By Glenna Crooks. I came of age in the “Keep on Truckin” era and like many boomers, intend to do so for decades to come. I like my independence (!) and my own desires pale by comparison to my Mom’s – who’s into her 80’s and still running circles around me.

The day may come, however, when our family may need to provide her with the support I see my friends providing to their parents. Some individuals who would like to be more independent, can’t be. The enabling systems to allow that aren’t sufficiently well developed and public policies haven’t yet caught up with the needs of older people and their family caregivers.

That’s why just a few weeks ago Disruptive Women launched Health In Place. This blogsite reported on the launch event. I recommended it as reading to catch up on and a movement to follow – and better yet, engage in.

Perhaps it was HIP that raised my own awareness and made a very small article news article jump off the page over the holidays.

It was about the Aetrex GPS Shoe (www.aetrex.com/aetrex-gps/), which uses GPS tracking technology embedded in the right heel to do real-time tracking of the wearer.  GPS tracking sends a signal to a central monitoring station to show the wearer’s location and relays that information to a tracking website for monitoring by caregivers.

Even better, caregivers can set up a geographic boundary known as a “geozone” and if the individual wanders off and leaves it, are notified via an email or SMS text to a mobile phone. Caregivers can also get emergency tracking in case they need to locate a loved one immediately.

What a wonderful application of availably technology to health and caring. I’ve written extensively about the nature of healing and healers and how our traditional definitions (which restrict “healers” to those in clinical roles) are narrow and no longer sufficiently embracing of the variety of those who contribute to our health and care.

I’m not sure if the folks at the GTX Corporation (www.gtxcorp.com) believe they are healers, but in my book, they are. Bravo to them for what they’re doing to contribute to lowering costs of care, lowing the risks associated with family caregiving and improving the quality of life for those involved.

By Glenna Crooks. Industries have outsourced jobs, sometimes within the US, sometimes outside. It’s a strategy some say is necessary and some find abhorrent. Others warn it has short-term attractions but long-term negative consequences.  

As it turns out, we not only outsource jobs, we outsource problems. A paper in the Journal of Personality and Social Psychology reviews a number of studies about how adults react to complex social policy issues. Though health issues were not included in the research, surely these qualify – they’re complex and involve social policy, as well.

According to the authors, people – including those who are college educated – react to information differently depending on whether the issue is simple or complex.

If an issue is simple, people are willing to learn more, ‘take charge’ and act on what they know. When the issue is complex, however, people avoid learning more. Rather than learning or taking personal actions, they ‘depend on’ and ‘trust in’ government to do it.  They even avoid information suggesting government can’t do it, and only focus on information that government can. 

If the issue was not only complex but also ‘urgent,’ people are even more reluctant to learn about it.

The authors were stunned, saying all things being equal we should have less trust that someone, anyone (including government) can manage a complex issue. Instead, the studies suggest we psychologically ‘outsource’ management of complex issues to someone else.

It happens in health care often, when management of serious disease is outsourced to the clinician or when a person fails to use reasonable self-care measures believing that the health care system will fix whatever eventually ails them. Apparently it also happens in the case of social issues, in which case we outsource to the government. To make matters worse, not wanting to shatter our faith in government, we shun information that suggests the government can’t manage it. (more…)

By Glenna Crooks. Soldiers returned from modern-era wars addicted to medicines used to treat the pain of their wounds. Society has been fearful of the power legitimate medicines can have on the unwary ever since.

Over the years, solutions to this problem were placed in the hands of law enforcement, which, among other measures, monitored physicians to assure they were not enabling existing addicts or creating new ones. Later, pharmacists were monitored as well and soon became engaged in measures of their own to prevent abuse. Recently, under the guise of patient safety, FDA joined in.

Intrusions led physicians to fear prescribing pain medicines for legitimate medical purposes and warned pharmacists away from essential community-based pain management. Law enforcement and regulatory barriers made it more difficult—even personally threatening and certainly more costly—for them to do so.

