Healthcare Reform in President Trump’s America – A Preliminary Look

Jane Sarasohn-Kahn

This post was originally published on 9 November 2016 in http://www.healthpopuli.com/.

Trump-tweet-on-helath-careIt’s the 9th of November, 2016, and Donald Trump has been elected the 45th President of the United States of America. On this morning after #2016Election, Health Populi looks at what we know we know about President Elect-Trump’s health policy priorities.

Repeal-and-replace has been Mantra #1 for Mr. Trump’s health policy. With all three branches of the U.S. government under Republican control in 2018, this policy prescription may have a strong shot. The complication is that the Affordable Care Act (aka ObamaCare in Mr. Trump’s tweet) includes several provisions that the newly-insured and American health citizens really value, including:

  • Extending health insurance to dependent children up to age 26
  • Closing Medicare’s “doughnut hole” (for Medicare Part D which covers prescription drugs for older Americans)
  • Covering people with pre-existing medical conditions
  • Covering preventive services, and
  • Providing subsidies that lower the cost of insurance.

What nobody likes is the direct consumer cost of health care — ACA’s lack of affordability, which was predicated on a competitive insurance marketplace and near-universal sign-ups for health insurance bolstered by a mandate for consumers to purchase insurance. Without these pillars in place, insurance companies have pulled out of local markets where they cannot be financially viable, leaving many consumers with only one choice for health insurance purchasing. Monopoly power in a local market means higher prices. Couple this with millions of consumers opting out of buying health insurance, leaving health plans with a sicker, generally older population to serve. Actuaries in health plans like a more standardized population with young, older, healthy, sick, and demographically diverse to be able to forecast utilization of health care services and, ultimately, the medical loss ratio (that is, patients’ costs incurred in the health plan).

Repeal-and-replace in Donald Trump’s healthcare world could result, in the short-to-medium term, in about 20 million Americans losing health insurance. The Commonwealth Fund estimated that this could increase the Federal budget deficit by between $330 bn to $550 bn over 10 years. (more…)

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Americans Have Begun to Raid Retirement Savings for Current Healthcare Costs

Jane Sarasohn-Kahn

ebri-changes-in-healthcare-usage-resulting-from-cost-increases

While American workers appreciate the benefits they receive at work, people are concerned about health care costs. And consumers’ collective response to rising health care costs is changing the way they use health care services and products, like prescription drugs. Furthermore, 6 in 10 U.S. health citizens rank healthcare as poor (27%) or fair (33%). (more…)


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Most Hospitals Offer Patients Electronic Access to Medical Records

Jane Sarasohn-Kahn

This post was originally published on http://www.healthpopuli.com/ on September 14, 2016.

Percent-of-hospitals-that-enable-patients-to-view-download-and-transmit-HI-grew-7x-between-2013-2015

The number of hospitals offering patients electronic access to their health information grew seven times between 2013 and 2015. Electronic health records access has gone mainstream in America, according to the latest findings by The Office of the National Coordinator for Health Information Technology (ONC-HIT).

The data are detailed in Electronic Capabilities for Patient Engagement among U.S. Non-Federal Acute Care Hospitals: 2012-2015, an ONC Data Brief.

Two in three U.S. patients can now view, download, and transmit their personal health information, shown in the bar chart. This hockey-stick growth, from 10% in 2013 to 69% in 2015, results from the HITECH Act, part of the Stimulus Bill which provided financial incentives to health care providers to adopt and implement electronic health records (EHRs). (more…)

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Money, Stress and Health: The American Worker’s Trifecta

Jane Sarasohn-Kahn

Financial stress impacts health, relationships, and work productivity and attendance for employees in the U.S. It’s the American worker’s trifecta, a way of life for a growing proportion of people in the U.S. PwC’s 2016 Employee Financial Wellness Survey for 2016 illustrates the reality of fiscally-challenged working women and men that’s a national epidemic.

Employees-say-financial-stress-impacts-health-first-PwC-survey

(more…)


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Digitizing Self-Healthcare with Google, Pfizer, Under Armour, Walgreens and WebMD

Jane Sarasohn-Kahn

How can digital technologies enable self-healthcare in novel ways? This was the theme of a meeting sponsored by Pfizer Consumer Healthcare and hosted by Google, with the title, “Advancing Consumer Health through New Technology and Next Generation OTC Healthcare” held on 12th April 2016 at Google offices in Manhattan’s Chelsea neighborhood.

