The presidential candidates, Sen. Obama and Sen. McCain, and the
vice presidential candidate, Sarah Palin are showing in their comments
on the financial crisis that none of them understand the crisis, the
economy or what’s behind the financial crisis.
They all need to sit down with their financial advisers and learn
what is going on so they can at least pretend to be smart about markets
and the economy.
What they are saying and the ignorance they’re displaying is simply appalling.
By
Could walking at a tortoise pace all day long in the office keep you thin or help you lose weight?
Many people seem to think so and have built themselves treadmill desks — basically a treadmill with a raised platform for their computer and phone. Moving at less than 1 mile per hour all day long helps them burn between 250 and 350 calories a day. Don’t believe me? See this New York Times article. (Illustration by Eric Lister, from Gelf)
A couple of years ago, when I wrote a story about people using treadmill desks for the online magazine Gelf, the phenomenon was just beginning to surface on personal blogs. It’s clearly taken off. (David, the Gelf editor who assigned me the story, now has is own treadmill desk.)
There’s actually a lot of science behind the idea of work-walking, which comes mostly from the Mayo Clinic. Dr. James Levine and his team published research in Science back in 2005 showing that thin people tend to fidget and move around more often than overweight people, thus burning more calories. They call it NEAT— Non-exercise Activity Thermogenesis.
Two years ago, Levine, an endocrinologist, told me that he wanted this idea to go beyond a few individuals. He wanted corporations to embrace the idea, or at least promote practices that get employees moving more.
We’re a fat nation, and our evolutionary biology combined with our current environments practically guarantee we remain so unless we adopt some creative interventions. This definitely is a step in that direction.
Jaan Sidirov at Disease Management Care Blog did a great job combining the best of the health blogs for this issue of Health Wonk Review.
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The central problem in the U.S. health care system isn’t cost or insurance, per se, it’s the challenge of increasing health care value to the patient/consumer.
That means we must improve the poor quality and inefficiency of care, so that we all receive only the care we need, delivered in a timely and effective manner, without waste and over-treatment, and with a focus on integrating “well-care” (prevention and self-management) with sick-care.
It also means dealing with the knowledge void, an ironic situation in which our health care community is drowning in oceans of information, yet no one knows the best ways to prevent health problems and treat them cost-effectively, especially when you take individual differences into account. To address this problem, we need better health information technologies, as well as a collaborated effort to develop, disseminate, and deliver cost-effective evidence-based care.
If consumers were to receive high value health care in this manner, costs would be lower since poor care costs more and delivering only the minimal necessary care typically results in better outcomes! More appropriate care, delivered competently and cost-effectively through cost-conscious, patient-centered “medical homes,” for example, is the only way to control costs long-term.
Everyone’s favorite naysayer Dmitriy Kruglyak is getting very self-satisfied this morning about the failure of Revolution Health to change the world in three years. Normally, I leave Dmitriy’s bizarre wofflings alone, but because he’s directly "pointed the finger" at me and by extension at my partner Indu Subaiya, it’s time to respond.
While there may be a demise in Steve Case’s investment, Dmitriy proves yet again that his background as a software geek with no background in understanding the health care system — and his professional jealousy as the creator of a failed conference about blogging — gets in the way of his limited analytical skills of what he claims I’ve been saying about Health 2.0.
Yes, Indu Subaiya and I founded the Health 2.0 Conference to focus on the use of new participatory software tools in health care. Had Dmitriy paid attention when he attended the conference in 2007 he would have noticed that the audience was asked, what would be the future of the search, social networking, & consumer tools that made up Health 2.0? The response was that 70% felt that these tools would be adopted by mainstream health care companies, rather than become a standalone industry. Which was exactly what I have been saying all along.
In "Zen and the Art of Motorcycle Maintenance," Robert Pirsig writes about the different reactions to our experiences living with modern technology, which he describes as romantic, classic, and a third and completely separate element and perspective, which he calls Quality.
I’m finding that there is a bit of all three in my Health 2.0 motorcycle tour and the interviews along the way. It’s a curious revelation, and I’m somewhat awestruck by the relevance of his musings about how we lived during the 1970’s to our situation here in the new century with health, wellness, and the Internet.
The September/October issue of Health Affairs is dedicated to reviewing concepts of the medical home. It is most likely the most current, authoritative, and impressive review of this emerging idea. Health Affairs is an excellent resource for health policy wonks to gather, but in recent years has become more accessible to the general health care audience. I would recommend it as required reading for anyone interested in learning about this trend.
Simultaneously, there have been some recently updated “state of the industry” reports coming out of the retail health clinic world. As noted by Jane Sarasohn-Kahn, the fact that more and more retail clinics are being created has increased access, improved quality through an evidence based approach to a limited set of clinical conditions, but has not done nothing to address the cost issue. In fact, increasing the supply of retail clinics, has simultaneously increased the demand for these services. This is a common phenomenon within healthcare, and the supply driven demand has been well described particularly in the hospital setting.
By Robert Laszewski
Let’s pretend that either Senator Obama or Senator McCain will be able to implement their respective health care reform plans if elected. This exercise should be easy. We’ve been doing it for months now.
Or, we can get real and expect them to do the same.
For all the arguments both candidates are making that they are change agents, including over their competing health care reform proposals, this dirty little secret remains –– neither Senator’s health care plan has a chance of being implemented.
By 
Jen McCabe Gorman drew a picture at HealthCampDC last that I really liked. Luckily, I found this image of her Medicine 2.0 presentation, so nobody has to decipher my sketch.
The one difference is that, on Friday, Jen pointed out that the outer square ("content") is Health 1.0 and Health 2.0 begins with the "community" square. After reading her research paper, I now understand that the next inner square is Health 3.0, or content + community + commerce and the final, innermost square is Health 4.0, which would add coherence to the equation. Health 4.0 in this model is the "evolutionary stage connect[ing] the real world of brick-and-mortar systems with the virtual world of online services."
The paper is well worth a read, whether you agree with this model or not. I’m going to have to think about the following points, for example:
Another weakness of current Health 2.0 initiatives is the tendency of communities to attract similar people. Many focus on connecting "like-minds," relatively homogeneous groups such as patients with the same diagnosis or physicians in the same subspecialty. Similar groups then generate very similar content. Users become settled and ‘comfortable’ and thus less inclined to venture out and advocate for other consumer groups and sytemic change.
When it’s routed through the government because their spending is done with mythically different dollars than private spending. Or at least it is in the bizzaro world of free-marketeer policy analysts. Let me explain…
A couple of weeks back a small consulting firm working for McCain sent me an article written by University of Minnesota economist Roger Feldman about the cost of Obama’s health plan. They were complaining that I hadn’t featured their analysis. So I read the report which suggested that the Obama plan would cause $450 billion in health spending. Bear in mind, Obama suggests that it’ll cost $65 billion, so this is quite some stretch.
I was going to write a long, learned article about this, but instead I’ll just show you the email back & forth.
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