Isn’t it ironic that the law and the healing arts should clash? Early civilizations considered both to have been gifts from God. Both were intended to serve man, not to victimize the most vulnerable. Yet, today’s clashes have done precisely that, and jeopardize those in pain.

Those near death for whom society should have the most compassionate response have been harmed as a result. They have immediate needs that, in some cases, only powerful medicines can help.

Unrelieved pain takes a terrible toll on patients and their loved ones. Unable to get help from physicians and incapable of negotiating the maze of intrusive legal restrictions on their care, at one time families turned to politicians for intervention. They asked Congress to legalize heroin as a pain treatment. Thankfully, that era’s street drug-of-choice was not needed – we had better drugs than heroin. Congress did not grant their wish. But the families were right about one thing: those medicines were not being used. I know their frustration and anger. I was witness to the devastation they felt when loved ones had died, in pain unnecessarily. (more…)

By Glenna Crooks. Everyone now and again, you meet someone who rocks your world – in a good way. It happened to me recently. I treated myself to a workshop and among those attending was a young woman with such inquisitiveness, openness, honesty and humor that I instantly became a fan. She was comfortable in her own skin, passionate about her beliefs and disarming in her directness.  And, there was not a mean bone in her body. She could tell you anything – including the truth you might not want to hear –and be grateful she did.  She had rare courage and extraordinary presence for a young woman. I decided I wanted Disruptive Women readers to know her.

She has epilepsy and since November is Epilepsy Awareness Month, this is the perfect time. Please allow me to introduce you to Jessica Keenan Smith.

How do you hope Epilepsy Awareness Month will help?  

More than 70 Million children and adults worldwide are living with epilepsy. Three million of them are in the US. That’s more people than were living with HIV/AIDS in 2008. I’ll bet that surprises most people.

Of those 70 Million, for 70% there is no known cause. A little research money would go a long way toward reducing that 70% number and then to finding better treatments, and my highest hope – cures. More awareness will help drive more research funding and scientific  interest in this important area of health. That’s why an Awareness Month is helpful.

Many diseases have been around for centuries, but they have treatments – even cures. Why hasn’t epilepsy enjoyed that same happy ending?

Well, let’s start with the fact that you can’t even tell that most people with epilepsy have it unless they are actively having a seizure. Then combine this with the fact that a negative stigma still exists. Add in the fact that there are more than 40 different types of seizures and you’ve got a tough nut to crack.

These factors make epilepsy very difficult to recognize, never mind research and cure. (more…)

By Glenna Crooks. It’s hard enough to be a parent these days, right? It’s harder still if your kids are ill. And really difficult when – as is increasingly the case – their condition is chronic and you, they and the adults who are there when you are not there must manage a regimen of care.

An increasing number of kids need some sort of special care: dietary management, medication management and ‘rescue’ strategies for medical crises and allergies. Some of these conditions are life-threatening and improper management can be deadly.

It’s hard enough to make modifications, even at home. Imagine what it’s like at school. If you don’t have a child in school, you may not realize how incapable schools are of meeting special needs. Worse yet, many schools have zero tolerance policies where medications are concerned. This means that even if a child is capable of managing their own medications, they may not have ready access to them.

So what happens when a school has a zero tolerance policy? I’ll never forget the experience of a youngster, who at the end of a focus group we conducted to explore asthma issues with poor children in Atlanta, cried. The tears came because the focus group facilitator hugged him in thanks for giving up his Saturday morning cartoons to come. Asked why, he told us that because he had to go to the nurse’s office to get his medication other kids thought he had HIV and so would not play with him. No one, he said, would touch him. My heart aches for that boy.

