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The toughest job in America

Today, the loneliest job in American isn’t being the Maytag repair man. And the hardest job in America isn’t necessarily the Presidency. It’s being a state governor.

Take Pennsylvania (the state I call my home). Governor Ed Rendell sought the position with an explicit goal of expanding health insurance to uninsured Pennsylvanians. After two years in the job, Rendell is facing declining tax revenues, increasing costs. Rendell is already facing a $281 million deficit in this fiscal year, which could increase to over $1 billion. A detailed analysis of this story was published by PR Newswire, "Pennsylvania’s Loss of Employer Health Coverage Outstripping National Average."

The Kaiser Commission on Medicaid and the Uninsured has been studying other state initiatives targeting covering the uninsured. The Commission has found that in California, Illinois and New Mexico, for example, have been unable to broaden health insurance access to citizens without it.

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Do you have an Avatar?

THCB Note: This post first appeared at The Disruptive Women in Health Care Blog. There’s lots more great posts. Check it out!

If you don’t have an avatar, you may want to seriously think about creating one. I
am. I’ll admit it, at first I was skeptical, but the more I see the
benefits of virtual worlds, the greater the value and potential I can
see for health care.

An Avatar, as Wikipedia notes, is “a computer user’s representation
of himself/herself or alter ego.” (Hmmm, wonder what Joe the Plumber’s
avatar might look like)…

Avatars are used in virtual worlds like Second Life and Whyville.

Second Life

Second Life is the most well-known virtual world with more than 13
million registered users. It is primarily a social environment with a
strong creative component, since any user is allowed to create content
within the world. This highly-modifiable environment makes Second Life
uniquely suited to educational campaigns. For example, a space could be
created to simulate the everyday difficulties that people with mobility
challenges (i.e., people in wheelchairs), cataracts, or
diabetes-related eye illnesses face to help educate those without these
conditions.

Whyville

Whyville is an educational virtual world geared towards preteens and
children (ages 8 to 15) whose goal is to engage its 3 million users
across a broad array of subject areas, including healthy living, art,
history, and social issues. One could imagine an opportunity for
multi-generational education by creating “DiabetesTown” within Whyville
that would educate users about the importance of proper diet and
exercise, regular vision screening, and what life is like for friends
and relatives with diabetes.

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Innovations in second life

THCB Note: Alice Kreuger recently updated THCB about all the exciting things she’s doing in Second Life on Virtual Ability Island. Here is a quick rundown. If you’re unsure about second life, check out this video.

We just opened Virtual Ability Island, which is accessed through our Web site. Newcomers with disabilities can come directly to the island from the site, including opening a new SL account and creating their avatar, entirely bypassing the Linden Labs orientation facilities.

Our innovative orientation facility is disability-friendly, and the instruction there is divided into two parts, beginning and advanced. The beginner course covers six basic skills that can be learned and practiced in an hour. The instructional sequence for newcomers is linear, provides embedded practice, and is based on principles of andragogy, the theory of adult learning.

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Tracking media coverage of health care

Headlines and A1 charts stuck with the stock market, Washington’s changeling rescue
proposals and the plights of anxious finance firms in the week between the Palin-Biden debate and John McCain and Barack Obama’s town hall face off last Tuesday. The economy was a subtext to most of the other issues drawn into the election vortex.

Coverage of two issues – health care and taxes – nearly doubled. Health care stories increased across all media from 256 stories to 439. Tax stories rose from just over 400 for the week to nearly 800 between the weeks ending Sept. 29 and Oct. 6, according to stories polled for the LexisNexis Analytics dashboard.

This spike in incidence is not unrelated. Tax stories are hot as voters stare at a growing deficit and watch their 401k’s plunge, but tax talk has also become a predictable symptom of health care reform stories.

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Health wonk review

It’s up over at Managed Care Matters. In compiling this edition, Joe Paduda wrote, "This is perhaps the most serious, thought-provoking edition of
HWR I’ve had the honor of hosting. There’s a lot of meat here, so don’t
expect to multi-task your way through.

