g. Do matches cause lung cancer? No, though it’s true that people who smoke are more likely to carry matches). I also described a case in which a Health 2.0 principle went terribly awry: a group of consumers were asked to rate their medications for efficacy by disease/condition. This was supposed to leverage the “wisdom of the crowds” to determine which medicines worked best (by popular vote). Of course, the result was that every pain syndrome (low back pain, headaches, fibromyalgia, etc.) resulted in a narcotic pain medicine as the highest ranked treatment option. Do you really need Oxycontin for that tension headache of yours? Obviously, narcotics are popular among users – but are a last resort for pain management in the real world. The “wisdom of crowds” rarely works in healthcare.

Matthew agreed to disagree with me on a number of issues – but we certainly found common ground on the primary care crisis. He and I both believe that a shortage of primary care physicians is going to result in a catastrophic shortage of care for Baby Boomers in the next decade. Dr. Poses added that primary care physicians make the same salary as school teachers in his home state of Rhode Island.

I think we have to agree with KevinMD – the way forward is not going to be pretty.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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