It aches and rages for the family whose 11-year old son died for lack of the inhaler he needed for his asthma. Though the school had a policy of making exceptions for inhalers, his parents had not been informed, the inhaler was in the admistrator’s office and the delays in medication administration cost his life. I doubt the $2.2 million negligence award was sufficient to ease his Mom’s suffering. (more…)

By Glenna Crooks. In February, just in time for Valentine’s Day, I wrote about chocolate and how countries with higher rates of chocolate had greater levels of satisfaction with health care. As one reply noted, it’s not a perfect correlation and causation can’t be established, but I was intrigued when the disparate bits of data showed up in my mail that week and couldn’t resist. Besides, it was partly blogged in jest, though I do look under ever rock to see if we can improve US health care.

If you want to refresh your memory about it, you can check it out at http://www.disruptivewomen.net/2011/02/07/chocolate-a-new-secret-weapon-for-health-care/#comments.

Now, comes a study from the British Medical Journal of findings presented at the European Society of Cardiology Congress recently in Paris that might explain (at least in part) why chocolate and satisfaction might be related.

Perhaps people in higher chocolate-consumption countries are happier with their health care system because they don’t use it. I wonder?

According to the article, high levels of chocolate consumption appear to be associated with a 37% reduction in heart disease and a 29% reduction in stroke. Both are major causes of admission to hospitals in this counry.

Frankly, I’m pretty happy about the US health care system when I don’t have to use it. Now I know a European secret…eat more chocolate and stay out of the hospital. I can’t think of a more palatable form of prevention.

By Glenna Crooks. Years ago at the time of my appointment in the Reagan Administration, someone told me, “Coming to Washington will open your eyes…and staying there will close them.”

I never forgot that. It’s the reason I eventually left government work. Not because of the politics, which I recall could be tough (at least in public).

But about five years into my time as an appointee, I did a speaking tour across the Midwest. I opted to drive between close-by cities and, as I did, saw that everything ‘looked strange.’ I realized then that I’d lost touch; my eyes had surely been opened in those years and, as predicted, they’d now closed. I could no longer ‘hear’ what the public wanted and ‘translate’ it into good public policy without great effort. I knew then it was time to leave.

Today’s New York Times ‘above the fold’ story headlined “After a Protracted Fight, Both Sides Emerge Bruised:  A full victory lap was not expected — or, perhaps, deserved — by those on either side of the debate, which has consumed the capital, unnerved the financial markets and infuriated Americans.”

The article addresses the political challenges to those involved in the coming months as they approach campaigns and reelections. As tough as I remember the politics being, it’s apparently tougher these days of debt ceiling maneuverings. But it’s hard to feel sorry for politicians these days, tough as it might yet get. Not from where I sit. My eyes are open by the fears and struggles of those I know – and my own, too.

• Friends – talented business people, scientists, researchers, problem solvers – have joined the ranks of the unemployed. Some are teetering on the brink of being among the long-term unemployed;
• Companies in the innovative health sectors continue to downsize and at precisely the time they should be investing more in research to solve some of today’s intractable problems, they’re cutting back on R&D as well;
• Physicians say they are uncertain about their futures and whether they can remain in business; (more…)

By Glenna Crooks. On June 20, New York Times writer Tara Parker-Pope wrote about how FICO, the company with the scores that describe our credit worthiness, has developed a new FICO Medication Adherence Scores to determine – using public, but not medical, information – who is likely to skip or incorrectly use medications.

Over the next year, 10 million people will likely be scored (without their knowing it, by the way) within a rage of 0-500. Those over 400 would be deemed ‘likely’ to use medication appropriately; those with lower scores would receive calls, cards, letters or some other intervention to boost their rates of adherence.

Halfway into the article, my HIPAA-involved policy-wonk self went bonkers. True, they don’t use medical records information but the fact that without consumers knowing it FICO can amass and organize other public information such as home and automobile ownership, job status, marital status, age and gender, then show payers how the weights of those factors vary by diagnosis enlightened me about the power of data mash-ups. Truth be told, it worried me as well. Who knew?

Wondering if the premise was even valid and also about a surprising finding from FICO’s work that women adhere to medication regimens less often than men, I called my guru on ‘all things adherence,’ Diana Long, to inquire.