Getting smarter and greener with electronic medical resources

I’ve described the iPod Touch as the next great technology for medical education, but the Kindle is also a device with great potential.

We’ve recently implemented Kindle support for all our 20,000 educational resources at HMS.

Our integration on the Mycourses educational website enables any Word or PDF document to be delivered to the Kindle wirelessly. There is a cost which is clearly explained to the user (10 cents per document to Amazon). Those that don’t want to pay the 10 cents can download documents to their PC and transfer the documents via USB cable.Continue reading…

Health Care Reform: The Public Speaks (With Forked Tongue)

Who says Congress doesn’t accurately reflect the will of the American people? The public has spoken about health care reform, and the message is clear: “Whatever.”

If you’re a politician who believes that soaring promises soothe voters, while the painful tradeoffs involved in voting for an actual proposal can only bring trouble, the latest figures from the11th annual Health Confidence Survey of the respected Employee Benefit Research Institute (EBRI) have got to be good news.

The public is practically demanding inaction! Asked what they would do to fix health care, an overwhelming 87 percent favored health tax credits, similar to the health plan of Republican presidential nominee Sen. John McCain, CQ Health Beat reports. On the other hand, a nearly-equally-overwhelming 83 percent favored letting people buy into the same health care system government employees get, the option trumpeted by Democratic presidential nominee Sen. Barack Obama.

Indeed, one might say the public and the politicians are in sync about the urgent need to pay lip service to the notion of health care reform. So, while a whopping 71 percent of respondents endorsed  "major change" or “a complete overhaul “of the health care system, it finished a distant third to the economy and energy costs as a priority. Only about half as many people think health care is as important a crisis as the cost of gasoline (13 percent vs. 24 percent). And should the war in Iraq or some other issue heat up, one can expect health care to continue to finish well back in the pack.

Finally, there was the fine print: About half the respondents said they are “very” or “extremely” satisfied with quality of care. And while hardly anyone had a good opinion about health care costs, the key figure to look at is the personal saliency of their concern. The percentage of Americans reporting an actual increase in their personal health care costs dropped to 55 percent from 63 percent.

Microsoft Healthvault: Coke, Pepsi or Intel Inside

This post appeared originally on DiabetesMine.

When Microsoft launched its HealthVault application last year — the first major commercial Personal Health Record (PHR) system on the open web — the Wall Street Journal reported that
“Consumers are just not that excited about these services.”  A year
later, I’m wondering: have they given us reason to be more excited
now?  Last week, I grilled HealthVault’s rival Google Health
about the progress they are making.  Keithtoussaintmsft1

Are these big players trying too
hard to be all things to all people?  Or, with their rather generic
“personal health platforms,” do they end up offering nothing much of
value, especially to people living with chronic illness?

This week, DiabetesMine caught up with Keith Toussaint, Senior Program Manager with Microsoft HealthVault, for a perspective from inside the Microsoft dynasty.

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Around the Web in 60 Seconds (Or Less)

The consumer genetics company Navigenics has partnered
with Scripps, Microsoft and Affymetrix in a landmark clinical study to
assess the behavioral impact of personal genetic testing on people
who choose to receive such screenings to identify their potential risk
for developing certain diseases.

Nonprofit hospitals feel the inner-city for affluent suburbs. No margin no mission, but what happens when the mission disappears? No tax breaks?

The credit crunch is squeezing hospitals, and forcing them to delay building improvements, the NY Times reports.

The BBC reports that researchers have identified the 9,000-year-old remains of a mother and her baby discovered off
the coast of Israel as the earliest concrete evidence of human TB,.

The WSJ Health Blog reports that nearly 1 in 6 online health insurance shoppers are ‘uninsurable.’

7-day countdown to Health 2.0

The Health 2.0 conference is just a week away and with that comes the viewing of David Kibbe’s documentary, "The Great American Motorcycle Tour for Health 2.0." Go check out his blog to get a taste of what’s to come.

Kibbetour

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