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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

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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