She said FICO might, in fact, be ‘on to something’ saying that we in health care have been myopic about patients’ behavior. We think it’s ‘all about us’ and don’t consider that not taking meds or following doctors’ advice might be a reflection of factors other than how sick we felt, what side-effects we feared or what costs we bore. She pointed out, for example, that just because a child knows how to use an inhaler does not mean they have mastered the strategic thinking/planning required to remember that tonight is the night for soccer practice, they should ‘plan ahead’ and take the inhaler to school that morning. The factors we develop as we grow up  – including skill and motivation – to get up for a job every day may be the same factors that determine whether we’ll take our meds, eat right or exercise. (more…)

By Glenna Crooks. Let’s face it: we in health care today need some miracles to deliver what’s being asked of us.

And….er…uh….just where are these miracles going to come from?

Another clinical study? A deeper dive into EHRs? More ‘command and control’ from quality assurance reviews? Another ‘gotcha’ hearing? Another malpractice trial?

I wonder about that a lot these days and sometimes I’m not optimistic because it seems intuitively obvious to me that we are not going to dig our way out of a hole by digging in the same hole faster, better or more efficiently.

We’re in need of radical solutions. I’ve been wondering about other approaches. Then I saw one. Quite unexpectedly from artists and musicians.

Huh?  

Yes. Artists and musicians. Here is one, describing the contribution of composers, musicians and artists to our understanding of the brain and more…

WOW!

OK, so I knew that artists who first drew anatomical structures accelerated early medical education and eliminated myths about the nature of internal organs. I’d also heard about how a double helix appeared long before Watson and Crick— at the start of the Middle Ages, in fact, appearing in early in the Renaissance in 1400, apparently first designed by DaVinci and later built into cathedral windows and by 1519 was an actuality in a double-spiral staircase in the Chateau de Chambord in 1519.

Then, came this video.

I am a fan of TED meetings, its formats, the way the speakers ‘up their game’ year after year. Now it occurs to me that artists may be in touch with something that the rest of us in health care need.  

If you like this one you’re sure to like others. www.TED.com is an easy site to access. Maybe one of the many other speakers will have useful insights for your arena of health care.

Heaven knows, we could use them.

By Glenna Crooks. Did you see the publication of a study on happiness and suicide made the news lately?

It was based on State-level data here in the US and replicates findings from other studies comparing nations in a similar way.

The investigators call the phenomenon a ‘dark paradox’ since the highest rates of suicide occurs in States with ‘happier’ people. This holds true even when adjusting for age, gender, race, income, marital status and employment status.

The study answers only one question: Is there a relationship between happiness in a State and suicide? The answer is ‘yes.’

The study does not answer the question about why that appears to be true, through the authors speculate that happy people create a context for living in which those who are not happy see their own conditions in some more stark – dark – way.

There could be other reasons. Perhaps happy people don’t invest in suicide prevention programs or are so cheery they don’t notice others around them are not. Perhaps happy people prefer to stay that way and so won’t engage with those who are depressed, leaving those who are at suicide risk with no source of support. Perhaps it is some other totally unrelated factor we don’t know to account for yet.

Noticing correlations is not new and does not require sophisticated statistics. People noticed long ago, for example, that the number of stork nests in Holland correlated with the human birth rate. Eventually the myth that ‘storks bring babies’ was debunked, giving way to modern biology.

My concern in this post is not about happiness, suicide or storks, but about correlation. Though happiness sounds great, suicide is no laughing matter and I do love those cute birth announcement cards with storks on them.

My concern is that this study is about correlation – only correlation. The study does not address causation. We in health policy frequently fail to make that distinction.

Given this correlation data, if States were a regulated profession, product, facility or company within the health sector, this week we might take that correlation data and draw causation conclusions. We might charge ahead with outrage, accusations, hearings, regulatory proposals, warning labels and report cards – all of which would confuse more than clarify.

