Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt
I am beginning to wonder, is COVID over? Of course no one has told the virus that it’s over. In fact infection rates are two to three times where they were in the post-omicron lull and new variants are churning themselves out faster and faster. We still have 300 people dying every day. But since we went past a million US deaths, no one seems to care any more.
For the health care system, COVID being over means a chance to get back to normal, and normal ain’t good. Normal means trying to get rid of that pesky telemedicine and anything else that came around since March 2020.The incumbents want to remove the public health emergency that allowed telemedicine to be paid for by Medicare, re-enforce the Ryan Haight act which mandates in-person visits for prescribing controlled Rx like Adderall for ADHD, and make sure that tortuous state license requirements for online physicians are not going away. This also means restrictions on hospital at home, and basically delays any other innovative way to change care delivery. Well, it was all so perfect in February 2020!
Hospitals aren’t going willingly into the night. The big systems still control American health care, and are prepared to fight on all fronts to keep it that way. But like office workers, nurses and doctors want a different life. The concept of virtual-first, community-based, primary care-led health care has been around for a long while and been studiously ignored by the majority of the system.
If hospitals can’t get the staff and keep losing money employing the ones they have, there will be new solutions being offered to clinicians wanting a different life-style. We just might see a different approach to health care delivery rising phoenix-like from the Covid ashes.
If you, like me, continue to think that TikTok is mostly about dumb stunts (case in point: vandalizing school property in the devious licks challenge; case in point: risking lives and limbs in the milk crate challenge), or, more charitably, as an unexpected platform for social activism (case in point: spamming the Texas abortion reporting site), you probably also missed that TikTok thinks it could take on LinkedIn.
Welcome to #TikTokresumes. Welcome to the Gen Z workplace. If healthcare is having a hard time adapting to Gen Z patients – and it is — then dealing with Gen Z workers is even harder.
TikTok actually announced the program in early July, but, as a baby boomer, I did not get the memo. It was a pilot program, only active from July 7 to July 31, and only for a select number of employers, which included Chipotle and Target. The announcement stated:
TikTok believes there’s an opportunity to bring more value to people’s experience with TikTok by enhancing the utility of the platform as a channel for recruitment. Short, creative videos, combined with TikTok’s easy-to-use, built-in creation tools have organically created new ways to discover talented candidates and career opportunities.
Interested job-seekers were “encouraged to creatively and authentically showcase their skillsets and experiences.” Nick Tran, TikTok’s Global Head of Marketing, noted: “#CareerTok is already a thriving subculture on the platform and we can’t wait to see how the community embraces TikTok Resumes and helps to reimagine recruiting and job discovery.”
Marissa Andrada, chief diversity, inclusion and people officer at Chipotle, told SHRM: “Given the current hiring climate and our strong growth trajectory, it’s essential to find new platforms to directly engage in meaningful career conversations with Gen Z. TikTok has been ingrained into Chipotle’s DNA for some time, and now we’re evolving our presence to help bring in top talent to our restaurants.”
Experts claim we could have been better prepared when the COVID-19 pandemic struck in early 2020. With an annual budget of $400-700 million, the Strategic National Stockpile (SNS) is designed to respond to chemical, biological, and other disasters. Its $8 billion inventory included 13,000 ventilators and a limited supply of personal protective equipment, N95 masks, and medical supplies. This left state and local governments scrambling as the COVID-19 pandemic accelerated and the capacity of many hospitals was overwhelmed.
Faced with immediate and visible death and suffering, leaders took drastic steps to contain the virus, “flatten the curve,” and mitigate economic consequences. Trillions of dollars were allocated to recovery and stimulus packages.
This scenario mirrors our general approach to health care: chronic underfunding of public health followed by high costs and loss of life.
While not as shocking as a sudden pandemic, millions of Americans struggle daily with medical and socioeconomic challenges. Our health care system is designed to care for these patients when they have a problem, not to keep them well. This creates a dichotomy where a minority of the population spends most of the health care dollars and little is invested in the remaining majority
A report this month published in the British Medical Journal found that 80% of 293 physician leaders and board members of 10 of the most influential medical associations in the United States (including the American College of Physicians, American College of Cardiology, American Psychiatric Association, Infectious Disease Society of America, American College of Rheumatology, the American Society of Clinical Oncology, Endocrine Society, American Thoracic Society, and Orthopaedic Trauma Association) received financial payments of $130 million in total for “leadership” activities between 2017 and 2019.
In doing so, they were replicating the behavior established in 1939 by Vannevar Bush. Born March 11, 1890, in Everett, Massachusetts, the only son of a Universalist preacher and the grandson of a whaler, Bush earned a math degree from Tufts, followed by a PhD in engineering from MIT. From the beginning of his career he straddled the academic and the industrial in a way that anticipated the future of almost all scientific research.
In 1939, with the Second World War consuming both Europe and Asia, the father of the Medical-Industrial Complex met with the president of Harvard University and the president of Bell Labs, and mapped out a strategy for overcoming our lack of scientific preparedness. Out of that small meeting came a short, four-paragraph proposal for a centralized science operation—outside the control of the military—which he presented to President Roosevelt on June 12, 1940.