Pharmaceutical brand drugs switching to over-the-counter packaged goods, the Cellscope Otoscope used by parents checking their young children’s earaches, connected shoes and earbuds for athletic enhancement, and omni-channel retail shopping….these are a few of the signals we see emerging to enable consumers’ to drive healthy behaviors, wellness and self-healthcare. Speakers from companies covering these market segments presented their views on health care consumers’ demand and use of digital tech for their own and their families’ health.

David Pogue, technology raconteur, moderated the session, kicking the discussion off with the scenario of a patient recently admitted to an ER with chest pain where clinicians took advantage of the patient’s Fitbit data. Based on that patient-generated data, the doctors were able to connect the data-dots in time to prevent the fellow from dying. Pogue ticked off many examples of tracking devices, covering sunlight exposure, posture, weight and BMI, heart-tracking t-shirts, smart shoes, earbuds, forks to slow down eating, and finally the SexFit Bondero for the gentlemen-folk. (more…)

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The Patient-Physician Experience Gap

Jane Sarasohn-Kahn

Today’s post first ran on Health Populi.

As patients continue to grow health consumer muscles, their ability to vote with their feet for health care services and products grows. That’s why it’s crucial for health care providers to understand how patients perceive their quality and service levels, explained in Patient Experience: It’s Time to Rethink the Consumer Healthcare Journey, a survey report from GE Healthcare Camden Group and Prophet, a brand and marketing consultancy.

The-Patient-Provider-Experience-Chasm-GE-Prophet-March-2016 (more…)


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Sleep And Health/Tech – It’s National Sleep Awareness Week

Jane Sarasohn-Kahn

The post below originally ran on Health Populi on March 9.

One in three people suffer from some form of insomnia in the U.S. With sleep a major contributor to health and wellness, we recognize it’s National Sleep Awareness Week.

As a health economist, I’m well aware of sleep’s role in employee productivity, absenteeism and presenteeism. U.S. companies lose 11.3 days of lost work performance per person who suffers from insomnia, according to research from a Harvard-based team published in the journal Sleep. The cost of this to U.S. business is about $63 billion annually.

Science writers at the BBC developed a long list of modern-life issues that deter us from sound sleeping. The major culprits are pervasive technology, lights, noise, heat, and stimulants (like alcohol and coffee), as illustrated in the BBC’s drawing of How We Live Now.

Some key health issues you may not know about sleep are that… (more…)


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Consumers Take Better Preventive Care of Pets Than Themselves, CIGNA Finds

Jane Sarasohn-Kahn

People Care Deeply About the Wellbeing of Their Pets Not So Much WellbeingThe post below first ran January 18 on Health Populi.

Nine in 10 pet owners know when their dog or cat is due for their shots. Eight in 10 women know the frequency with which they get manicures and pedicures. 80% of men know the mileage between old changes.

But only 50% of family health care decision makers know their blood pressure, and only 20% know their biometric numbers like cholesterol and BMI.

Americans are great at doing preventive care for their pets and automobiles; but not so much for their own bodies and health, finds the report CIGNA Preventive Care Research, a survey of 1,000 U.S. consumers between 25 and 75 years of age who have health insurance and are the health care decision makers for their families. The survey was conducted in September 2015. (more…)


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The Future 100 from JWT – Health Is Everywhere in 2016

Jane Sarasohn-Kahn

Today’s post first ran on Health Populi on December 9.

Food + Drink, Beauty, Tech + Innovation, Retail, Lifestyle…JWT pulls out their crystal ball for 2016, and I see health, everywhere.

JWT-Future-100_FINAL_COVER-HR-300x194The Future 100 – Trends and Change to Watch in 2016 is J. Walter Thompson Intelligence Innovation Group’s annual trend forecast, which I highly value and mine each year to help THINK-Health continue to hone our own environmental analyses for health and healthcare. [Here’s what I wrote one year ago about JWT’s 2015 forecast].

Health is baked into JWT’s 2016 trendscape, well beyond their “Health” chapter. (more…)

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Social Determinants Impact Health More Than Health Care

Jane Sarasohn-Kahn

imageToday’s post first ran on Health Populi on November 9.

The factors of where people are born, live, work and age — social determinants — shape human health more than health care. Yet in the U.S. much more resource per capita is funneled into healthcare services than into social ones.

Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity was published by The Kaiser Commission on Medicaid and the Uninsured in November 2015, calling attention to the opportunity and wisdom of baking health into all public policy.