If States were part of our regulated health sector, this week we might be debating whether to post  warnings at State lines: “Warning: You are now entering UT (or HI) a State known to have more happy people. Living here could increase your risk of suicide. Consider lowering your suicide by moving to NJ, NY, RI, MA or WV instead.”

It’s about time we in health policy learned what our colleagues in the sciences know – that the ‘more’ we know, the ‘more we know we don’t know.’ That is why science proceeds carefully, debates extensively and knows it will never have a ‘final’ answer. There is a certain humility in that and sometimes I think we in the policy world could use a dose of it.

By Glenna Crooks. Having been engaged in rare disease research and orphan drug development for many decades and as one who continues behind-the-scenes to encourage the work, events of the last few weeks about Makena’s launch sent chills through me. 

The firestorm that followed created some heat but none sufficient to help relieve the shivers. Others might declare the outcome a “win” but the more I read, the worse it seems. I’m not privy to what really happened, only what the press reports. It does not look good… for virtually anyone of the players involved, especially the critics. 

Those critics raised tough questions and to date only the company has faced them. It’s about time the critics themselves –and perhaps others as well – face some.   

For those who’ve missed the story, on February 3, 2011, the FDA approved a drug intended to reduce the risk of certain pre-term births in women who’d already had at least one pre-term birth. 

In truth, a number of treatments are already available for women in this situation. None of them sound easy. They include certain other medications (including IV medications) and restricted activity (like bed rest) that prevent women from going to work, making meals or providing care for other children or family members. Oh, and they can’t have sex, either. In some cases, women are hospitalized and, when all else fails the birth is premature. If they survive, the babies then receive care in neonatal intensive care units at the high costs we all know and frequently bemoan. 

One of the treatments already available was an injection that compounding pharmacies—perhaps one down the street from you—made at a fairly low cost. Though there is no indication the FDA had concerns about this particular pharmacy-compounded product, the American Journal of Perinatology in March 2009 reported on a study of OBs saying they were “very concerned;” apparently it made care for these women more difficult. Perhaps understandably, the women did not want to take a product the FDA had not approved. Add to that, other FDA studies had indicated a third of pharmacy-compounded products (in general) had doses higher or lower than the physician prescribed. Perhaps that is why FDA was interested in a product they could regulate.     

NIH had been interested, too, had studied the drug in question and apparently found it was effective and prevented premature labor. 

Somehow a company got involved, but then it sold its rights to another company. Press reports don’t say why. That second company bought the rights, paying $92M up front and promising another $107M in payments over time. 

The second company then committed over $250M, including more than $60M in research and clinical trials involving multi-year follow-on studies of 1,700 mothers and 500 babies. The second company says the studies were four times larger than the previous NIH studies and twelve times more expensive. When it appeared the FDA would approve their version, they built relationships with specialty pharmacies to make sure that patients could get access, set up patient assistance programs and started the launch.  (more…)

By Glenna Crooks. Over a decade ago, researchers noticed an interesting finding: women who believed they were subject to heart disease were four times more likely to die than women with similar risks who did not hold similar fatalistic views.

Some people called this a ‘nocebo’ effect. The Washington Post called it the ‘evil twin’ of the ‘placebo’ effect, which most everyone knows by now is a treatment that produces a positive effect for patients even when it shouldn’t because is isn’t real.

Nocebos, like placebos, are ‘self fulfilling’ prophesies at work. Apparently, the brain (and body) cooperates with the deception.

A study just published in Science Translational Medicine takes this to new levels.

Healthy people agreed to participate in a pain experiment. Heat applied to their leg caused pain and a baseline of their tolerance determined. On a scale of 0-100, the average pain rating was 66. Placed in an MRI with an IV inserted, they were administered a powerful pain-relieving drug…but not told so. Pain levels dropped to 55, so apparently the drug had some effect. That was Stage One of the study.

Stage Two started when the research subjects were told the drug was now being administered. Average pain dropped to 39, mmmmmm.