The president read the report, seized his pen, and scratched at the top, “OK-FDR.” With that stroke, the National Defense Research Committee (NDRC) was created, and with it, the fully codified and institutionalized era of academic-industrial partnerships in research.
When it comes to money back guarantees in health care, it’s
often less about the money and more about the guarantee.
That’s the biggest takeaway shared by two organizations—Geisinger
Health System and Group Health Cooperative of South Central Wisconsin (GHCSCW)—that
separately rolled out closely-watched campaigns to refund patients their
out-of-pocket costs for health care experiences that fell short of expectations.
Both programs started as a way to inject a basic level of
consumerism into a process long bereft of one. In fact, as consumer frustration
over medical costs rise, a money back guarantee has the potential to win back a
But like many experiments in health care, the effort
produced some unexpected results as well. Instead of a rush on refunds,
executives from both systems said their money-back pledge served even better as
a continuous-improvement tool, with patients providing almost instantaneous
feedback to staff who felt newly empowered to address problems.
Financial well-being, or the state
of an individual’s personal monetary affairs, is one of the six core indicators
of wellness in the Gallup-Healthways Well-Being Index. Poor financial
well-being can lead to a whole host of short and long term mental and physical
health issues, including depression, anxiety, troubled relationships and
It is surprising how American
hospitals and other health providers have neglected financial well-being when
considering their patients’ health. In a recent study by the American Cancer
Association, 56% of Americans suffer from hardships related to the cost of
Medical costs are the primary cause of 67% of all bankruptcies in the United
To think that health care costs are not having a deleterious effect on
American’s general well-being is a complete fallacy.
Even as a former health technology data scientist, I was largely in the dark about how health provider pricing works. Finding health provider pricing is like pulling teeth; it’s extremely time0consuming, frustrating (and sometimes painful) to get a health estimate for even the simplest procedures. Having poor or inadequate insurance can feel like a weight holding you down during your most vulnerable time, in the midst of a major health crisis.
Practices cannot survive the COVID-19 cash flow crisis
By JEFF LIVINGSTON, MD
Will doctors be able to keep their practices open during the worst pandemic in our lifetime? Our country needs every available doctor in the country to fight the challenges of Covid-19. Doctors working in independent practices face an immediate cash flow crisis threatening their ability to continue services.
The CARES Act was signed into law on Friday, March 27, 2020. The law offers much-needed help to the acute needs of hospitals and the medical supply chain. This aid will facilitate the production of critical supplies such as ventilators and PPE. The law failed to consider the needs of the doctors who will run the ventilators and wear the masks.
Cash flow crisis
Private-practice physician groups experienced an unprecedented reduction in in-office visits as they moved to provide a safe and secure environment for patients and staff. In compliance with CDC guidelines, practices suspended preventative care, nonurgent visits, nonemergent surgery, and office procedures.
These necessary practice changes help keep patients safe and slow the spread of Covid-19. The unintended consequence is an unreported and unrecognized cash flow crisis threatening the viability of physician practices.
The only way to
fully eliminate medical debt would be a comprehensive single payer plan, which
allowed no fees at the point of service.
However, such a
plan would require setting all prices for all doctors, hospitals, labs, and
drug companies. All providers would have to be satisfied – in advance — with
what the government is going to pay them on each procedure.
Germany accomplish this through collective bargaining. Japan, France, Taiwan,
Israel and Scandinavia also have national fee schedules. However, I do not
think you could get all the providers in Toledo to agree on one schedule, much
less every provider group in America.
would also require new income and payroll taxes of at least ten per cent more
than we pay now, if we want first-dollar coverage.
The first section of this article stated that many forms of medical debt can be reduced or cancelled by stronger enforcement of consumer protection laws. These debts are not inevitable and are not due to poverty. It would not require trillions of federal dollars to cancel them, either – just the willingness to go against lobbyists.
I advocate the following attacks on medical debt:
cancel balance bills and surprise bills if there was no prior disclosure.
In most cases,
providers will not have the right to collect anything more than what the insurers pay them.
We must cancel the older, inactive “zombie debts” that are being purchased by collection agencies.
This line of
business must terminate. Providers throughout the country are selling
uncollected medical debt for pennies on the dollar to collection agencies, who aggressively attempt to force
patients to pay the full amount due. These debt collectors harass patients at
work and at home, deploying unscrupulous tactics even after the statute of limitations
on the debt has expired.
proposal by Sen. Bernie Sanders to cancel $81 billion of medical debt is a very
good start—but it is only a start.
The RIP Medical
Debt group—which buys old medical debts, and then forgives them—is absolutely
in the right spirit. Its founders Craig Antico and Jerry Ashton deserve great
credit for keeping the issue of forgiveness alive.
over $88 billion in new medical debt is created each year; most of it still
held by providers, or sold to collectors, or embedded in credit card balances.
Tragically, none of this has to happen! In France, a visit to the doctor typically costs the equivalent of $1.12. A night in a German hospital costs a patient roughly $11. German co-pays for the year in total cannot exceed 2% of income. Even in Switzerland, the average deductible is $300.
U.S. patients face cost-sharing that would never be tolerated in Germany, says Dr. Markus Frick, a senior official. “If any German politician proposed high deductibles, he or she would be run out of town.”