The social determinants of health (SDOH) include economic stability, the physical environment and neighborhood, education, food, community and social context, and the health care system, shown in the second exhibit. (more…)


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Insurance Should Pay For End-of-Life Conversation, Most Patients Say

Jane Sarasohn-Kahn

Today’s post first ran yesterday on Health Populi.

aging 18 in 10 people in the U.S. say that Medicare as well as private health insurance plans should pay for discussions held between patients and doctors about hatlhcare at the end-of-life.

The September 2015 Kaiser Family Foundation Health Tracking Poll asks people their opinions about talking end-of-life with their doctors. The vast majority of people support the concept and physicians being paid for holding such conversations in doctor-patient relationship.

The question is germane because the Obama Administration has announced plans to pay doctors for office visits to discuss end-of-life (EOL) issues with Medicare patients. (more…)


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The Internet Of Things, Privacy and Women

Jane Sarasohn-Kahn

The post below ran on Health Populi on August 4.

A Congressional hearing on the Internet of Things was held on July 29, 2015.

“As we talk about your home, your lighting, your messaging, your voice, and, of course, your health and your actual biological function, issues like privacy and data security for these interoperable technologies become not just something to talk about but an area in which we in Congress play a large and potentially destructive — if we’re not careful — role in the development of these technologies,” cautioned the Honorable Bob Goodlatte, Chairman of the Judiciary Committee, U.S. House of Representatives.

cong briefingPictured with Chairman Goodlatte are the other witnesses particpating in the hearing: Gary Shapiro, President and CEO of the Consumer Electronics Association; Dean Garfield, President and CEO of the Information Technology Industry Council; Mitch Bainwol, President and CEO of the Alliance of Automobile Manufacturers; and Morgan Reed, Executive Director of ACT |The App Association. (more…)

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Health Politics: Learning From History in Art from the Reagan/AIDS Era

Jane Sarasohn-Kahn

7.27 1Today’s post first ran on Health Populi on July 24.

The high cost of specialty drugs, opaque information on risks of many existing prescription drugs, and lack of cures for diseases impacting millions of people are forces driving patients into activism, the likes of which we haven’t seen since the emergence of AIDS.

I was reminded this yesterday, not inside the Beltway at an FDA or Congressional hearing, or in an online social network of patient activists.

I was visiting the newly re-opened and re-built Whitney Museum, an architectural gem now re-energizing the Meatpacking District in Lower Manhattan.

It wasn’t the building design (which is getting rave reviews from architecture critics) that turned my mind toward a déjà vu on health politics, but in the Neil Bluhm Family Galleries on the 5th floor which features artworks created during the AIDS crisis beginning in the early 1980s. (more…)

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What the SCOTUS ACA ruling means for health consumers

Jane Sarasohn-Kahn

The post below ran on Health Populi on June 29. Disruptive Woman Jane Sarasohn-Kahn puts together a great piece on what the Supreme Court’s ruling on the Affordable Care Act means for consumers.

Now that the Affordable Care Act is settled, in the eyes of the U.S. Supreme Court, what does the 6-3 ruling mean for health/care consumers living in America?

scotusI wrote the response to that question on the site of Intuit’s American Tax & Financial Center here. The top-line is that people living in Michigan, where the Federal government is running the health insurance exchange for Michiganders, and people living in New York, where the state is running the exchange, are considered equal under the ACA’s health insurance premium subsidies: health plan shoppers, whether resident New Yorkers or Michiganders, can qualify for health premium discounts. This means that people shopping for health insurance under the ACA are all-American, whatever state they live in. The yellow and the white states, when it comes to insurance subsidies, are all one color now. (more…)

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All women are health workers

Jane Sarasohn-Kahn

How women define health Center for Talent Innovation

The following post originally ran on Health Populi on May 26. See the original post here.

The spiritual and emotional top the physical in women’s definition of “health,” based on a multi-country survey conducted in Brazil, Germany, Japan, the UK and the U.S.

The Power of the Purse, a research project sponsored by the Center for Talent Innovation, underscores women’s primary role as Chief Medical Officers in their families and social networks. The research was sponsored by health industry leaders including Aetna, Bristol-Myers Squibb, Cardinal Health, Eli Lilly and Company, Johnson & Johnson, Merck & Co., Merck KGaA, MetLife, Pfizer, PwC, Strategy&, Teva, and WPP. (more…)


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