Stage Three came next. Even though the drug was administered still, the researchers lied… subjects were told it was stopped. Average pain intensity rose to 64. Very close to the baseline. Wow. Tell the person – the patient – there is no help on board and the nocebo takes over.

These were not just subjective reports. The MRI’s confirmed that the brain’s own pain networks responded in ways that matched the subjective ratings.

Change the expectations…change the response.

So what does this have to do with politics and media? Plenty maybe. You decide.

I’ve been thinking about this for a long time. Here’s why: Long ago and far away, I trained for the Olympics. My sport was Karate. There’s more.

In a training accident, a sparring partner kicked me in the head, bones in the left side of my face were fractured and reconstructed. After successful surgery, for nearly six months I spent the first hour of every morning in a dental chair to get the refining, pain-relieving work done. 

How might other patients be like me?

What if I had not liked my dentist? What if I had not trusted him?  Could I have gotten up every morning and made the drive to see him? Would I have shown-up? Or not? Cancelled my appointments? Not been adherent to the regimen? Walked away angry and disappointed? Litigious?

I can’t even remember his name today, except he was a really nice, funny, skilled, terrific guy. Eventually there was no more pain. I went on my way.

Sometimes, as I watch the anti-healer drumbeat from politicians and the media (old and new) I wonder about other people who need help.

What would it be like to be admitted to the hospital and believe that the surgeons, nurses or hospitalists there were uncaring, incompetent and likely to cause my death, not my recovery?

What would it be like to have a chronic condition and believe that my doctor had no interest in me and my health but only her own selfish interests and income? That she lacked the intelligence or ethics to stave off the influences of the many forces that make it hard to put my interests first? To believe that a pizza for lunch would influence her choice of therapeutic option?

What would it be like to get up every morning to take a medicine and believe that the company who discovered and developed it employed people only in it for the money? And that it was probably poison to boot, likely to cause bad – even fatal – side effects?

While those of us who are patients and those of us who are healers are trying to make healing  happen it seems to me there are others whose interests are not about healing.

It seems to me there are those - politicians – with interests to drive a wedge between patients and their healers in order to get media attention. It makes for flashy hearings.

Likewise it is in the interest of the media to drive that wedge to sell news.

You decide. For yourself. For those you love.

By Glenna Crooks. This is the week many of us will consider – or finally make – Valentine’s Day purchases. Some of us will consider chocolate. Maybe more of us should.

I wondered about that as I saw some disparate bits of data over the weekend. An article on Valentine’s Day spending was informative: couples will spend just under $70 on each other and we’ll spend, on average, $5 on pets, $6 on friends, $5 on teachers and $3.50 on co-workers.

What will we be buying? In all, about $12.B in treats for the day: $3.5B on jewelry, $1.6B on clothing, $3.4B on dinner, $1.7B on flowers, $1.5B on candy (of which $285M will be on chocolate) and $1.1B on greeting cards.

I get interested in items like this when I hear that we ‘can’t afford health care.’ I’ve noticed over the years how we can spend more on the launch of a blockbuster movie in a weekend than we spend immunizing our children against measles, mumps and rubella in a year. 

In the past, I might have gone on a rant about that but this weekend another set of statistics caught my eye as well; those related to chocolate. Seems that chocolate-making companies have higher margins than other food companies, raking in 11.7% profits over the 8.1% of others.

Chocolate is a discretionary, luxury item and – though some friends will disagree – not at all essential to a person’s health or well-being, so we need not quibble over those margins, argue for price controls or suggest the industry become a public utility. That same article cited per-capita rates of chocolate consumption, however, which got me to thinking that consumption of chocolate appears to be correlated with two items we care about in health care: expenditures and satisfaction.

Sure enough! Though not a perfect correlation, it’s directionally so. Countries with higher rates of chocolate consumption have lower rates of dissatisfaction with health care and lower per capita health care spending. Wow!  Note in particular the difference between Switzerland and the US. The Swiss eat twice as much chocolate, have a dramatically lower percentage of people who grouse about healthcare and spend nearly half per capita as Americans. 

The policy wonk in me says perhaps we ought to make chocolate a covered benefit and promote its use! And, I’m only half kidding.

By Glenna Crooks. I learned an expression last week: “A whole lot of dirt flying, but no holes bein’ dug.”  It comes to mind when I watch attempts to repeal health reform.

Let’s get real about what the law is and isn’t.

Health reform…isn’t. To ‘reform’ means to ‘return to a former good state.’ What ideal state are we trying to reclaim? Did we ever have one? When was care idyllic? Was it when people believed the evil spirit Febris sent fevers? Or when as a child my Mother saw her Dad die, a victim of infectious disease in the pre-antibiotic era? When Marcus Welby practiced with great bedside manner but without today’s diagnostic and therapeutic armamentarium? Or more recently when my Mother saw her son die, a victim of infectious disease in the antibiotic-resistant era?  

We don’t need to reform the health care system. We need to transform it. Unfortunately, the law…doesn’t…transform, either.

It does not address how we will meet the unmet medical needs for new therapies. It does not address all – or even the most important – components of health.

The law fails to address the biggest determinants of health, which according to my friends Mike McGinnis and Bill Foege are what we do for ourselves each day (40%) and the quality of our social and physical environments (20%). According to Bill and Mike, only 10% of our health is determined by the health care we receive – the primary focus of the current law. Is that focus a bad thing? Is it so limited and flawed as to merit repeal?

The law does not transform health or health care, but it does transform the financing of care. We needed a wise dose of that. We needed some wise doses of other things as well, but financing is a step in the right direction to address issues that – however difficult – must be accomplished in order to move forward.

Repeal would be a giant step backwards towards a past no one argues was ideal.

I’ll admit to being disappointed initially that the law was so limited, but no longer. I’ve come to terms with my frustration, believing that those involved probably did the best they could at that time and we won’t get anything better for a long time to come.

Now, we need to stick with it and make it work. Tinker at the margins? Yes. But repeal? No.

It’s going to take years to figure out how to make the current financing components work. It’s going to take decades to figure out how to get more therapies developed for those who need them, how to change our communities to make them healthier places to live and how to change our own behaviors to control the components of health – and drivers of cost – we can.

Now is the time for digging that lays that foundation for the future. Plenty of people in patient groups, among employers, insurers and especially in the states are hard at work figuring out how to do that.

They could use some help. The efforts to repeal the law don’t qualify.

By Glenna Crooks. Robin has already wished everyone a Happy New Year. To those wishes, I add mine: a Healthy New Year, too!

Got plenty to clean off your desk? Probably.

A pile of papers, postponed ‘to do’ list items and accumulated emails? Likely.

Is that competing with New Year’s resolutions to exercise more?

Is it stressing you beyond your promises to remain calm, unruffled and Zen through 2011?

Are you already planning to postpone the workout (for just one day) and have some high fat, high calorie comfort food to relieve that stress (just for today)?

Tempting, even for me, trying to practice what I preach about prevention.

Maybe this will help: a reminder that health has a number of important contributions for us and the people we care for in the work we do. It brings them not only longer, better quality lives but also the ability to create economic security for themselves, their families and their nations.  Good health for us means likewise and helps us stay ‘on the job,’ addressing the challenges of working in today’s health care sector — piles of papers, unanswered emails, stress and all.

This is worth the time – piles of papers and all! It’s a wildly entertaining, short presentation on a value of health we rarely discuss…that of creating wealth.

Hans Rosling is a master – of data and communication about the value of health.

http://www.flixxy.com/200-countries-200-years-4-minutes.htm

If you like this one, though this next link will take you to earlier versions, you’ll find them additionally entertaining and informative….

http://www.ted.com/index.php/talks/view/id/92.

Happy and Healthy 2011 to you!